Tooth decay is largely preventable, but it remains one of the most common diseases of childhood — five times as common as asthma, and seven times as common as hay fever, according to the Centers for Disease Control and Prevention. CDC says 42% of children ages 2 to 11 have had cavities in baby teeth; 21% of those ages 6 to 11 have had cavities in permanent teeth. A new education campaign by the American Academy of Pediatric Dentistry highlights the seriousness of dental decay in children and urges parents and caregivers to start early to prevent it. USA TODAY's Michelle Healytalks with Warren Brill, a pediatric dentist practicing in Baltimore and president of the AAPD.
Q: You say early childhood tooth decay is a serious problem that can result in severe pain, infection and tooth loss even in toddlers. Is it increasing?
A: We're reaching epidemic proportions of a rapid form of tooth decay especially in younger children, often from disadvantaged backgrounds. We're seeing increases in the rate of what we call early childhood caries (ECC) or what use to be called baby bottle tooth decay. It develops most commonly with infants and toddlers when they are put to sleep with a bottle in their mouth, put to sleep nursing, or walk around with a sippy cup. That, combined with the fact that their teeth aren't being cleaned as carefully as they should, leads to this situation.
Q: How can cavities be deadly?
A: Yes, they are caused by bacteria in the mouth. Dental caries can spread from the tooth into the nerve where the tooth becomes abscessed. Then it can spread into the bloodstream. In 2007 in Maryland, a 12-year-old named Deamonte Driver died after bacteria from an abscessed tooth spread to his brain.
Q: The campaign says children should have their first dental exam by age 1. Why? A survey shows 40% of parents wait until after age 2.
A: Many just haven't learned about the new data that we have. ... As soon as you have a tooth you have the possibility of getting decay. We want to see kids as early as possible so we are sure the parents know the proper oral hygiene techniques for infants and toddlers, what they should feed them, what they shouldn't feed them, and to assess the growth and development to make sure everything is normal and growing to its fullest potential.
Q: You say babies should have their teeth brushed with a tiny "smear" of toothpaste, not just water, as was once recommended. And kids 2-5 should get a little more, a "pea-size" amount. But what about health concerns raised by some groups? The Fluoride Action Network says swallowing fluoride can cause permanent tooth discoloration, stomach ailments, acute toxicity and skin rashes?
A: It's a question of amount and frequency. If you follow the guideline in terms of a slight smear of toothpaste on the toothbrush and you brush the teeth twice a day, you're well within the established safety limits for fluoride. ... There are lots of water supplies where fluoride is naturally occurring, but the majority are not, so fluoride is added to the water to help as the teeth are forming. The fluoride you get from toothpaste helps the parts that have formed, to enrich them and make them stronger. But this is all done within well established limits of safety. And you only use a tiny little bit to prevent them from swallowing.
Q: Any special concerns for older kids when it comes to oral health?
A: One of the things I'm seeing, and my colleagues tell me they're seeing , is with the advent of these high energy drinks, monster drinks, etc., is teenagers with a mouthful of decay that we never saw before. Teens should not be drinking those drinks. They're dental poison, so to speak, because they just contain so much sugar.
Q: Doesn't access to dental care, especially access to dentists willing to treat children on Medicaid, remain a big problem for many low-income families?
A: Distribution of providers is a part of the problem. But another big part is that federal and state governments haven't really gotten behind (dental programs for the poor). They can pass all the laws they want, but if they don't come up with the money to adequately fund the programs, then it's going to be really difficult, if not impossible, to attract providers.
Dental care reminders for kids:
Birth to 2 years
• Before teeth erupt, clean baby's mouth and gums with a soft cloth or infant toothbrush at bath time.
• Once teeth erupt, brush them gently with a soft child's size toothbrush and a 'smear' of fluoridated toothpaste twice a day.
• At bedtime, give nothing but water. Any sugary liquids or carbohydrates (milk, formula, fruit juice) expose teeth to bacterial acid all night long
• Take a child to see a dental provider by his or her first birthday
2 to 5 years
• Assist or brush your child's teeth at least twice a day, once in the morning and once at night with a pea-size amount of fluoridated toothpaste. They don't have the ability to brush effectively alone. They should spit out and not swallow excess toothpaste after brushing.
• Schedule dental visits every six months for routine cleanings
• Begin flossing a child's teeth when any two teeth are touching
• Limit the amount of juice you give a child to less than 6 oz. per day.
• Parents should supervise their children's brushing until they are 7 or 8 years old
• Don't forget to floss their teeth once teeth are touching
• Chewing gum with XYLITOL, a non-sugar naturally occurring substance,
to stimulate saliva flow helps clean the mouth (Make sure to ask the teacher first)
• Avoid carbonated beverages, which can erode enamel on teeth; sport drinks and juice pouches keep acid levels high and are also bad for teeth.
Source: American Academy of Pediatric Dentistry