On a private practice level, dental professionals who tions between the ages of 3 and 18 have adjusted daily
are interested in collaborating with medical providers calorie requirements downward to reflect the prevalence
on diabetes care, building a micro-system of collabora- of a sedentary lifestyle. Those children and adolescents
tion between a general dental practice and a primary who have increased physical activity will require more
care medical practice will provide the framework for calories. ⁷ Health promotion today that addresses the
cross referral of patients. To assist dental providers in dangers associated with children’s over-consumption of
developing micro-systems of collaboration with primary energy-dense, nutrient-poor foods and beverages and
care medical providers, a questionnaire designed to help physical activity patterns will help reduce the risks for
identify gaps in knowledge of evidence based research, future chronic degenerative diseases such as CVD, type 2
training, equipment and supplies, and weaknesses in diabetes, cancer, obesity, and osteoporosis. ³⁴ Patient edu-
protocols related to prevention and treatment of diabe- cation material that helped parents understand the risks
tes in the dental practice is provided. The questionnaire, of childhood and adolescent obesity and the suspected
entitled Needs Assessment for Implementation of Appro- link to gum disease is located in the Patient Education
priate Prevention, Screening and Treatment of Diabetes Material section which can be accessed and downloaded
in Dental Practice Settings may be accessed and down- from www.thesystemiclink.com.
loaded from the Clinical Decision-Making Tools section
at www.thesystemiclink.com. In addition, the National Healthcare providers must provide useful advice about
Diabetes Education Program recently launched an on- diet to parents but are often constrained by time to pro-
line resource at www.betterdiabetescare.nih.gov to help vide that level of care. However, information on caloric/
healthcare professionals better organize their diabetes energy values of food can be provided through literature
care and help users design and implement more effective and referral to the abundance of consumer-oriented
healthcare delivery systems for those with diabetes. ² websites. Parental participation in plotting a child’s BMI
percentile followed by clinical assessment of those re-
Transdisciplinary Intervention Opportunities for sults against standard growth curves allows parent/cli-

Dental and Medical Providers nician coassessment of a child’s weight gain in a given Opportunities for transdisciplinary intervention of diabe- time period. Healthcare providers are urged to access the tes for dental and medical providers exist at all levels of CDC’s website at www.cdc.gov/growthcharts (Figure 2), prevention (i.e., primordial, primary, and secondary). which contains important information and detailed steps to plot BMI-for-age for pediatric patients. Dental provid-

Primordial Prevention ers have a joint responsibility with members of the medi-Primordial prevention of diabetes includes targeting the prenatal state, childhood, and adolescence to promote healthy lifestyles before risk factors are acquired. Today, it is known that the atherosclerotic process begins in youth, culminating in the risk factor-related development of vascular plaque in the third and fourth decades of life. ⁷ Good nutrition, a physically active lifestyle, and absence of tobacco use contribute to lower risk prevalence and either delay or prevent the onset of cardiovascular disease. ⁷

Central to these measures is education about the benefits of optimal nutrition and physical activity. ⁷ According to the American Heart Association (AHA), “To be sedentary, have a nutritionally adequate diet, and to avoid excessive caloric intake in contemporary society is difficult.” ⁷ To address the crisis associated with the obesity epidemic, the AHA formulated the concept of energy balance. The concept of energy balance has simplified the science of _{matching appropriate energy intake to energy expen-} The www.cdc.gov/growthcharts website contains detailed information _{to plot BMI-for-age for pediatric patients.} diture. For example, new dietary guidelines for popula-