Oral health and cystic fibrosis in pediatrics: A survey of health professionals.

BACKGROUND: Children with cystic fibrosis (CF) are usually managed by hospital-based, multidisciplinary teams (MDTs). This study aimed to investigate oral health perspectives, training, and practices of health professionals working with children with CF. METHODS: Data were collected through an online survey distributed to health professionals caring for children with CF by the CF Director in 12 Australian hospitals. The questions related to perspectives, training, and dental referral/advice relating to oral health for children with CF. The data were analyzed using descriptive statistics. RESULTS: Forty-four participants (26 physicians, 8 nurses, 6 physiotherapists, 2 dieticians, 1 psychologist, and 1 pharmacist) completed the survey. Most (n = 33, 75%) indicated they rarely/never check or discuss dental health. Of those who did, most reported lacking skills to inspect teeth and discuss dental health. Frequently reported barriers were lack of skills, training, knowledge, and time. Most respondents (n = 30, 68%) indicated they rarely/never recommend patients to see the dentist. The most frequently reported barrier to referrals was not considering it part of their role (43%). CONCLUSIONS: Closer working relations between CF units and dental teams may remove barriers that prevent non-dental clinicians from supporting patients with CF maintain oral health. Better integration of dental care within the MDT through improved professional training, increased referral practices, and availability of digital resources may help to improve dental care for all children, including children and adolescents with CF.

Early childhood caries: an update.

Early childhood caries is the currently accepted term used to describe dental caries occurring in infants and toddlers. It is a multifactorial, transmissible and infectious disease that has recently been under scrutiny in the literature. The microflora, substrate, saliva and host are key factors involved in the pathogenesis, together with the immature host defence system and developing bacterial flora. Immature enamel surfaces and developmental defects of enamel should also be considered in the aetiology. This paper addresses the controversies of the cariogenicity of bovine milk, human breast milk and infant formulas. Clinical management should be planned according to age, extent of lesions, compliance of primary caregivers and where treatment is rendered (private or public sector). Cases of early childhood caries need comprehensive restorative management and preventive treatment together with the help of other health care professionals.