So you’ve recently learned your child has a cavity?

Nov 13 2015

So you’ve recently learned your child has a cavity?

People come to me for a second opinion, at times in disbelief about why and how their young child has cavities. To most parents, its a shocker  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, it is seven times more prevalent than asthma. So, yes, its real and it happens in children of the rich, the poor, and everyone else in the middle. Here’s some food for thought on ECC:


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, much of it comes from today’s lifestyle. The typical American family is too busy and 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 breastfeeding) 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 really primes the bacteria to be destructive. Acids from bacteria in plaque breakdown the tooth’s enamel and the ECC cycle is triggered. Other less obvious catalyst 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 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 cant 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 a first dental visit before age 1.

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