More Preschoolers with Cavities Requiring Dental Surgery
March 8, 2012
What’s worse than going to the dentist? Taking your kids to the dentist—especially to find that they’ve got multiple cavities before they’re in kindergarten. The New York Times reports that a rise in the number of preschool cavities has led to a rise in the number of preschoolers requiring extensive dental work (often necessitating general anesthesia). Um, I guess not going to the dentist is actually worse than going.
As a mom of 2- and 4-year-old boys, I found myself squirming as I read the article, which led with a 2-year-old Seattle boy’s root canal, fillings and crowns, done to repair 11 cavities (kids that age have just 20 teeth in total). The Times reports that dentists nationwide are seeing more preschoolers from all socioeconomic backgrounds with 6 to 10 cavities or more, with a level of decay often necessitating general anesthesia because such young children have a hard time tolerating such extensive dental repairs while awake. (I’d have a hard time doing so too!)
While the number of preschool cavities is rising, dentists say that such tooth decay (and its painful treatment) is mostly preventable. Constant snacking, too much juice or other sugary beverages, drinking bottled water instead of fluoridated tap water and simply not knowing that kids so young should see a dentist are behind many of these cavities.
We checked in with Lawrence Limb, DMD, a pediatric dentist in New York City, to get his take on whether this is as serious and widespread a problem as it seemed after reading the Times’ report (hint: it is) and his suggestions for how parents can help prevent tooth decay in the littlest of kids.
In babies, Dr. Limb said that parents can usually get away with wiping the gums prior to the eruption of teeth to reduce the amount of bacteria on the gum pad. “As the teeth erupt (around six months), start introducing a toothbrush after each feeding,” he suggests. The American Academy of Pediatric Dentistry (AAPD) recommends using a “smear” of fluoridated toothpaste and a soft, age-appropriately sized toothbrush until age 2, and then a “pea-size” amount for kids ages 2 to 5. And while brushing after each feeding might be ideal for dental hygiene (albeit a lofty goal) while babies are at home, he acknowledges that for those in daycare or young children at school, brushing a minimum of twice a day should suffice.
Of course, brushing a young child’s teeth isn’t as easy as brushing one’s own. But Dr. Limb points out that giving up on brushing or not doing a thorough job will lead to cavities and fillings down the line—which are vastly more painful than the temporary discomfort (or all-out tantrums) associated with brushing. If your child is particularly resistant to teeth brushing, Dr. Limb reassures that, “Kids do grow out of it as traumatic as it may seem. Treating the teeth [when there are cavities] is much more traumatic and difficult for the parent, patient and dentist.”
So, think you’ve got it covered because you brush your children’s teeth twice daily? How ‘bout flossing? “Flossing is as important as brushing,” says Dr. Limb. “It’s not easy to do as a parent, but it’s necessary,” especially between the back molars, which kids will need for chewing until 10 to 12 years of age, and which are at the highest risk of developing dental caries (cavities).
And no need to wait until all of your child’s teeth are in to make a first visit to a dentist. The AAPD recommends seeing a pediatric dentist once the first tooth emerges, or no later than the child’s first birthday. Surprised? I was too—especially since my kids’ pediatrician hadn’t recommended making that first trip until age 2 (which in all honesty seemed really early to me even then). But, Dr. Limb explains that that first trip is important in terms of helping to establish not just proper oral hygiene but also getting parents to be more mindful of their children’s diet and nutrition and their impact on dental health. Following that first visit, Dr. Limb and the AAPD recommend check-ups every six months.
Not concerned about potential cavities because your child’s teeth look fine and he seems happy? Dr. Limb explains that cavities are often found in the back teeth (which are tough for parents to see well) and adds that many kids never experience any kind of oral pain unless there is a significant amount of decay—so don’t assume that your kid’s teeth are healthy just because he hasn’t complained to say anything is hurting. Additionally, dentists can find and treat cavities at a very early stage, using local anesthesia and a DVD for distraction, instead of the heavier duty sedation required for long, multiple procedures.
Adds Dr. Limb, “There are risks with general anesthesia or any kind of sedation with a child. Any conscientious doctor will always be concerned. In my office we try to treat children while awake. [These procedures] also place a great amount of financial liability on the parent—but can be easily avoided. As dentists, we really try to drive home the fact that these things can be avoided—[cavities] are treatable, but prevention is the best treatment overall.”
Dr. Joel Berg, director of the Center for Pediatric Dentistry at the University of Washington and Seattle Children’s Hospital, explained to TIME.com why treating cavities in baby teeth is so important, especially when those teeth will fall out anyway: “’We have to fix cavities to treat the overall health of the child. We see kids coming into emergency rooms with swollen faces from untreated cavities. Kids are not good at reporting tooth problems and this can lead to other orthodontia problems later and even trouble paying attention at school.’”
To help prevent cavities in the first place, Dr. Limb and other dentists recommend:
- seeing a dentist regularly
- drinking fluoridated water (bottled water generally has little to no fluoride)
- eating a balanced diet
- reducing the frequency of snacking
- paying attention to proper oral hygiene (including regular brushing and flossing)
- avoiding sharing utensils or putting your child’s pacifier in your mouth, as tooth decay can be contagious
Has your child had any cavities yet?