1.3 Anticipatory Guidance

Anticipatory guidance is direction or guidance that an oral health professional provides to parents that applies to the period between the current visit and the next one, anticipating changes in age, environment, and behavior. For young children, anticipatory guidance should cover the following:

• Oral development
• Oral hygiene
• Diet
• Fluoride
• Habits
• Injury prevention and dental emergencies

For a healthy child with no existing dental caries but with risk factors for caries (e.g., parent does not brush the child’s teeth, no access to fluoride, child continues to drink from a bottle), the oral health professional would address these three areas of risk by (1) counseling the parent about brushing the child’s teeth, (2) prescribing fluoride supplements, and (3) counseling the parent about weaning the child from a bottle to a cup.

Birth to Age 1

When providing anticipatory guidance to parents of children from birth to age 1, the oral health professional should discuss the following:

• Tooth eruption patterns (show the parent the child’s oral cavity structures).
• Oral hygiene (rationale for and instructions on how to clean the child’s gums and teeth).
• Fluoride (note that although breastfeeding provides many benefits for infants and is not cariogenic, breastmilk has no fluoride, and this needs to be considered when determining the overall fluoride intake for children who are breastfed).
• Non-nutritive sucking habits (sucking the thumb, fingers, or a pacifier). (For more information about non-nutritive sucking habits, see A Health Professional’s Guide to Pediatric Oral Health Management.)
• Safety issues, particularly hazards that can lead to orofacial injury.

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