The Well Child Visit: Oral Health Assessment and Guidance

An exit survey and a chart review from similar time periods were conducted to determine what, if any, oral health issues were discussed and documented during pediatric well-child visits at The University of Illinois at Chicago Medical Center. This study focused on children age 6 months to 4 years old. Results from both the survey and chart review were compared and contrasted for similarities and differences. One hundred surveys and 133 chart reviews were analyzed. Over 80% of both survey and chart review subjects were from ethnic minorities. The population was of low socioeconomic status as a majority of parents identified their primary method of payment to be from governmental insurance. Diet, oral assessment, and referral for the age 1 dental visit and/or determining establishment of a dental home were the oral health topics most frequently discussed and documented by parents and providers. Fluoride use and placement of fluoride was negligible. Weaning from the bottle and/or sippy cup, juice consumption, teething, identifying if tooth pain was present, and dental injury prevention were discussed and/or documented at varying levels between the survey and chart review. No statistically significant differences between the survey and chart review were noted. Although more frequently discussed and documented, only 41% of parents could correctly identify the correct timing of the first dental visit. Minimal variance among provider type was noted. Third year residents provided significantly less oral health assessments compared to second year residents. No overall variance related to counseling or recommendations was noted between provider levels. Juice consumption was discussed more frequently with nurse practitioners. Attending physicians tended to document less bottle/sippy cup discussion and less referrals for the age 1 dental visit.