The investigator found that autistic spectrum disorders are characterized by impairments in social interaction and verbal and nonverbal communication, and by preferences for repetitive interests and behaviors. Early signs that distinguish ASD from other atypical patterns of development include poor use of eye gaze, lack of gestures to direct other people's attention (particularly to show things of interest), diminished social responsiveness, and lack of age-appropriate play with toys (especially imaginative use of toys). Careful attention to parents' concerns and specific inquiry into and observation of how children interact, communicate, and play will help ensure that early signs are detected during regular health maintenance visits. The author concludes that family physicians have an important role in early identification of children with A SD. Early diagnosis of these disorders is essential to ensure timely access to interventions known to improve outcomes for these children. A Proposal to Label the Fluoride Content of Bottled Water The Oral Care Report, Vol. 11, No 1, 2001 Autistic Spectrum Disorders in Preschool Children Zwaigenbaum L. Can Fam Physician 2001 0ct;47:2037-42 Recently, Dr. Lawrence Meskin, editor of the Journal of the American Dental Association (JADA), suggested that labellng the fluoride content in bottle water would be helpful to patients and the professionals who care for them. With claims of 8.1% of the total beverage market and an estimated per capita consumption in 1999 of 16.1 gallons, bottle water is showing continuing growth. Coca-Cola and Pepsi have entered the market with bottled purified (not spring) water and dental care providers are increasingly unable to advise their patients regarding optimal consumption in fluoridated communities. The possibility exists that patients are receiving less than the recommended amount for the prevention of dental decay. If, as statistics are beginning to show, consumption of bottled water is on the rise due to its availability and popularity and eight studies of bottled water sold in the United States show an average fluoride content of 0.1 to 0.2 mg/L (ppm), consumers are receiving less than the recommended optimal amount (=lppm) of fluoride on a regular basis. In this study, the author wanted to review existing data on early signs of autistic spectrum disorders (ASD) and on how these disorders can be distinguished from other atypical patterns of development, and to describe a developmental surveillance approach that family physicians can use to ensure that children with these diagnoses are detected as early as possible. The literature was searched from January 1966 to July 2000 using terms autistic disorder/ diagnosis and diagnosis, differential and (infant or child, preschool). Articles were selected based on relevance to developmental surveillance in primary care and on experimental design, with emphasis on prospective studies with systematic measurement procedures using up-to-date diagnostic criteria. 2 Dannon recently introduced "Fluoride To Go", a fluoridated spring water with fluoride content labeling, one of only a few manufactures that lists the fluoride content of their bottled water. In a 1995 study by VanWinkle et al, none of the 78 bottled waters tested for fluoride listed the concentration on the label. Until the fluoride content of bottle water is known, consumers will be receiving unknown amounts of fluoride. The increasing consumption of bottled water supplies presents an unknown effect on the "incidence and prevalence" of dental caries on an ever-increasing segment of the population. carious surfaces; none said they would seal overt caries. Surface preparation was used always or sometimes by 87 percent of the respondents. The estimated one- and three-year sealant retention rates were 89 percent and 78 percent, respectively, for practitioners and 83 percent and 71 percent, respectively, for dental schools. The survey demonstrated wide variations in selection criteria, placement techniques and evaluation methodologies, yet showed remarkable similarities between practitioners and dental schools. The reported retention rates were consistent with those reported in the literature. The survey results suggested that pediatric dentists were searching for evidence-based selection criteria and a technique protocol for sealant placement that improved clinical success. The wide technique variations reported were likely a result of training diversity, diagnostic uncertainty, technique and material sensitivity, and an attempt to improve the success rate. Sealant Use and Placement Techniques Among Pediatric Dentists Primosch RE, Barr ES. JAm Dent Assoc 2001 0ct;132(10):1442-51 Nursing-bottle Syndrome Caused by Prolonged Drinking from Vessels with Bill-shaped Extensions Our investigating 186 infants between the ages of one and six with carious destruction of the maxillary primary incisors, it was learned which risk factors were responsible for the condition known as nursing bottle syndrome. One hundred and twentyeight infants (68.8 percent) were given a nursing bottle, twelve (6.5 percent) a feeding cup or other bottles with bill- shaped extensions, and forty-one (22.0 percent) both a nursing bottle and vessels with bill-shaped extensions; in all cases the feeding was excessive and prolonged beyond the first year of life. An additional five infants (2.7 percent) were breast-fed excessively beyond the first year. The results confirm the risk of tooth destruction, typical of nursing bottle syndrome, by prolonged and frequent consumption of cariogenic beverages from vessels with bill-shaped extensions. It is important, therefore, that a warning regarding dental health hazards of such feeding methods be issued. Pit and fissure sealant use varies widely among dentists. The authors conducted a survey to determine the current variations and patterns of sealant placement among pediatric dentists. The authors mailed a 20-question survey to American Academy of Pediatric Dentistry members from six states, who represented one-third (1,210) of the membership, as well as to all 52 pediatric dentistry departments in U.S. dental schools. The authors examined selection criteria, placement techniques, evaluation methodologies, and the one-and three-year estimated success and reapplication rates of sealant placement. Results indicated that the response rates were 70 percent for practitioners and 90 percent for dental schools. Approximately 80 percent of respondents said they sealed caries-free and questionable carious surfaces. Only 20 percent of the respondents said they sealed incipient Dentistry for children and teenagers...teaching prevention for future dental health. Pediatric Dentistry Review is a publication of this office It’s information is intended solely for dentists and other healthcare providers. It is not intended for use as a replacement for dental/ medical advice For individual situations or conditions, appropriate dental/medical consultation should be obtained.