Dental Care for International Adoptees
Winter 2005

A dental examination, preferably by a pediatric dentist, should be part of the evaluation of every newly adopted child. All children should have had a dental exam by the time they are a year old.

It is important to talk with parents about their role in the oral hygiene of their newly adopted child. Young children, birth to age six or seven years, lack the manual dexterity to use a toothbrush, so parents will need to routinely brush or help brush their children’s teeth with a small, soft toothbrush. Until a child is about two to three years old, no toothpaste should be used.

If the child will not be getting sufficient fluoride from drinking water and other sources, fluoride supplementation may be needed. Older children may not know how to brush or floss, so parents may need to talk with them about regular brushing, flossing, and how to do this.

Dental disorders in internationally adopted children may be caused by such factors as poor nutrition, disease, poor hygiene, lack of health or dental care, and poor maternal health care during pregnancy.

Primary care providers should check for the presence of early childhood caries, also known as baby bottle caries. This decay is easy to overlook because it typically develops on the back of the upper teeth and the back teeth. Early childhood caries result from using a bottle during naps or at night, or from extended feedings using propped bottles. These caries can be severe. 

Other conditions to watch for include:

• Cellulitis, a potentially dangerous infection of the soft tissues of the gums and face, with extensive, hard swelling
   
• Gingivitis, gum inflammation due to infection
   
• Periodontitis, inflammation that occurs when gingivitis spreads to the ligaments and bone that support the teeth
   
• Hypoplastic tooth enamel, with grooves, pits, or fissures; sometimes enamel is entirely absent
   
• Tooth wear due to bruxism (grinding or clenching the teeth); may be associated with a neurological condition or behavior disorder
   
• Trauma to the frenulum, which anchors the tongue to the floor of the mouth
   
• Stained, missing, or broken teeth

Online Dental Directory

Iowa dentists who provide EPSDT Care for Kids services are listed at:
www.uiowa.edu~c090247/Final EPSDT Registry 2002.htm

Watch for more about dental care for children
in upcoming issues!

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