USA - Cavities: a preventable childhood health crisis

The most chronic childhood disease isn't asthma but dental caries, or cavities.
"It's five times more common than asthma," said Dr. Deborah Studen-Pavlovich, professor and chairman of the Department of Pediatric Dentistry in the University of Pittsburgh School of Dental Medicine.
According to the Centers for Disease Control's Division of Health, more than half of children aged 5 to 9 have had at least one cavity or filling, and 78 percent of 17-year-olds have experienced tooth decay.
The CDC also said children and adolescents living in poverty (annual income of $17,000 for a family of four) "suffer twice as much tooth decay as their more affluent peers, and their disease is more likely to go untreated."
Those caries and other dental health issues not only can cause pain and affect children's speech and self-image but also lead to systemic health issues that can affect their overall health.
In fact, according to CDC data, dental-related illnesses translate into more than 51 million missed school hours per year.
But, 90 percent of all tooth decay is preventable simply by following rules of good nutrition and, more important, care of teeth and gums. That effort should start when the child is an infant.
"Prevention is better than treatment," Studen-Pavlovich said. "It's cheaper.
"Examine early. You want the first dental visit at 1."
But dental visits are only a small part of appropriate dental care. "You only see a dentist twice a year, and that leaves 363 days (without that attention)," Studen-Pavlovich added. "You need good home health care to maintain your teeth. I think everyone looks for a quick fix, but the bottom line is to take care of teeth every day. It has to be a habit. You don't just exercise once a month. Dental health is part of total health."
Parents have to provide that care for the first few years. It should start when the children are infants, with parents using a washcloth wrapped over a finger to clean their baby's gums, Studen-Pavlovich said.
Babies also should not be allowed to fall asleep with bottles of milk, juice or other sugary liquids in their mouths. The same holds true for pacifiers dipped in sugar or honey.
"That's because when a child sleeps, his or her salivary process slows, allowing sugary liquids to coat the teeth and gums (and) cause tooth decay," according to a release from the American Academy of Pediatric Dentistry.
As primary, or baby, teeth come in, kids can learn to brush, "but parents need to supervise until the child has permanent 6-year-old molars in with sealants," Studen-Pavlovich said. "Then the child can take over. Up until then he doesn't even have the dexterity to throw a ball and catch it. How can they take care of teeth?"
The dental care market is filled with products to make dental care more fun for kids. They run from "disclosing tablets," which turn plaque to bright colors to show children where to brush, to toothbrushes bearing pictures of favorite characters, to fun-flavored rinses and toothpastes.
But parents must be careful with flavored products containing fluoride as children may swallow them and take in too much of the chemical compound. Too much fluoride, which is a topical agent for preventing cavities, can lead to fluorosis, which mottles the surface of developing teeth waiting to erupt through the gum.
The risk of fluorosis also means parents should be careful of fluoride supplements. They're probably not needed, Studen-Pavlovich said, if the water supply is fluoridated optimally. Municipal water sources generally are, and, she said, "some wells have naturally occurring fluorides in them."
Poor dietary habits come into play with older children and teens, Studen-Pavlovich said.
"You see adolescents with uncontrolled diets. They stay after school for activities, and they don't eat regular meals," she said. "Once you have more than three meals and two snacks per day, you don't leave teeth time for remineralization.
"Any time you have a lot of food, the pH balance becomes more acidic and the enamel breaks down. Carbohydrates are not good for that. It's not only just sweets that are bad."