Original Publication
Open Access

Protecting All Children's Teeth (PACT): Oral Habits

Published: January 19, 2014 | 10.15766/mep_2374-8265.9674

Included in this publication:

  • Instructor's Guide.doc
  • Oral Habits Course 8 PACT.ppt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Protecting All Children's Teeth (PACT) was created by the AAP Oral Health Initiative to educate medical students, residents, pediatric primary care providers, and others interested in infant, child, and adolescent health about the importance of oral health in overall health. The curriculum provides in depth coverage of child oral health, oral health guidance, and preventive care to increase comfort in recognizing dental disease and conditions and communicate with dental professionals. The 13 modules of the PACT training program comprehensively address oral health promotion, disease prevention, diagnosis, and treatment of oral health disease in children.

Oral habits, including nonnutritive sucking, teeth grinding (bruxism), and nail biting, are extremely common in children and are often a source of concern for families and questions for pediatricians. The information provided in this presentation is intended to help health professionals appropriately reassure parents, address concerns and intervene when necessary.

The PACT Oral Health Curriculum has been in use since 2007 by physicians in training at the medical school and residency levels, as well as those in clinical practice. The content has been used by Pediatric, Family Medicine and Emergency Medicine physician training programs, as well as by Physician Assistants, Nurse Practitioners, Nurses, Dentists and Dental Hygienists in training and in clinical practice.

Educational Objectives

  1. Discuss the benefits of non-nutritive sucking.
  2. Summarize the AAP policy on pacifier use and Sudden Infant Death Syndrome.
  3. State the dental effects of non-nutritive sucking and the suggested age for intervention.
  4. Describe the oral effects and suggested management of bruxism. As this presentation is part of a complete oral health curriculum, educators and learners are encouraged to view the additional 12 courses in PowerPoint format.

The learning objectives of the entire PACT curriculum are as follows. Specific objectives are contained within each course. Upon completion of this training, participants should be able to:

  1. Cite the structures of the mouth, their locations and nomenclature, and distinguish between normal and abnormal oral anatomy.
  2. Provide anticipatory guidance to families regarding dental development, teething, oral hygiene, dietary practices, and Early Childhood Caries prevention strategies.
  3. Assess dental caries risk in young children and discuss referral options for high-risk patients.
  4. State the proper ages for initiating routine oral health screening and establishing a dental home.
  5. Describe the risk factors associated with Early Childhood Caries, and review the impact this chronic disease has on a child's overall health.
  6. Discuss the important role that fluoride plays in preventing dental caries, as well as fluorosis prevention strategies.
  7. Cite potential barriers to optimal oral health care and the consequences of poor oral health for patients with special health care needs.
  8. Address concerns and provide intervention strategies for unhealthy oral habits, such as nonnutritive sucking, teeth grinding (bruxism), and nail biting.
  9. Properly diagnose, manage, and triage common oral pathology, with appropriate reassurance or referral.
  10. Distinguish between acquired, congenital and developmental oral findings and recognize the oral manifestations of common systemic diseases.
  11. Describe the epidemiology and the complications and consequences of dental injury.
  12. Provide the immediate management of an injured tooth, appropriate triage, and anticipatory guidance regarding prevention.
  13. Prepare, educate, and empower adolescents to take control of their oral health as they move towards adulthood.

Author Information

  • Melinda Clark, MD: Albany Medical Center
  • David Krol: Robert Wood Johnson Foundation

None to report.

The web-design of the PACT program was funded by the AAP Oral health Initiative, with support from the Maternal and Child Health Bureau (MCHB).


Clark M, Krol D. Protecting all children's teeth (PACT): oral habits. MedEdPORTAL. 2014;10:9674. https://doi.org/10.15766/mep_2374-8265.9674

This publication is co-sponsored by the American Dental Education Association.