ABSTRACT: Because almost one tenth of American children aged 2 to 11 years have untreated tooth decay, a physical examination that includes inspection of the mouth is crucial. Look for cavitated or noncavitated lesions, dental fillings, and missing teeth; gingivitis and/or plaque, chalky white spots, or deep fissures on the teeth suggest dental decay. Dental care strategies that can be discussed at well-child visits include the benefits of daily flossing and brushing with fluoridated toothpaste, limited intake of dietary sugar, the establishment of a dental home, and use of protective mouthguards and face protectors during sport activities. Fluoride supplementation can be prescribed for children exposed to inadequate amounts in the water supply. The Caries-Risk Assessment Tool can help identify children at high risk for tooth decay. The pediatrician can have a great impact on ensuring that children obtain necessary dental care; a literature review found that children referred to a dentist by a primary care provider were more likely to visit a dentist than those not referred.
