Nothing But the Tooth- Part I

Sep 22 2013

Nothing But the Tooth- Part I

People come to me for a second opinion, at times in disbelief about why and how their young child has cavities. Most of these parents feel a great deal of guilt and are surprised to learn that Early Childhood Caries (ECC) is an actual recognized serious dental disease that affects children in San Diego and the rest of US. In fact, tooth decay is the most common disease affecting this generation of kids. Though caries is a preventable condition, we’re seeing a steady rise and children in all classes of the society are getting decay. In fact, dental decay is seven times more prevalent than asthma. So yes, its real and it happens in the children of the richest, the poorest, and everyone else in the middle. As parents, we can and should take charge and my next few blogs posts will hopefully give you a glimpse into Early Childhood Caries:

I’m a thoughtful parent. How could it be that my child has cavities?

There is not a quick explanation for this, but no doubt, so much of it comes from today’s lifestyle. The typical American family is too busy and too surrounded by carbohydrates while basic daily oral hygiene needs are often below par. The earliest and arguably most severe pattern of decay starts with a child who demands a bottle (or breastfeeds) to fall asleep. Today’s working parents often have no option but to cave in and do “whatever it takes” to get the kids to bed. The milk sits on a child’s tooth and primes the bacteria to be destructive. Acids from bacteria in plaque breakdown the tooth’s enamel and the cycle of destruction begins. Other less obvious catalysts to tooth decay are frequent snacking (carbohydrate rich goldfish, potato based snacks, sticky raisins..etc) and frequent bottle or sippy cup use (watered down apple juice, milk, formula..etc). So yes, even thoughtful parents find themselves having to deal with childhood cavities.

What can I do to prevent ECC?

Starting early is undoubtedly the best option. Meeting thousands of famlies in San Diego, I find as a general observation, parents are too focused on trying to keep kids from having chocolate and not as good with the vastly more important issue of oral hygiene. I will post more on this observation with some suggestions in the future. Religious brushing (and flossing where teeth touch) needs to start well before the first birthday. I advise all this knowing how difficult it is to brush a wiggle worm but having watched so many children over the years, those who have brushing as part of their nightly routine (and yes that involves protesting and even kicking and crying in the average two year old) simply embrace it as they turn 3 or 4 years old. Also, we’ve got research that shows even the “smartest” 4 and 5 year olds can’t brush all areas where plaque sits. So, parents need to continue actively brushing their kids well into elementary school. Informed parents value starting preventive dental care before decay is present and the guidelines by our pediatrician colleagues recommend first dental visit before age 1.

In future posts, we’ll get more into dealing with oral health challenges for parents with kids who are 4 years or older and some suggestions on how to keep them cavity free. Until then, brush on and brush proud.

Dr J is a board certified pediatric dentist, serving his hometown in San Diego at one the most respected specialty practices, Scripps Pediatric Dentistry. He is an honors graduate of UC Berkeley, and UCLA School of Dentistry. His specialty training was completed as Chief Resident at UNC, one of only 2 three year pediatric programs in the US. He is an associate professor at UCLA in pediatric dentistry and on staff at Rady Children’s Hospital. He is also a proud father to two girls.

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