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Volume3 Issue5
S
upporting
Y
our
P
ractice
Keypolicies andclinical guidelines related to infant and
toddler oral healthappear tobepresent incurricula.
Other concepts related to infant oral health, suchas the
useof fluoride toothpastes andvarnishes, infant feeding
practices andcariesdiagnosis, arealso taught.Most
programs recommendfluoridated toothpaste for infants
and toddlers (dentistry80%, dental hygiene65.2%). Nearlyall
respondents said that their programdiscussesprofessional
recommendations for afirst dental visit andwereaware
of CDA’sposition statement onearlychildhoodcaries.
2
All
respondents indicated that their curriculum teaches students
about the relationshipbetweenbottle feedingandoral
health, and themajority reported teaching students about
breastfeedingandoral health.
PrenatalOralHealthCurriculum
Respondentsnoted that inmost dentistryanddental
hygieneprograms, prenatal oral health is acomponent
of thecurriculum. Time isdesignated in thecurriculum
of 40%of dentistryand69.6%of hygieneprograms for
teachingprenatal oral health. Educating students about the
relationbetweenperiodontal diseaseduringpregnancy
andprematurebirthand lowbirthweightwas commonly
reported (dentistry70%, dental hygiene95.7%).Most
respondents also reported that their program informs
students about the roleof prenatal nutrition in infant oral
health. Allmentioned teachingabout bacterial transmission
frommother to infant.
Discussion
A searchof theCommissiononDental Accreditation
of Canada’s (CDAC) accreditation requirements for a
graduatingdentistry student foundnone specifically
addressing infant oral health. CDAC requires thatDoctor
ofDental SurgeryandDoctor ofDentalMedicineprogram
graduates “becompetent in themanagement of theoral
healthcareof thechild, adolescent, adult andgeriatric
patient.”
15
Thedocument doesnot identifymanagement
of infant oral healthas a separate requirement, although
its inclusion is implied. Similarly, there isnomentionof
specific requirements relating to infant oral health for a
graduatingdental hygiene student; thesegraduatesmust
be “competent tomanagehealthpromotionandoral health
care for a rangeof clientswithin the lifecycle, including
children, adolescents, adults, and seniors.”
16
Becausedental
development andprogressionof dental diseaseduring
childhoodvarygreatly frombirth toadolescence, the lackof
specific inclusionof the infant and toddler agegroupsmay
lead to their omission fromcurricula.
Sohowbest canweassist educators topreparedental
professionals tocare for pregnantwomenandyoung
children?Basedonour findings,wepropose that curricula
consider didactic, clinical domainand system-widechanges.
DidacticTeaching
Theamount of didactic teaching inprenatal and infant oral
health reportedbydentistry (70%and100%, respectively)
anddental hygiene (82.6%and100%, respectively) programs
is encouraging. Although respondingdental hygiene
programs reportedmore timededicated todidactic teaching
in infant and toddler oral health thandentistry schools, 44%
of themdonot recommendafirst visit by12monthsof age.
This suggests theneed for re-acquaintancewithcurrent
clinical practiceguidelines. A surveyofManitobadentists
found that only58%wereawareof the recommendation
for afirst dental visit,
6
but thisproportionappears tohave
increased followingahealthpromotioncampaignby the
profession (FreeFirst Visit program).
7,21
Itwas reported that
aFirstDental Visit campaignby theBritishColumbiaDental
Association (BCDA) that includedhands-onworkshops and
anonline learning tool has also led to increasednumbersof
dentistswelcoming infants and toddlers to their offices.
With limitedhuman resources for education,
23,24
innovative
ways todisseminate knowledgeabout current guidelines
onprenatal and infant oral healthcouldbehelpful. Time
couldbebetter devoted topromotingclinical experiences
in this area, abarrier notedbyeducators inour study.
Development of standardizedcurriculausing innovative
web-based teachingmethods, similar to that developedby
BCDA,mayprovide studentswitha foundational level of
knowledge.
25
Evidence suggests thatweb-baseddelivery
canproduce learningoutcomes equal to face-to-face
education.
26
Clinical Experience
Our study found that, althoughmanyprograms teach
about the timingof afirst visit, less thana thirdoffer
hands-onexperiences inperformingassessments. This
lackof clinical experience increases thepossibility that
studentswill not engage in theseactivities following
graduation.
24,27
Unfortunately,most of thehands-onclinical
experience that students receive iswithchildren4yearsof
ageandover.
24,27
A recentCochrane review found that combining interactive
anddidactic formats is amoreeffectiveapproach thaneither
alone.
28
Specific todental education inearlychildhood,
evidence suggests that comfort is a significant predictor
of general dentists’ stageof readiness
todeliver preventiveoral health services
to this cohort. Strategies topromote
comfort and self-efficacy throughclinical
experiencesduringdental education
havebeen shown to improve knowledge
Based on our findings, we propose that curricula
consider didactic, clinical domain and system-
wide changes.
