Oral Health for Children

Every child has a right to good oral health. Oral health problems in children can impact on many aspects of their general health and development, causing substantial pain and disruption to their lives and often altering their behaviour. Oral health is an integral part of overall well-being and essential for eating, growth, speech, social development, learning capacity and quality of life.

To promote oral health every child should have access to:

Oral health education including oral hygiene instructions and dietary advice, and access to affordable toothbrushes and toothpaste containing fluoride as soon as the first primary tooth erupts
Preventive interventions, appropriate to the infrastructure and priorities of the country, which may include dental sealants, community fluoridation, and regular fluoride varnish applications
Treatment of early stage decay to stop it from progressing to cavities, and treatment of dental cavities, acute pain and other oral diseases
Environments that eliminate advertising of unhealthy foods to children.

Through good oral health all children will have an equal opportunity to thrive and reach their full
potential for a promising future.

Introduction

Dental caries is the most common chronic condition in childhood. Worldwide it affects 60-90% of schoolchildren in industrialized countries. Reducing risk of dental caries can be achieved through the use of topical fluorides from several sources. It is clear that fluoride toothpaste is the most efficacious and readily available intervention across the world, although higher risk populations can also benefit from the application of fluoride varnish or other preventative measures.

Oral hygiene and fluoridated toothpaste

Regular tooth brushing with fluoridated toothpaste reduces both caries risk and gingival inflammation by mechanically removing food debris and cariogenic bacteria. In addition, the fluoride effect promotes the restoration of mineral to tooth sites that have been softened by decay.

Dental sealant

Studies found that resin-based sealants can induce a reduction in dental caries experience of around 90 percent after 12 months and 60 percent at 48–54 months. Any primary or permanent tooth judged at risk would benefit from sealant application.

High-risk pits and fissures should be sealed as soon as possible. Sealants also slow caries
progression if the lesion is not cavitated.

Fluoride varnish

Many clinical trials have confirmed the anti-caries effect of professional topical fluoride treatments, including 5% neutral sodium fluoride varnish. Fluoride varnishes can prevent or reverse enamel demineralization. In children with moderate to high caries risk, fluoride varnishes and fluoride-releasing restorative and bonding materials have been shown to be highly effective in stopping and hardening existing decay and reducing the risk of new decay and are best utilized as part of a comprehensive preventive program in the dental home.

When a dental home cannot be established for individuals with increased caries risk as determined by caries risk assessment, periodic applications of fluoride varnish by trained nondental healthcare professionals may be effective in reducing the incidence of early childhood caries.

Addendum

Addendum to the resolution on Community Fluoridation

Community fluoridation is the most cost-effective prevention measure for tooth decay in those countries where is it practical and feasible. In countries with a safe drinking public water supply, community water fluoridation is the prevention measure of choice and in countries that do not have a public water supply, salt fluoridation is recommended. Fluoridation prevents tooth decay for people of all ages, and is the foundation for better oral health. Before community water fluoridation began, children consuming naturally occurring, optimally fluoridated water had 50% to 60% less tooth decay compared to children in fluoride-deficient communities (1). Salt fluoridation has benefits similar to water fluoridation, and can prevent dental caries by 33% to 66% (2). In the United States where other fluoride sources are now very common, water fluoridation has been shown to prevent tooth decay by about 25% over a person’s lifetime (3).

References

References: Resolution

Ahovuo-Saloranta, A., A. Hiiri, et al. (2008). “Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.” Cochrane database of systematic reviews(4): CD001830.
Gift, H. C., S. T. Reisine, et al. (1992). “The social impact of dental problems and visits.” American journal of public health 82(12): 1663-1668.
Griffin, S. O., E. Oong, et al. (2008). “The effectiveness of sealants in managing caries lesions.” Journal of dental research 87(2): 169-174.
Marinho, V. C. (2008). “Evidence-based effectiveness of topical fluorides.” Advances in dental research 20(1): 3-7.
Marinho, V. C. (2009). “Cochrane reviews of randomized trials of fluoride therapies for preventing dental caries.” European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry 10(3): 183-191.
Marinho, V. C., J. P. Higgins, et al. (2003). “Fluoride toothpastes for preventing dental caries in children and adolescents.” Cochrane database of systematic reviews(1): CD002278.
Robinson, P. G., S. A. Deacon, et al. (2005). “Manual versus powered toothbrushing for oral health.” Cochrane database of systematic reviews(2): CD002281.
Sheiham, A. (2005). “Oral health, general health and quality of life.” Bulletin of the World Health Organization 83(9): 644.
World Health Organization (2012). World Health Assembly.
Wong, M. C., J. Clarkson, et al. (2011). “Cochrane reviews on the benefits/risks of fluoride toothpastes.” Journal of dental research 90(5): 573-579.

References: Addendum

Centers for Disease Control and Prevention (2001). “Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States.” Morbidity and Mortality Weekly Report, 50(RR14); 1-42. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm
Pan American Health Organization, (2005). “Promoting oral health: The use of salt fluoridation to prevent dental caries.” Washington, D.C.
Centers for Disease Control and Prevention (2012). “Fluoridation basics.” Available at http://www.cdc.gov/fluoridation/benefits/background.htm.