March 2018 Volume LIII Number 2

 
 
 
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Pediatric Oral Health Research and Policy Center Updates

March 2018 Volume LIII Number 2

AAPD Speaks to Childhood Obesity and Sugared Drinks

"Calories, Cavities, and Kids: The Role of Dental Professionals in Addressing Childhood Obesity" was a topic of interest for the National Network of Oral Health Access (NNOHA) during a one-hour webinar on Feb. 5, 2018. Presented by Policy Center Director Robin Wright, Ph.D., the continuing education session discussed how oral health professionals can join collaborative efforts with their colleagues to combat childhood obesity. To listen to the webinar and view the slides, visit http://www.nnoha.org/.

TAKE-HOME POINTS

Nearly 32 percent of children ages 2–18 are either overweight or obese, and eight percent of infants and toddlers have high weight for recumbent length.
Sugared drinks are the single largest category of caloric intake in children.
In a recent AAPD survey, 17 percent of pediatric dentists stated they offer childhood obesity
information or other healthy weight interventions in their practices. Nearly 94 percent of pediatric dentists offer informational counseling on the consumption of sugar-sweetened beverages (SSBs).
Only 14 percent of pediatric dentists agree that parents are receptive to obesity counseling in the dental office, while 81 percent think parents are receptive to advice about sugared drinks.
Pediatric dentists see a child’s weight as a medical rather than a dental issue, while sugared drink consumption is perceived as integral to the practice of pediatric dentistry and the care of children.
The chief barriers to offering obesity-related counseling are concerns about parent reactions to weight management interventions in the dental office, such as offending the parent, appearing judgmental and creating parent dissatisfaction.
Nearly 88 percent of pediatric dentists agreed they would be more interested in advising par- ents about weight management if there were a clearer clinical link between obesity and dental disease.
You and your team have an excellent opportunity to address such dietary habits as sugared drinks and thus support early obesity prevention and promote healthy weight in children.

Caries-Risk Factors Accessible During Well-Child Visits Validated in a Secondary Testing Site

The AAPD Policy Center has completed its third year of research exploring oral health promo- tion in primary care and identifying common risk factors for a more effective caries-risk assessment tool for primary care providers. As an essential piece of this research project, patient data from Marshfield Clinic, a secondary testing site, were analyzed to further validate significant variables previously identified by Nationwide Children’s Hospital (NCH) in Columbus, Ohio. Marshfield, a large multi-site community health and dental system in Wisconsin, has a semi-rural patient popula- tion, making the system an ideal complement to NCH’s mostly urban-based pediatric clients.

Marshfield data identified a history of broken appointments and Hispanic ethnicity as predic- tors of lifetime caries experience. This is parallel to previous results from NCH data analyses during Year 2 of the study. Additionally, the variable of "speaks a language other than English" was identi- fied, a significant variable determined during the development of the caries-risk predictive model. Table 1 below compares the significant variables of the two testing site populations.

Open PDF attached to view table 1.

This analysis lends support to the overall research project demonstrating risk factors in a child’s medical record may be used to predict the presence of dental disease and/or the assessment of "high" caries risk at the time of the child’s first dental visit. A full Year 3 report will be available in 2018 through the AAPD Policy Center website at http://www.aapd.org/policy_center/.

Evidence-based Dentistry Committee Update

Two new EBD guidelines have been accepted by the National Guideline Clearinghouse:

  • Clinical Practice Guidelines for use of Vital Pulp Therapies in Primary Teeth with Deep Caries, and
  • Clinical Practice Guideline on the Use of Silver Diamine Fluoride for Dental Caries Management in Chil- dren, Adolescents and Individuals with Special Healthcare Needs.

The AAPD’s evidence-based guide- lines are being produced in accordance with standards created by National Academy of Medicine (formerly known as the National Institute of Medicine) and mandated by the National Guideline Clearinghouse (NGC), an initiative of the Agency for Healthcare Research and Quality, and therefore will be eligible to be included in the NGC. Inclusion in the NGC guarantees our guidelines will be seen by private and public payers. The guidelines are available as open access publications on the AAPD’s website.

Patient education materials, based on the new guidelines, have been developed for indirect pulp therapy, pulpotomy and silver diamine fluoride and are available for purchase in the AAPD’s online store.

The non-vital pulp systematic review workgroup met in December to begin work; in vivo and in vitro protocols will be registered within the year.

A new guideline workgroup on be- havior guidance for the pediatric dental patient began work in January. The new behavior guideline, based on an existing systematic review, will be published next fall.

For more information, please contact Director, Research and Policy Center Robin Wright at rwright@aapd.org.

Click here for a PDF version of this article.