Paradigm shift: Infant oral health care--primary prevention

To demonstrate that the profession and society has been historically focused on repair of disease and not health promotion.

A search of the historical and contemporary literature and the author's academic and clinical experiences.

Progress has been made in developing programmes to prevent dental disease, but the prevalence of the disease remains high and the co-morbidities are increasing. Decay in primary teeth has increased in all populations but greater in minority, less educated and poor populations. Many preventive interventions have been shown to be effective in cohort studies, but only fluoride use has received a high recommendation grade with the highest level of evidence.

A cure for dental disease has been elusive. Until a cure is discovered, we must select those interventions that have the highest level of success and target them to at risk populations. Educational programmes must be relevant and applicable to the community and lifestyles of the targeted populations.