Stage

Summary of Anticipatory Guidance

Infancy (Prenatal to 11 months)

• Healthcare professionals ask questions about maternal diet, good oral health hygiene, and attendance at regular dental checkups to set the stage for optimal child oral health.
• In the early months of infancy, guidance focuses on
  • Holding the infant while feeding
  • Never putting an infant to bed with a bottle
  • Using a cloth or soft toothbrush with tap water and a small smear of toothpaste to gently clean

gums and new teeth

• As an infant reaches 6 months, guidance expands to include
  • Introducing fluoride varnish and fluoridated water or fluoride supplements
  • Minimizing exposure to natural or refined sugars in the infant’s mouth
  • Weaning off bottles as the infant approaches 12 months
  • Recommending no juice until age 1 year
  • Finding a dental home

Early Childhood (1 to 4 years)

• Routines are a critical component of early childhood. Healthcare professionals support families by reinforcing tooth brushing as a routine conducted twice daily.
• Teach spitting but not rinsing the mouth after brushing and no drinking or eating after brushing.
• At the 12-month health supervision visit, healthcare professionals focus on the importance of a dental home, providing information about what families can expect.
• Healthcare professionals continue to emphasize
  • Eating a healthy diet
  • Avoiding sweetened food and beverages
  • Keeping bottles out of cribs or beds
  • Avoiding sippy cups with juice
  • Using fluoride varnish and fluoridated water or fluoride supplements

Middle Childhood

(5 to 10 years)

• Oral health is integrated into larger discussions of children’s physical growth and development, which are priority areas in health supervision visits.
• Healthcare professionals continue to focus on
  • Oral health hygiene (daily tooth brushing and flossing)
  • Connections to a dental home
  • The importance of caring for permanent teeth
  • Limiting sweetened beverages and snacks
  • The importance of dental sealants
• As children become engaged in contact sports, healthcare professionals emphasize the importance of using a mouth guard.

Adolescence (11 to 21 years)

• Similar to the middle childhood years, oral health is integrated into the priority areas of physical health and development.
• Healthcare professionals shift conversations during adolescent years to help them understand the importance of
  • Routine oral health hygiene (daily tooth brushing and flossing)
  • Limiting soda and sweetened beverages
  • Reducing in-between-meal snacks
  • Chewing sugarless gum
  • Using a mouth guard during contact sports
• In later adolescence health supervision visits, healthcare professionals begin conversations about smoking and drug use that can impact oral health.