Changes to the recommended screenings or risk assessments for hepatitis B virus infection, sudden cardiac arrest/death, suicide risk and behavioral/social/emotional concerns are part of the 2022 Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule).
Updates also were added on use of fluoride varnish and fluoride supplementation.
The Periodicity Schedule at https://bit.ly/2YZe41u addresses well-child visits from birth to age 21.
Here are the changes:
- Hepatitis B virus infection: Assess risk between birth and age 21 years (range in which the risk assessment can take place). The change aligns with the U.S. Preventive Services Task Force (USPSTF) and the 2021-2024 AAP Red Book, https://bit.ly/3wOFFmF..
- Sudden cardiac arrest and sudden cardiac death: Assess risk at 11 to 21 years (range in which the risk assessment can take place). Footnote 33 was added to align with the AAP policy statement Sudden Death in the Young: Information for the Primary Care Provider, https://doi.org/10.1542/peds.2021-052044.
- Depression and suicide risk screening: Suicide risk has been added to the depression screening recommendation (annually from ages 12 to 21 years) for consistency with Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management, https://doi.org/10.1542/peds.2017-4081, and AAP policy. Footnote 16 was updated with links to resources.
- Behavioral/social/emotional screening: This more comprehensive screening has been updated from the “psychosocial/behavioral assessment” recommendation (annually from newborn to 21 years) to align with AAP policy and other recommendations and guidelines. Footnote 14 was updated with links to resources. The screening should be family-centered and may include queries about social determinants of health, racism, poverty and relational health.
- Fluoride varnish: Footnote 37 now reads that the USPSTF recommends primary care clinicians apply fluoride varnish to the primary teeth of infants and children starting at the age of primary tooth eruption, https://bit.ly/3LZfUqo. After teeth are present, apply varnish every three to six months in the primary care or dental office based on caries risk. See the AAP clinical report Fluoride Use in Caries Prevention in the Primary Care Setting, https://doi.org/10.1542/peds.2020-034637.
- Fluoride supplementation: Footnote 38 notes that if the primary water source is deficient in fluoride, consider fluoride supplementation. See the AAP clinical report above.