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AAP National Conference: Get the scoop on how to handle oral health issues :

October 23, 2016

A lot of things go on in a child’s mouth, and parents sometimes aren’t sure whether they should see the dentist or pediatrician, said Rebecca Slayton, D.D.S., Ph.D., a member of the AAP Section on Oral Health.

When these patients show up at your office, you may not always have the background to address their oral health concerns. To get up to speed, plan to attend a session led by Dr. Slayton titled “Oral Health Questions: Get the Toothful Answers from the Dentist.” The Audience Response Session will be held from 4-5:30 p.m. Sunday (A2169) in Room 303 of Moscone South and again from 2-3:30 p.m. Monday (A3112) in Room 307.

Dr. Slayton will begin by giving some basic information about oral health and discuss situations pediatricians might see in their offices. Then, she will present some cases and photos. Using the audience response system, attendees will be able to weigh in on what they think is going on and what they would do.

“I kind of teach them about it to begin with and see if it stuck,” said Dr. Slayton, an AAP associate member and director of the Department of Dentistry at Seattle Children's Hospital.

The cases will be based on questions Dr. Slayton typically gets from pediatricians such as whether they need to do something if a permanent tooth is erupting but the baby tooth has not fallen out yet. Parents often are concerned that the child will have “shark teeth” because it looks like there are multiple rows of teeth.

“The permanent teeth are supposed to be lined up in such a way that as they come in, as they’re developing, they cause resorption of the roots of baby teeth,” she said. “But if they’re not lined up quite right, then they come in in front of or behind the baby teeth, and the roots don’t get resorbed.”

Another common scenario is a child is brought to the pediatrician’s office or emergency department after a tooth was knocked out accidentally. Dr. Slayton will review how to determine whether the tooth should be saved.

Nutrition also affects oral health and can be particularly problematic in patients with special health care needs. A child with autism, for example, may have oral sensitivities that limit the foods he is willing or able to eat.

“Often, those foods are not the ones that are that great for teeth,” Dr. Slayton said. “They may be OK for overall health but dentally may not be the best.”

Pediatricians could help the family find replacement foods that are lower in sugar and make sure the child brushes regularly with a fluoride toothpaste. However, that may not always be possible.

“It’s definitely one of the challenges we’re still wrestling with,” Dr. Slayton said.

During the session, Dr. Slayton also will emphasize the importance of collaboration between pediatricians and pediatric dentists.

“I try to encourage people (pediatricians) to get to know their (dental) colleagues on a more social level,” she said, “so that they know who they are and they can call them up and say, ‘Hey, I’ve got this patient who really needs care.’”

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