The American Dental Association (ADA) celebrates Children’s Dental Health Month in February. What started in 1941 as a day turned into an entire month by 1981. And judging by the statistics, that may not be enough. Data from the CDC shows from 2011-2016, 23% of children aged 2-5 years had dental caries.1 THE Care Quest Institute for Oral Health states that “early childhood dental caries remains the most common, preventable infectious disease among children in the United States.”2
Every year during the month, I visit preschools and kindergartens to get kids excited about brushing, cleaning between their teeth, making healthy choices with what they eat and drink, and seeing the dentist. Part of the presentation always involves wearing all my PPE, lab coat, goggles, mask and gloves. I like to show kids that while I may look different or even scary, I’m the same person they were laughing at a minute ago. While I’m covered, I have the kids open their mouths and take a quick look.
This year, I had a surprise.
In the 20+ years I’ve been doing this, I’ve never seen so much obvious untreated decay in children’s mouths — and that was from a quick glance. There is no telling what a proper examination would reveal. Many of the schools I visit are in affluent neighborhoods where access to care is not an issue. So what’s the problem? Why the change?
The American Academy of Pediatric Dentists (AAPD) reported in 2019 State of Little Teeth that while tooth decay had decreased, one in five children under the age of 5 have developed tooth decay and almost half of children aged 6-11 are affected.3 Children living in poverty are twice as likely to develop caries.
Dental house
These preschoolers are COVID-19 babies. Haven’t been to the dentist yet? THE AAPD recommends that children see a dentist for an initial checkup by their first birthday.4 Some sources say to make an appointment when the first tooth erupts. Having an established dental home helps identify any early problems and sets a standard for dental care. Scheduling a “get to know” visit can show a child that going to the dentist can be fun.
The fluoride debate
Aren’t these kids getting fluoride in their drinking water and toothpaste? Fluoride has become a hot topic. Depending on where parents fall on the survey, this could be something they avoid. If fluoride is something you or they aren’t a fan of, I won’t light the fire, but offer other anti-wear products. Review products with nanohydroxyapatite, arginineor xylitol to create an oral environment less prone to decay.
Diet
The preschool teachers specifically asked me to talk to the kids about what they were eating and drinking at snack time. Obviously, lunch boxes are filled with sugary drinks and treats. When I asked the kids to tell me a healthy snack they could put in their lunchbox, some mentioned fruit bars or sticky snacks. Both can be full of sugar. Constantly sipping juice from glass cups seems commonplace.
Mouth breathing
Another thing I saw in my “quick glance” was the full baby teeth. Typically, baby teeth have large gaps in between to make room for the larger permanent teeth to erupt. Crowded baby teeth may indicate that the arches are too narrow, leading to poor facial development and unhealthy airway development.
Give a role in children’s nutrition the development of their jaw? Could all the squishy pouches and processed soft foods rob them of the opportunity to chew and therefore leave them with a gaping or underdeveloped jaw? They are then forced to breathe through their mouths, increasing the risk of tooth decay and gingivitis.
My experience may be unique, but I have a feeling it’s not. Spreading the message of good oral health to children, parents and carers is so important. With minimally invasive interventions like silver diamine fluoride for a painless way to care for tooth decay, I hope to see less and less tooth decay in children in the future.
References
- Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Bruxism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services. 2019.
- Expanding inclusion and access for children’s dental health. CareQuest Institute for Oral Health. September 27, 2023.
- Hill BJ, Meyer BD, Baker SD, et al. State of Little Teeth report. 2nd ed. Chicago, IL: Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry; 2019.
