Caries continues to be a problem, and early childhood caries (ECC) can lead to severe oral infections and even repeated treatment requiring general anaesthesia. Today, caries is still predictive of caries. Signs of risk of periodontitis can be seen as early as during the deciduous teeth phase. Both illnesses have long-term impacts; on the other hand, both can be managed with good early diagnostics and by intervening when the disease is still preventable.
As many as one in every five children has a chronic systemic illness, the most prevalent being allergies, asthma, diabetes and autoimmune diseases, of which rheumatoid arthritis is the most common. Nearly 10 % of children suffer from mental problems. Changes in the way people eat, a more sedentary lifestyle and increased screen time have led to a rise in the prevalence of obesity among children and adolescents. While smoking has become less prevalent the use of snuff has become more common among adolescents. All this poses a threat to oral and general health in the future.
Dental practitioners must be prepared to assess whether a child's right to a safe environment, normal growth and development and good health is met. Promotion of oral health must be continuous on population as well as on individual level, and new methods to achieve this need to be developed. All children have the right to good oral health.
Headlines
Continuous oral health promotion is essential at population as well as individual level - caries and periodontal disease persist among children.
Systemic and psychiatric diseases, as well as neuro developmental disorders are common among children, affect oral health, and therefore must be born in mind in dental treatment planning.
Overweight is today's problem and threatens both child's general and oral health, the same is true for eating disorders, although rare.
Problems in maintaining child's oral health concerns the entire family.
Dental professionals possess a key role in detecting child's health being neglected by care takers.
Introduction
The child's development and growth is a bio-psycho-social cascade where the development in all three era is necessary and problems in any of them interfere with normal growth. Parents, dental and medical professionals as well as the society are responsible for guaranteeing a healthy environment, child's undisturbed development, and health. According to The United Nations Convention on the Rights of the Child article 24 () every child has the right to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. Along with the right to evaluation and support of somatic development and health, every child and family has similar right for psychosocial development and welfare (). Good oral health is an essential part of general health and necessary for growth and development. On the other hand, poor oral health is a risk for general health and systemic diseases may be a threat to oral health. (figure 1)
Figure 1. Good oral health is essential for health and wellbeing of all children. The photo was taken in the Oulu University Hospital Finland for this purpose with the written consent of the mother.
Systemic and psychiatric diseases and weight
Systemic diseases
Even one fifth of Finnish children have a chronic systemic disease with varying severity. The most common are allergies, asthma, neurodevelopmental disorders, coeliac disease, type I diabetes (DM I) and autoimmune diseases of which juvenile idiopathic arthritis (JIA) is the most common. The proportion of children diagnosed with obesity, inflammatory bowel disease (IBD), DM I, and JIA as well as with organ transplants, operated heart conditions and the survivors of childhood cancer, has been increasing in recent years (). In Finland, 500 children ( 1 %) and adolescents are diagnosed with dm i annually, while the number is 400 children for congenital heart diseases and 150 children for jia. chronically ill children often have a higher risk of oral diseases compared with their healthy peers and they have special needs in dental care. for example, children with congenital heart disease comprise a risk group for dental caries () and diabetics are prone to gingivitis and have greater plaque accumulation (). JIA often involves the temporomandibular joint and thereby affects the developing occlusion (). If left untreated, poor oral health can have a devastating impact on the overall health, especially for those with certain systemic health problems and conditions. Lack of preventive and timely therapeutic care may exacerbate systemic problems. Oral health care of patients with systemic health problems often necessitates consultation with the medical specialists who treat the child and treatment may need to be rendered in hospital settings. Having pathways to ensure children's oral health at appropriate level and way needs continuous attention
High and low BMI
In recent years snacking has replaced regular meals. Consumption of soft and energy drinks has increased, causing a threat for general as well as oral health (). Frequent snacking and intake of sweet products are associated with overweight (), but also with dental caries (). Indeed, children's overweight and obesity are common in today's industrialized world (). Simultaneously with dietary changes, time spent in front of TVs, PCs and mobile applications has increased at the expense of physical activity, in particular among the teens (). Literature of the association between overweight and caries is contradictory; both high and low BMI have been shown to associate with decaying. The association appears different in countries of differ
