P0793 - Improving Oral Health in Infants in the Outpatient Setting

Background:
Early dental caries is the most common chronic childhood disease, yet this problem is often unaddressed. Most children will not be seen by a dentist until they are three years old, but statistics show that more than 30 percent of children already have caries by that time. The overall purpose of this study is to understand how to better promote oral health for six and nine-month-old infants in the outpatient setting.

Methodology:
Two separate procedures were used to determine if the addition of oral health questions to the well child visit templates within the electronic medical record impacts resident behaviors related to the promotion of infant oral health. The first aspect of the project consists of resident surveys. The residents were electronically sent a pre- and post-survey regarding their practice of asking specific oral health questions at the six and nine month well child visits. After completion of the baseline survey, the questions were added into the well child visit templates within the electronic medical record. The questions included how often the parents brush the child’s teeth, if they use fluorinated toothpaste, if the child has a dental home, and if the child is put to bed with a bottle. The second aspect of the project is a retrospective and prospective chart review. The medical records of the infant well child visits were reviewed before and after the implementation of the templates, to assess whether the resident addressed oral health. Survey responses by residents about their own behaviors, as well as the documentation in the electronic medical record, were statistically compared for a significant change after the implementation of the templates.

Discussion:
It is our hypothesis that the frequency of residents addressing oral health during the infant well visits will significantly increase after the addition of oral health questions to the templates. Pediatricians should be stewards in providing education about the importance of good oral health practices, including the proper way of taking care of our oral health, as well as the consequences if neglected. Health care providers can also assess the status of a patient’s oral health and can make referrals. According to the American Academy of Pediatric Dentistry, children should be seen by a dentist by the age of 12 months. If poor oral health is not addressed early, it can be associated with difficulties in eating, soft tissue and bone infections, and impaired school performance.

Conclusion:
Early dental caries is the most common chronic disease impacting children, with many negative sequela if left unaddressed. When procedures are put into place to better assess infant oral health, including the addition of templates into the electronic medical record, pediatricians are better equipped to promote infant oral health.