Sources for Periodicity Recommendations
American Academy of Pediatric Dentistry Periodicity Schedule
   Birth-12 Months
   12-24 Months
   2-6 Years
References
Recommendations for Preventive Pediatric Dental Care

Detailed recommendations regarding the periodicity of professional dental services for children can be found in the AAPD's Reference Manual section on "Periodicity of Examination, Preventive Dental Services, and Oral Treatment of Children" and in ... this Guide. [See Below] The AAPD's Reference Manual is available on the Internet at www.aapd.org. The AAPD periodicity schedule outlines the recommended content and periodicity of developmental assessments, clinical examinations, diagnostic tests including radiographic assessments, counseling and prevention activities, and periodic reevaluations. These recommendations generally call for procedures to be repeated at six-month intervals or as indicated by individual patient's needs or risk for disease.

Recommended policies and practices for general health supervision of children, including oral health, also have been promulgated in a series of Bright Futures publications developed with support of the U. S. Department of Health and Human Services. The Bright Futures oral health guide also can be found on the Internet at www.brightfutures.org/oralhealth/index.html.

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American Academy of Pediatric Dentistry Periodicity Schedule

Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance and Oral Treatment for Children.

Birth-12 Months (for Children with Special Health Care Needs or at High Risk for Caries)

1. Complete the clinical oral assessment and appropriate diagnostic tests to assess oral growth and development and/or pathology.
2. Provide oral hygiene counseling for parents, guardians, and caregivers, including the implications of the oral health of the caregiver.
3. Remove supra- and subgingival stains or deposits as indicated.
4. Assess the child's systemic and topical fluoride status (including type of infant formula used, if any, and exposure to fluoridated toothpaste), and provide counseling regarding fluoride. Prescribe systemic fluoride supplements if indicated, following assessment of total fluoride intake from drinking water, diet, and oral hygiene products.
5. Assess appropriateness of feeding practices, including bottle and breast-feeding, and provide counseling as indicated.
6. Provide dietary counseling related to oral health.
7. Provide age-appropriate injury prevention counseling for orofacial trauma.
8. Provide counseling for non-nutritive oral habits (digit, pacifiers, etc.).
9. Provide diagnosis and required treatment and/or appropriate referral for any oral diseases or injuries.
10. Provide anticipatory guidance for parent/guardian.
11. Consult with the child's physician as needed.
12. Based on evaluation and history, assess the patient's risk for oral disease.
13. Determine the interval for periodic reevaluation.

12-24 Months ²

1. Repeat Birth-12 month procedures every six months or as indicated by individual patient's needs/susceptibility to disease.
2. Review patient's fluoride status, including any childcare arrangements, which may impact on systemic fluoride intake and provide parental counseling.
3. Provide topical fluoride treatments every six months or as indicated by the individual patient's needs.

²All children should have established a dental home during this period.

2-6 Years

1. Repeat 12-24 month procedures every six months or as indicated by individual patient's needs/susceptibility to disease. Provide age-appropriate oral hygiene instructions.
2. Complete a radiographic assessment of pathology and/or abnormal growth and development, as indicated by individual patient's needs.
3. Scale and clean the teeth every six months or as indicated by the individual patient's needs.
4. Provide topical fluoride treatments every six months or as indicated by the individual patient's needs.
5. Provide pit and fissure sealants for primary and permanent teeth as indicated by individual patient's needs.
6. Provide counseling and services (athletic mouth guards) as needed for orofacial trauma prevention.
7. Provide assessment/treatment or referral of developing malocclusion as indicated by individual patient's needs.
8. Provide diagnosis and required treatment and/or appropriate referral for any oral diseases, habits, or injuries as indicated.
9. Assess speech and language development, and provide appropriate referral as indicated.

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References:

1. American Academy of Pediatric Dentistry, Reference Manual 2000-01 Pediatr Dent 2000; 22.

Recommendations for Preventive Pediatric Dental Care*

Because each child is unique these Recommendations are designed for the care of children who have no contributing medical conditions and are developing normally. These Recommendations will need to be modified for children with special health care needs or if disease or trauma manifests variations from normal. The Academy emphasizes the importance of very early¹ professional intervention and the continuity of care based on the individualized needs of the child.

1. First exam at the eruption of the 1st tooth and no later than 12 months.
2. Initially, responsibility of the parent; as child develops jointly with parents; then when indicated only child.
3. Initially play objects, pacifiers, care seats; then when learning to walk sports, routine playing, and intraoral/perioral piercing.
4. At every appointment discussion the role of refined carbohydrates; frequency of snacking.
5. At first discuss the need for additional sucking; digits vs. pacifiers; then the need to wean from the habit before the eruption of a permanent incisor. For school-aged children and adolescent patients, counsel regarding any existing habits such as fingernail biting, clenching, or bruxism.
6. As per AAP/ADA Guidelines and the water source.
7. Up to at least 16 years.
8. By clinical examination.
9. Especially for children at high risk for caries and periodontal disease.
10. As per AAPD Radiographic Guidelines.
11. Appropriate discussion and counseling should be an integral part of each visit for care.
    
    * American Academy of Pediatric Dentistry, May, 1992
    

See also:
     Guide to Children's Dental Care in Medicaid