Global Initiative for Asthma (GINA) 2017
–Advise pregnant women and parents of young children not to smoke.
–Encourage vaginal delivery.
–Minimize use of acetaminophen and broad spectrum antibiotics during first year of life.
Environmental exposures such as automobile exhaust and dust mites are associated with higher rates of asthma, while others (household pets and farm animals) may be protective. Avoiding tobacco smoke and air pollution is protective, but allergen avoidance measures have not been shown to be effective primary prevention.
Public health interventions to reduce childhood obesity, increase fruit and vegetable intake, improve maternal-fetal health, and reduce socioeconomic inequality would address major risk factors. (Lancet. 2015;386:1075-1085)
–School-based professionals should be educated by licensed health care professionals to understand the risks of a concussion.
–Licensed health care professionals should educate athletes about concussion risks.
–Athletes with a concussion should be prohibited from returning to play or practice in contact sports until a licensed health care provider has cleared them to return.
–Licensed health care providers should recommend retirement for any athlete with repeated concussions who has chronic, persistent neurologic or cognitive deficits.
USPSTF 2014, AAP 2014, AAFP 2014
–Apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary teeth eruption.
–Supplement with oral fluoride starting at age 6 mo where water supply is fluoride deficient (<0.7 mg/L).
Fluoride mouthwash used regularly by children under 16 reduces risk of dental caries by >25%. (Cochrane Database Syst Rev. 2016;7:CD002284)
The CDC’s My Water’s Fluoride resource provides county-level information on content of fluoride in the water system. https://nccd.cdc.gov/DOH_MWF/
Do not use fluoridated toothpaste under age 1 y. Children less than 2 y should use a “smear” of fluoridated toothpaste. Children 2- to 5-y-old should use a “pea-size” amount of fluoridated toothpaste.
CLINICAL RECOMMENDATIONS FOR USE OF PROFESSIONALLY APPLIED OR PRESCRIPTION-STRENGTH, HOME-USE TOPICAL FLUORIDE AGENTS FOR CARIES PREVENTION IN PATIENTS AT ELEVATED RISK OF DEVELOPING CARIES
Age Group or Dentition Affected
Professionally Applied Topical Fluoride Agent
Prescription-Strength, Home-Use Topical Fluoride Agent
Younger than 6 y
2.26% fluoride varnish ...