Pediatricians can take the following steps to address oral health at all well-child visits:

• Promote good nutrition: breastfeeding, healthy bottle-feeding when needed (only breastmilk or formula, no bottle in bed, stop bottle at 1 year), consuming non-sugary snacks and beverages, and drinking fluoridated water. Check families’ food security and refer to food assistance programs as needed.
• Emphasize good oral hygiene: Brush children’s teeth twice daily with fluoride toothpaste (a smear for those younger than 3 years and pea size for those 3 and older), with adult assistance until age 8.
• Assess caries risk through a targeted history and tooth exam.
• Teach parents the “lift the lip” method to look at the teeth.
• Engage families in healthy behaviors with motivational interviewing techniques.
• Apply fluoride varnish every three to six months based on risk.
• Refer children to a dental home by age 1 year, with warm handoffs when needed. Reassure families that dental offices take precautions to ensure safety from COVID-19.

Pediatricians also can build and maintain collaborative relationships with local dental professionals. Advocate together for policies, health systems and environmental changes to improve the social determinants of child nutrition and oral health.