Childhood Tooth Decay – an Epidemic?
Did you know that pediatric dental disease, also referred to as childhood tooth decay, is the #1 chronic childhood illness?
When left untreated, childhood tooth decay can have devastating consequences that extend beyond the dental chair. Rampant decay can negatively impact a child’s overall quality of life, inhibit their cognitive and social development and compromise their growth, function and self esteem.
Pediatric dental disease is 5 times more common than asthma and 7 times more common than hay fever. If your child is not getting immediate treatment, pediatric dental disease can lead to malnourishment, bacterial infections, required emergency surgery and even death. Pain and infection caused by tooth decay can lead to problems in eating, speaking and learning. Dental disease has been linked to heart disease, stroke, diabetes, pneumonia, poor pregnancy outcomes and dementia.
Oral Health Crisis
In the U.S. alone, dental care is the most prevalent untreated health need of children:
- An estimated 17 million children in America go without dental care each year.
- More than 51 million school hours and 164 million work hours are lost each year due to dental disease, leading to increased educational disparities and decreased productivity.
- Approximately 43% of America’s lack dental insurance, including more than 20 milion children, almost 3 times the population lack medical coverage.
- For every $1 spent on oral health preventive measures, American taxpayers are saved as much as $50 in restorative and emergency procedures for the under and uninsured.
- Only 1.5% of 1 year olds have had a dental office visit compared with 89% who have had an office-based visit with their physician.
- More than 25% of children aged 2-5 years and 50% of those aged 12-15 years suffer from tooth decay.
Even in our practice, and even if the parents favor natural foods, we still see many children with tooth decay. How is this possible?
Tooth decay is the result of an infection with certain types of bacteria that use sugars in food to make acids. Over time, these acids can make a cavity in the tooth.
Throughout the day, a tug of war takes place inside our mouths. On one team are dental plaque—a sticky, colorless film of bacteria—plus foods and drinks that contain sugar or starch (such as milk, bread, cookies, candy, soda, juice, and many others). Whenever we eat or drink something that contains sugar or starch, the bacteria use them to produce acids. These acids begin to eat away at the tooth’s hard outer surface, or enamel. On the other team are the minerals in our saliva (such as calcium and phosphate) water, and other sources. This team helps enamel repair itself by replacing minerals lost during an “acid attack.” Our teeth go through this natural process of losing minerals and regaining minerals all day long. But when a tooth is exposed to acid frequently — for example, if you eat or drink often, especially foods or drinks containing sugar and starches — the repeated cycle of acid attacks cause the enamel to continue to lose minerals. A white spot may appear where minerals have been lost. This is a sign of early decay.
Tooth decay can be stopped or reversed at this point. Enamel can repair itself by using minerals from saliva or other sources. But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is permanent damage that a dentist has to repair with a filling.
How can we help our teeth remain strong and healthy?
- Limit between-meal snacks. This reduces the number of acid attacks on teeth and gives teeth a chance to repair themselves.
- Save candy, cookies, soda, and other sugary drinks for special occasions
- Limit fruit juice.
- Make sure your child doesn’t eat or drink anything with sugar in it after bedtime tooth brushing. Saliva flow decreases during sleep. Without enough saliva, teeth are less able to repair themselves after an acid attack.
- Make sure your child brushes
Here’s what you should know about brushing:
- Do NOT use fluoride toothpaste. Contrary to commercials about the benefits of fluoride, it’s a dangerous substance which harms your health and that of your children. See our article about fluoride.
- Additionally, do NOT use kiddie toothpaste with fruit flavors – the amount of sugar in these toothpastes is much more than regular toothpastes and harmful to your child’s teeth!
- Have your child brush two times per day
- Supervise young children when they brush – for children aged 2 to 6, you put the toothpaste on the brush. Use only a pea-sized amount of toothpaste.
- Encourage your child to spit out the toothpaste rather than swallow it. Children under 6 tend to swallow much of the toothpaste on their brush.
- Until they are 7 or 8 years old, you will need to help your child brush. Young children cannot get their teeth clean by themselves. Try brushing your child’s teeth first, then let her finish.
Visit our practice regularly for cleanings and an examination.
During the visit our hygienist will:
- Remove dental plaque
- Check for any areas of early tooth decay
- Show you and your child how to thoroughly clean the teeth
- Schedule your next regular check-up
Early Childhood Tooth Decay
Once your child has teeth, he is susceptible to tooth decay. Mother’s milk, formula, cow’s milk and fruit juice all contain sugars.
Babies may get early childhood tooth decay from going to bed with a bottle of milk, formula or juice. Unrestricted at-will breast-feeding at night may increase the risk of tooth decay.
Once your child has teeth, lift his or her lips once a month and check the teeth. Look for dull white spots or lines on the teeth. These may be on the necks of the teeth next to the gums. Dark teeth are also a sign of tooth decay. If you see any signs, come to our practice right away. Early childhood tooth decay must be treated quickly. If not, your child may have pain and infection.
If you give your child a bottle of milk, formula or juice at bedtime, stopping all at once will not be easy. Here are some tips:
- Put plain water in the bottle.
- If this is turned down, give your child a clean soother, a stuffed toy or a blanket.
- If your child cries, do not give up.
- Comfort him or her, and try again.
- If this does not work, try watering down your child’s bottle over a week or two, until there is only plain water left.
Many different types of food can cause tooth decay in children, not just candy. Foods that are high in carbohydrates, as well as some fruits, juices and sodas, peanut butter, crackers and potato chips are culprits. Factors that cause tooth decay include the frequency in which the foods are eaten and the time they remain as particles in the mouth. For example, the average 12-ounce can of soda contains 10 teaspoons of sugar; and many manufacturers incorporate sugar into their foods to help ensure a return purchase. Today, the average person consumes approximately 150 pounds of sugar a year, or about 40 teaspoons a day.
It’s not only our culture that defines the amount of sugar we consume, but also a lack of education on how much sugar we consume every day – especially when it comes to children and the elderly. Parents may believe they are doing right by feeding their children processed fruit juice or raisins, however products such as these are mostly sugar. Processed foods also can be harmful because of the low-nutrition and high-sugar content. Substituting these products for fresh fruits and vegetables is a better option.
Kids who consume too much soda and not enough nutritional beverages are prone to tooth decay in addition to serious ailments later in life, such as diabetes and osteoporosis. Drinking carbonated soft drinks regularly can contribute to the erosion of tooth enamel. Enamel breakdown leads to cavities. If erosion spreads beneath the enamel, pain and sensitivity may eventually result. This can cause nerve infection, which can result in the need for a root canal.
How to Prevent Tooth Decay in Children
Children at school should rinse their mouth with water after meals, leaving their teeth free of sugar and acid. Encourage children to drink water. Use a straw when drinking soda to keep sugar away from teeth. Remember, bottled juices are not a good alternative due to the high sugar content.
The Good:
1. Sugar-free lollipops and hard candies: These treats stimulate saliva, which prevents dry mouth. A dry mouth allows plaque to build up on teeth faster, leading to an increased risk of cavities.
2. Sugar-free gum: Chewing gum can actually prevent cavities, not only because it helps to dislodge food particles from the teeth, but also because it increases saliva. Saliva works to neutralize the acids of the mouth and prevent tooth decay.
3. Dark chocolate: Chocolates are loaded with sugar, but studies have shown that the antioxidants in dark chocolate can be good for the heart and may even lower blood pressure. Just be sure to eat it in moderation.
The Bad:
1. Sugary snacks: Candy corn, cookies, and cake all contain a high amount of sugar, which can cause tooth decay.
2. Chewy/sticky sweets: Gummy candies, taffy, and even dried fruit can be difficult for children and adults to resist, but they are a serious source of tooth decay, particularly when they get stuck in the crevices between teeth and make it nearly impossible for saliva to wash away.
3. Sour candies: High acid levels in these treats can break down tooth enamel quickly. The good news: Saliva slowly helps to restore the natural balance of the acid in the mouth. We recommend that children wait 30 minutes to brush their teeth after consuming acidic foods or drinks, otherwise they will be brushing acid onto more tooth surfaces, increasing the erosive action.
So this Halloween season, try not to overdo the sweets. And, that goes for the little ones, too!
