Preventive Pediatric Dentistry

#### **Chapter 1**

## Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept

*Krishna Patil, Rucha Davalbhakta, Buneet Kaur, Sujatha P, Smita Patil, Siddharth Shinde and Chetana Jagtap*

#### **Abstract**

Tooth decay, if left untreated even in the earliest stages of life, can have serious implications for a child's long-term health and well-being. Early preventive care is a sound health and economic investment. Dental assessments and evaluations for children during their first year of life have been recommended by the American Academy of Pediatric Dentistry (AAPD) and the American Association of Pediatrics (ADA). Establishment of dental home and use of anticipatory guidance is one of the concepts in comprehensive oral health care. AAPD and ADA support the concept of a "dental home," which is the ongoing relationship between the dentist and the patient. Establishing a dental home means that a child's oral health care is managed in a comprehensive, continuously accessible, coordinated, and family-centered way by a licensed dentist. The dental professional's ability to provide optimal oral health care, beginning from when the child is 1-year-old, dental visit leading to preventive care and treatment as part of an overall oral health care foundation for life, is enhanced by dental home. The establishment of the dental home also assures appropriate referral to dental specialists when availability of direct care is not possible within the dental home.

**Keywords:** dental home, caries, neglected, primary health care, comprehensive

#### **1. Introduction**

The dental home for kids is the brand new idea for most of the dental career; however the concept of figuring out of child with the practitioner is acquainted for the scientific career. It provides evaluation to preventive and emergency services to kids.

Although oral health of kids residing in evolved international locations has been advanced drastically over beyond a long time still there are numerous youngsters in growing nations who preserve to suffer from oral sicknesses including caries, gingival infection and malocclusion. Early identification and management of the contributing factor play a crucial function now not handiest in prevention of oral ailment but additionally contributes for development of top of the line health within the children.

A only a few infants more youthful than 12 months have oral issues and require intervention, but almost all have an oral environment with the hazard of disease.

Early life caries have greater effects than caries taking place in person life as because of caries there is reduction in best frame weight of the child. It also represents sizeable economic and social burden and the timelines of preventive and early intervention is crucial for effective control (**Figures 1** and **2**).

Benefits of dental domestic have extended emphasis on prevention and ailment control, higher fitness effects at lower fee. Certain environmental factors may also impact the implementation of dental domestic [1].

"The dental domestic is the continuing dating among the dentist and the patient, which include all factors of oral health care brought in a complete, continuously handy, coordinated, and circle of relatives-centered way. Establishment of a dental home starts off evolved no later than twelve months of age and includes referral to dental professionals whilst appropriate" [2].

The dental home will offer a key message to the parents in addition to the care givers and it will likely be a notable for them to understand it and enforce it at the home level in preference to going to the dentist.

**Figure 1.** *Dental home.*

**Figure 2.** *Zero cavities.*

#### **2. Principles that guide the concept of dental home**

#### **2.1 The age one visit**

The kid's first visit to the dentist should be when the first tooth erupts in the oral cavity preferably when first enamel erupts. When the child visits at the recommended age, a dental home can be set up and Anticipatory Guidance be established as a part of the kid's total health care [3].

In 1997 Nowak said that the first dental visit gives us information about the threat of dental sicknesses, it also offers anticipatory steering and decides the periodicity of future visits [4].

Predictive control, used in pediatric medicine, is a method of presenting realistic and developmentally relevant health data about a child to mothers and fathers in anticipation of important physical, emotional, and psychological milestones. Proactive guidance publications provide mothers and fathers with warnings about their next options, their role in maximizing their developmental potential, and their unique needs. The fact that it makes it recognizable. In the field of pediatrics, these active counseling criteria were introduced through wellchild care visits. The information provided through predictive guidance is well understood by parents, as the process of interviewing by a pediatrician gives parents the opportunity to talk about their children and clarify their questions [5].

#### **2.2 Anticipatory guidance in dentistry**

This is a new paradigm for improving boom and development, caries prevention, and normal oral health. Preventive management in dentistry provides oral hygiene education, expert assessment, preventive measures, and nutritional advice from approximately 6 months to 2 years of age. This is step-by-step software that dentists are taught to those who actually seek care and are customized for each individual child. This is a time-consuming process consisting of oral testing, prevention, analysis of dietary plans, home care instructions, fluoride supplementation [both topical and systemic], and general feeding instructions [6].

Benefits of active consultation in dentistry:


### **3. Need for dental home**


### **4. Mission of dental home**


### **5. Objectives**


### **6. Challenges in establishing a dental home**


*Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept DOI: http://dx.doi.org/10.5772/intechopen.105947*


#### **7. Services provided**

A dental home must offer following offerings:


#### **8. Importance of dental home**

It is gratifying to realize that we have the assist of the dental and health care community in our ongoing efforts to make sure first-rate oral health care of all our children. By organizing a dental home and taking preventive steps advocated by way of the pediatric dentist, mother and father can avoid their youngsters contracting early childhood caries—that is great devastating enamel decay that results in pain, failure to thrive, and in many instances, good sized and steeply-priced restorative work [13].

#### **9. Some key findings**

According to an article in Pediatrics, the authoritative magazine of the American Academy of Pediatrics, visiting children for oral health screenings and preventive services earlier saves money. The study looked at a cohort of 9200 Medicaid children in North Carolina between 1992 and 1997, and was spearheaded by Dr. Jessica Y. Lee of UNC-Chapel Hill. The average cost of a dental appointment for a child under the age of one is \$262. This increased to \$546, and the child's first visit was no longer till he or she was 4 years old. (These prices are based on the baby's spending over the course of the study, not on annual expenses) [14].

Medicaid-enrolled kids who had an early preventive dental visit had been much more likely to use next preventive offerings and revel in lower dental costs [15].

#### **10. Characteristics of dental home**

The following traits and there benefits so that it will be helpful for the uplifting of the dental domestic [16].

#### **10.1 Accessible**

Due to smooth of get right of entry to the care provided is in baby's network and it will likely be useful in coverage normal and adjustments in coverage accommodated.

The benefits can be that the source of care is near home and reachable to family. Minimal trouble encountered with price. Office is ready for treatment in emergency state of affairs. Office is nonbiased in coping with youngsters with unique health care needs. Dentist is aware of network desires and management.

#### **10.2 Family focused**

Recognition of centeredness of the circle of relatives is vital which enables to collect Unbiased complete records are shared on an ongoing bias.

This will help in low discern/child anxiety enhance care. Care protocols are secure to circle of relatives and suitable function of dad and mom in domestic care established.

#### **10.3 Continuous**

Same number one care is being supplied from infancy to formative years. Assistance furnished with transitions.

*Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept DOI: http://dx.doi.org/10.5772/intechopen.105947*

This will help in suitable bear in mind durations based on toddler's want. Continuity of care is higher attributable to remember system versus episodic

care.

Co-ordination of complicated dental remedy is possible.

#### **10.4 Comprehensive**

Health care will available 24 h consistent with day. Preventive, number one, tertiary care supplied. Emergency get entry to be ensured.

The Care supervisor and primary care dentist are in identical vicinity.

#### **10.5 Co-ordinate**

Families related to support, education and network services. Information and file is centralized.

School, workshop, remedy linkages are properly installed and known to all the members.

#### **10.6 Compassionate**

Expressed and confirmed difficulty for baby and family. Dentist-toddler dating is set up. Family relationship is mounted. Children much less stressful thanks to familiarity.

#### **10.7 Culturally competent**

Cultural heritage diagnosed, valued, reputable. Mechanism is mounted for communiqué for ongoing care. Specialized sources are recognized and demonstrated if wished. Staff can also talk other languages and realize dental terminology.

#### **11. Steps taken when a patient approaches dental clinic**


#### **12. Advantages of dental home**


#### **13. Dental home in Indian scenario**

In India, about 50% of children under the age of 5 and 80% of middle-aged people suffer from tooth decay. The incidence of dental diseases is high in India.

The fact that dentistry focuses on treatment rather than prevention. Expanding the scope of dental treatment (dentists, further training institutions) and technological advances have had little effect on actual prevention. Dental diseases are very preventable. However, it is widely believed that prevention is the responsibility of the government and its affiliates and is no longer a clinician practice. Definitive preventive techniques involving the addition of water fluoridation and the ban/replacement of sugar substances are no longer used in India due to the complexity associated with such issues. Therefore, the average person is often unaware of dental treatment and conveys ignorance (and sometimes frustration) about their oral problems that require complex treatment. The AAPD concept of dental homes can be called Indian dental homes. This is none other than a preventive dental clinic established to detect and prevent dental disorders that stand up in the circle of individuals or patients, and for loved ones. Preventive strategies in a special way [19].

We have a duty to provide people with sufficient and timely information on the prevention of dental diseases.

For example, a Preventive Dentistry Clinic must achieve the following goals:


*Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept DOI: http://dx.doi.org/10.5772/intechopen.105947*

c.The concept of health promotion.

d.Bridging the gap between the dentist and the general public in terms of communication.

The identification and removal of risk factors connected with a disease is considered primordial prevention.

#### **14. Creation of awareness about prevention of oral diseases using concept of dental home**

In order to render such preventive care, it's far important to satisfy parents/ prospective parents early. Gynecologists, pediatricians, own family physicians are the folks who are available touch with them lots earlier than we do. We need to set up conversation with them such that powerful and timely referrals are made to preventive dentistry clinics.

Also, colleges and pre-school day care centers may be informed about the dental domestic idea or a preventive dentistry medical institution. A be aware consisting of—Do you know you may benefit your child's tooth and oral health with the aid of starting preventive dental care before baby-birth?—can attract the eye of prospective mother and father if installed a gynecologist's workplace.

We need to make preventative dentistry more accessible to the general public in a simple and effective way; for example,


#### **15. Key messages for the parent**


#### **16. Conclusion**

Dental domestic is an important idea for dentists to understand. The advantages of obtaining early career dental care and intervention are supported by evidence, which is supplemented by anticipatory advice for parents and frequent supervision visits based entirely on the child's risk of dental disorder. The dentist office should expand the availability of preventative oral health care for children in order to eliminate

*Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept DOI: http://dx.doi.org/10.5772/intechopen.105947*

health disparities. The dental domestic concept, which warrants more examination and collaboration with the clinical domestic, would provide comprehensive health care to all children.

### **Author details**

Krishna Patil1 \*, Rucha Davalbhakta1 , Buneet Kaur3 , Sujatha P2 , Smita Patil1 , Siddharth Shinde4 and Chetana Jagtap1

1 Department of Pedodontics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Pune, Maharashtra, India

2 Department of Pedodontics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Sangli, Maharashtra, India

3 Pedodontics, New Delhi, India

4 Department of Orthodontics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Pune, Maharashtra, India

\*Address all correspondence to: krishnapatil1000@gmail.com

© 2023 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

### **References**

[1] Nowak AJ, Casamassimo PS. The dental home A primary care oral health concept. Journal of the American Dental Association. 2002;**133**. DOI: 10.14219/ jada.archive.2002.0027

[2] American Academy of Pediatric Dentistry. Available from: https://www. aapd.org/research/oral-health-policies\ recommendations/Dental-Home/. [Accessed: October 19, 2021]

[3] Oral Health Risk Assessment Timing and Establishment of the Dental Home. American academy of pediatrics policy statement, organizational principles to guide and define the child health care system and/or improve the health of all children. Pediatrics. 2003;**111**(5). DOI: 10.1542/peds.111.5.1113

[4] Crall J, Silverman J. AAPD-OHS dental home initiative, overview partnering to provide dental homes and optimal oral health for HS/EHS children throughout the U.S. MSDA Symposium. 2009

[5] Nowak AJ. Pediatric Dentistry: Infancy Through Adolescence. 3rd ed. Philadelphia: Saunders; 1999. pp. 187- 188. DOI: 10.1548/845214545.ch7

[6] Giriraju A. Nagesh Lakshminarayan dental home: A concept for early and everlasting smile: Review article. Scholars Journal of Dental Sciences. 2017;**4**(3):121-124. DOI: 10.21276/ sjds.2017.4.3.8

[7] American Academy of Pediatric Dentistry. Policy on the Dental Home. The Reference Manual of Pediatric Dentistry. Chicago, Ill: American Academy of Pediatric Dentistry; 2020. pp. 43-44. Available from: https://www.aapd.org/media/

Policies\_Guidelines/P\_DentalHome.pdf. [Accessed: October 19, 2021]

[8] McDonald and Avery's Dentistry for the Child and Adolescent. 7th ed. Chapter 11/247. DOI: 10.1588/514878955. ch7

[9] Hunke PH. The dental home and age one visit: The centerpiece of children's oral health care improvement. In: Presented to the Oral Health and School Readiness National Symposium. Vol. 18. 2016. Available from: https://issuu.com/ peterjordan8/docs/dentalhome

[10] The Dental Home It's Never Too Early to Start American Dental Association. 2007. Available from: https://www.aapd.org/assets/1/7/ DentalHomeNeverTooEarly.pdf. [Accessed: October 19, 2021]

[11] Building better oral health: A dental home for all Texans. A report commissioned by the Texas Dental Association. Tex Dental Journal Winter. 2008;(Suppl):1-56

[12] Thompson CL, McCann AL, Schneiderman ED. Does the texas first dental home program improve parental oral care knowledge and practices? Pediatric Dentistry. 2017;**39**(2):124-129. DOI: 39.22516/Peddent.2017.2.3

[13] Kolstad C, Zavras A, Yoon R. Costbenefit analysis of the age one dental visit for the privately insured. Pediatric Dentistry. 2015;**37**(4):376-380. DOI: 376.2258/Peddent.2015.4.37

[14] Savage MF, Lee JY, Kotch JB, Vann WF. Early preventive dental visits: Effect on subsequent utilization and costs. Pediatrics. 2004;**114**:418-442. DOI: 10.1542/peds.2003-0469-F

*Perspective Chapter: Dental Home – A Neglected Primary Oral Health Care Concept DOI: http://dx.doi.org/10.5772/intechopen.105947*

[15] Grembowski D, Milgrom PM. Increasing access to dental care for Medicaid preschool children: The access to baby and child dentistry (ABCD) program. Public Health Reports. 2000;**115**:448-459. DOI: 10.1452/ s0115-1452(4)445-9

[16] Tandon S. Text book of Pedodontics. 2nd ed. New Delhi: Paras Medical Publications; 2009. p. 227. DOI: 11.1252/ 5245896523.ch21. Chapter no 21

[17] American Academy of Pediatrics. Preamble to Patient Centred Medical Home Joint Principles. 2007. Available from: https://www.acponline.org/ acp\_policy/policies/joint\_principles\_ pcmh\_2007.pdf. [Accessed: October 20, 2021]

[18] Edelstein BL. Environmental factors in implementing the dental home for all young children. In: National Oral Health Policy Centre at Children's Dental Health Project. pp. 1-18

[19] Girish Babu KL, Doddamani GM. Dental home: Patient centered dentistry. Journal of International Society of Preventive and Community Dentistry. 2012;**2**(1):8-12. DOI: 10.4103/ 2231-0762.103448

[20] Ramos-Gomez FJ, Crystal YO, Ng MW, Crall JJ, Featherstone JDB. Pediatric dental care: Prevention and management protocols based on caries risk assessment. Journal of the California Dental Association. 2010;**38**(10):761. DOI: 11.1526/523322(10)746-61

[21] Nikhil M. Textbook of Pediatric Dentistry. 3rd ed. pp. 17-21. DOI: 11.1255/ 5245846523.ch3. Chapter 3
