Oral Health Programme for infants and toddlers

​The implementation of the School Dental Service programme which aimed at preventing and treating dental caries in school-going children has been extremely successful reducing the number of children with caries-free dentition, from 27.8% in 1970 to 58.2% in 1994. However, recent studies have indicated a high caries prevalence, as high as 48% in 18–48-month old infants¹. There is also low oral health awareness among Singaporean parents whereby only 8% of children aged 3–6 years and 3% of children aged 18–48-months received regular care^1,2.

The American Academy of Pediatric Dentistry recommends that all children should have their first dental visit at no later than one year of age. Early preventative dental care can be given through a non-invasive oral health programme. Through such a programme, the number of emergency and cost of dental care can be reduced. Prevention of early childhood caries can also prevent pain and infection which can affect a child's nutritional intake, growth and development, and quality of life.

To overcome these issues, the NDCS Paediatric Dentistry Clinic launched an oral health programme for infants and toddlers in Singapore. Children under 18 months were enrolled in a two-year risk-based preventive oral health programme. The risk-based preventive programme comprised the following:

1. Oral health education about the aetiology of dental caries, caries progression and prevention, and parental oral health
2. Anticipatory guidance on diet, oral health care practices, including tooth brushing and fluoride use, non-nutritional habits, trauma prevention, and growth and development
3. Topic fluoride varnish (5% sodium fluoride; Duraphat®, Colgate, Waltrop, Germany), which was applied on all tooth surfaces for children who had high caries risk
4. Recommendation for dental review visits

The study found that the two-year, customized, risk-based preventive oral health programme was successful in reducing severe early childhood caries (SECC). Children who did not see a dentist at an early age (control group) were three times more likely to have SECC when compared with those who were enrolled in the infant oral health programme (intervention group). There was good oral hygiene practices and fewer high caries risk habits in the intervention group.

The study provides evidence that it would be worthwhile collaborating with medical and early childhood professionals and developing an infant oral health programme that can be tailored to the local population.

¹Hong CH, et al. Int J Paediatr Dent. 2014;24:32-42. 

² Gao XL, et al.  Community Dent Health. 2009;26:12-7