USPSTF updates how to prevent caries in kids

Fluoride supplements and varnish are in, but the jury is still out on whether oral screenings for dental caries performed by primary care physicians (PCPs) provide any benefit, according to the US Preventive Services Task Force’s (USPSTF) updated recommendations for preventing dental caries in children aged 0 to 5 years.

In revisiting its 2004 recommendations, the Task Force says that the evidence is clear that PCPs should begin prescribing fluoride supplements at age 6 months for children whose local water supply is deficient in fluoride (ie, below 0.6 ppm).

The recommendations also say that the moderate benefits of fluoride varnish (“fluoride treatments”) outweigh the potential harm of fluorosis. As such, PCPs should begin applying varnish as soon as primary teeth begin erupting.

Because these protocols both received a “B” recommendation, both are required by the Affordable Care Act to be covered by insurers without out-of-pocket costs to the patient.

However, the evidence is unclear, says the recommendation statement, about whether PCPs performing routine oral screening examination for dental caries in preschool children is beneficial. The Task Force found no studies addressing the issue.

According to the recommendations, almost half (42%) of US children aged 2 to 11 years have dental caries in their primary teeth. Dental caries is the most common chronic disease among US children, 4 times more common than asthma and 7 times more common than hay fever. Untreated caries can result in pain, tooth loss, impaired growth, and decreased weight gain, and can affect appearance, self-esteem, speech, and school performance. 

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