Children's first dental visit: attitudes and practices of US pediatricans and family physicians.

PURPOSE The aim of the present study was to survey the recommendations and practices regarding the first dental visit by young children, as reported by family physicians and pediatricians in the United States. METHODS A representative sample of family physicians and pediatricians was surveyed in the year 2000. The initial survey was mailed out to 1,500 family physicians and 1,000 pediatricians who were selected from the AMA Masterfile. After the first mailing, 3 follow-up questionnaires and a postcard reminder were mailed to the nonresponders within a period of 3 months. The questionnaire described case scenarios of 2, 12-month-old children, one with low caries-risk and the other at high risk with noticeable cavitation of the maxillary front teeth. RESULTS The response rate to the survey was 43% (622 out of 1,439) for family physicians and 52% (493 out of 957) for pediatricians. When the case scenario of a child with high caries risk was presented, more than 90% of the respondents recommended that the child see a dentist as soon as possible. For the child with low caries-risk, the proportion of respondents recommending early dental visit was significantly lower: only about 19% of family physicians and 14% of pediatricians. For a child at low risk for dental caries, about 40% of family physicians and 63% of pediatricians recommended the first dental visit around the third birthday. The majority of the respondents (pediatricians=91% and family physicians=77%) reported frequent screening for gross tooth decay. However, only a minority of them (pediatricians=33% and family physicians=19%) frequently checked for early signs of tooth decay as part of their regular practice. CONCLUSIONS US physicians can decide on referral patterns based on the risk status of a child. However, the majority of respondents do not regularly screen for early signs of early childhood caries.