Dental caries are highly prevalent in children in Massachusetts. Caries are a preventable, multi-factorial process involving the complex interplay between teeth, bacteria, and dietary sugars, resulting in destruction of the tooth structure. The Massachusetts
Medical Society and Massachusetts Dental Society would like to strongly advocate for renewed focus by medical and dental providers on caries prevention through following best practices:
- All children should have their teeth brushed by a caregiver starting at age 6 months with a smear of fluoridated toothpaste twice daily, increasing to a pea size amount at age 3.
- Children should have access to fluoridated water in their community starting at age 6 months If not, fluoride supplements should be prescribed for children ages 6 months to 16 years whose primary drinking water has low or no fluoride.
- All children should be offered fluoride varnish twice a year in the medical and/or dental office starting at age 6 months (more often for higher risk children) to age 6 years; higher risk children should continue up to age 21. Fluoride varnish is
a reimbursed service for both medical and dental providers.
- All children should be referred to a dentist by age 1. Dentists not comfortable seeing children by age 1 should refer children to dentists who do see young children.
- All children and their families should have routine oral health engagement starting at 6 months in the medical setting through an oral health risk assessment, oral exam, and anticipatory guidance. They should be counselled on a range of preventive
measures including routine brushing, flossing once teeth are touching, restricting sugary drinks and foods because of their cariogenic effects, and avoiding bottles in cribs/bed with anything other than water.
All recommendations are based on the best evidence and reports from the American Academy of Pediatrics, American Academy of Pediatric Dentistry, and the American Dental Association. For further education, please consider completing the Smiles for Life
National Oral Health curriculum.
-Theodore A. Calianos, II, MD, FACS, President, Massachusetts Medical Society
-Dr. Meredith Bailey, President, Massachusetts Dental Society
