Recommendation calls for primary care physicians to apply flouride varnish on young patients’ teeth
The U.S. Preventive Services Task Force (USPSTF) has issued new guidelines (updating a 2004 version) calling for primary care physicians to paint fluoride varnish on the teeth of patients 5 years old and younger. The varnish should be applied as soon as the first tooth appears. An earlier recommendation that primary care physicians prescribe oral fluoride supplements for children who do not get sufficient fluoride in local drinking water was repeated.
But the group stopped short of supporting pediatric dental exams by primary care physicians, saying there is insufficient evidence to recommend such exams. This conflicts with American Academy of Pediatrics guidelines, which call for primary care physicians to examine the teeth of their youngest patients. The American Dental Association recommends that children start seeing a dentist by age 1 or when their first teeth appear.
Studies show cavities are found in more than 40 percent of children between the ages of 2 and 11, and recent research has found benefits for programs where primary care physicians look for signs of dental disease in their youngest patients, referring those who are at risk for caries to dentists.
Many pediatricians, however, do not know children should see a dentist by age 1. And few dentists know how to treat patients that young. A recent study from the University of Toronto and the Hospital for Sick Children in Toronto concluded that the problem is particularly troublesome in low-income families. Children in the study from that demographic were 2.73 times more likely to have never visited a dentist.