SAN ANTONIO—Delayed immunization status, a low appointment attendance rate, and breastfeeding at 12 and/or 15 months of age are risk factors for caries in young children, researchers reported at the 2016 annual meeting of the American Academy of PAs (AAPA).

Patrick Killeen, MS, PA-C, chief physician assistant at Western Connecticut Health Systems in Danbury, and colleagues sought to identify health screening measures from the well-child encounter that may also be associated with the risk for caries. They obtained dental health information from a major tertiary pediatric center and conducted a cross-sectional univariate analysis with more than 40 variables related to routine nutrition, safety, development, and other screenings contained within the 12- and 15-month well-child templates to determine their association with “lifetime caries experience” or “caries risk status.”

A total of 1,736 patients had a 12- and/or 15-month preventive medical visit(s) and at least one dental appointment (mean age, 40 months). In addition to observing well-accepted risk factors for caries such as Hispanic ethnicity and high poverty rate, the researchers found that delayed immunization status, a history of missed appointments, and still breastfeeding at 12 and/or 15 months of age were also associated with an increased risk.

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“The new risk factors for caries identified in this analysis are standard parts of well-child care that medical pediatric providers are adept at asking and require little or no additional data input above baseline well-child screening measures,” stated Mr. Killeen. “Next steps toward improving provider adherence to oral health screening at well-child visits are to incorporate these variables into a new medically specific caries-risk assessment tool within the electronic health record. Earlier oral health screenings, prompting more referrals of young children to a dental home, will help provide access to preventive dental services to those children most at risk for dental problems.”


  1. Killeen P, Casamassimo P, Frese W, et al. Caries risk assessment in the medical office identifying common risk factors toward a more effective screening tool. ePoster presented at: 2016 meeting of the American Academy of PAs; May 14-18, 2016; San Antonio, TX.