Bright News for Pearly Whites

The most common chronic disease in young children is not what you think.  It’s not the viruses that cause constant runny noses or those dreary nights of when a child wakes mom up in the middle of the night and says, “I feel sick.”  Actually, the answer is dental caries, also known as cavities.

Cavities are caused by bacteria (most commonly Streptococci mutans) that break down sugars and create acid byproducts that can demineralize and weaken teeth.  Eating sweets without brushing your teeth is an obvious risk factor, but a premature birth and even having a mother with lots of cavities can further increase a child’s risk for getting caries.  These cavities can cause problems in the future, including pain causing poor self-esteem or school performance, stroke, obesity, heart disease, and even poor control with diabetes.


In December 2015, the AAFP introduced a framework applauded by dental, health care, and advocacy programs.  It encourages preventative interventions and structured referrals to dentistry.  This program is being tested in 19 clinics to determine if the idea would work nationally.  Usually physicians prescribe fluoride if needed and encourage using fluoride toothpaste.  With this new policy, family physicians will start to note risk factors (for example, diabetics, low-income families) to emphasize diet and oral hygiene habits and even apply fluoride varnish (the foamy stuff the dentist puts in your mouth and tells you not to swallow) in the same visit, an action that can decrease caries by 40 to 50% in children.

Before, physicians may note a child with cavities and simply believe that the dentist knows about the child’s oral health.  In the short future, physicians can take an active role in directing these patients to dentists as well as educating the families in the clinic.  Perhaps this overlap and continuity of care can be applied to not only teeth and gums, but also other organ systems.  For now, let’s just celebrate the sweet news!



Crawford, Chris. “AAFP Supports Integration of Oral Health Into Primary Care.” AAFP Supports Integration of Oral Health Into Primary Care. AAFP, 24 Dec. 2015. Web. 06 Mar. 2016.

Tinanoff N, Douglass JM. Clinical decision-making for caries management in primary teeth. J Dent Educ. 2001;65:1133–42.

Editor: Shireesha Sankella (thank you!)


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