In 2001 we initiated an Infant Visit program to make an effort to educate parents of very young children about oral health care. There are many aspects to consider in this type of program and the following are merely my thoughts and ideas about how we created a program that is successfully working for us.
 

We have worked out an educational program that our trained Dental Assistants present to the parent regarding:

1. The use of fluoride supplements (our community does not have fluoride in the water)
2. The importance of home care-- brushing or, at a minimum, wiping the teeth clean after each feeding
3. Avoiding bottles at night time with anything other than water (and how other liquids can effect the teeth)
4. Nursing and its relationship to primary tooth decay
5. The impact of oral habits, such as pacifiers or fingers
6. Caries risk assessment
7. Caution about potential sources of injury

When requested, the assistant also demonstrates home care by using the knee-to-knee technique for holding the infant and having a second person involved in the cleaning. We demonstrate this with the use of a toothbrush, but also encourage the parents to use anything the child will tolerate, including Q-Tips or "Tenders," which we give them in a packet during the visit. We explain that the brush is optimum, but if the child resists or fights it, using anything is better than using nothing. We also emphasize the importance of cleaning the teeth after each feeding

For each parent that brings a child into the office, we provide a packet in a small plastic bag with our logo on it. In the packet are several items, most of which were ordered from the ADA:

1. A growth and development chart showing average eruption times for primary and permanent teeth
2. Fluoride information
3. Nursing and bottle feeding information
4. Nutrition and its relationship to decay
5. A toothbrush
6. A "Tender" as an alternative to to a toothbrush for cleaning

These packets have also been distributed to the local pediatricians' offices with a request to encourage parents to bring their 6-12 month old children into a dental office for information. The local pediatricians have been fairly supportive and only requested that our office's logo not be on the bag so that they would not appear to be promoting one particular dental office. We felt that was reasonable and included in the packet a listing of all the participating offices in our area. Because we feel this is a actually more of a public service than specifically a promotional concept for our office, we had no problem with their request.
 

1. How do you create time for this in your busy schedule?
    Because the doctor's time is minimal (the program is mostly administered by the trained assistants) there is only a minor impact.
2. Aren't you "singing to the choir?" (Only the intelligent parents will bring their children in)
    There is undoubtedly truth in this, but we believe that we must begin somewhere. One generation ago, people only went to the dentist to have problems solved-- that is, there 
    was no such thing as a "preventive visit." Now, people routinely come into dental offices each six months for checkups and it is considered perfectly normal. It has been an  
    enormous boon to the dental health of our entire society and programs involving infants may require years to become "mainstream," but without a beginning there can be
    no hope for developing that new mindset.
 3. Do you believe this has really had an impact?
    Yes, we do. We have been doing it since 2001, and trust that other offices and other groups have adopted the concept and that it IS spreading. As a pediatric practitioner, I
    spent the first 25 years of my career wringing my hands and lamenting the problem of Early Childhood Caries and wondering why these parents didn't know any better. It
    eventually occurred to me that I could continue on that path, thus ensuring that I had continued doing nothing constructive about it or that I could begin to do whatever I
    can for whomever is willing to learn.
4. What if I don't want to see children at this age?
    By all means, do NOT tell parents "we don't see children until the age of ________" (whatever your policy may be). It is far better when parents call asking about when to
    start dental visits to tell that YOU do not see children until the age of ________ but that you recommend children be seen no later than 12 months and that you will be glad
    to refer them to a pediatric dentist who will see them. This is not about promoting pediatric dentistry-- it is about avoiding the impossibly difficult situation of a parent
    hearing your policy, waiting until that age and presenting with a child who needs extensive care. Please do not allow this to occur.