DID YOU KNOW THAT TEETH CAN "CATCH" CAVITIES?
by E. Walter Wolford, DDS, MPH
NM Public Health Division
Dental Health ProgramDecay of a child's baby teeth-Early Childhood Caries (ECC)-is a very common, and also unnecessary, health problem of infants and toddlers. It can be considered an epidemic with rates up to ninety percent in some communities. Major factors contributing to early tooth decay are germs, genetics, oral hygiene and diet.
Germs are a key component of tooth decay (cavities). primary germs responsible for the tooth cavities belong to the family called Streptococcus Mutans (S Mutans). These germs can be passed to the infant or toddlers through mouth contact with parents and other adults, during feeding (such as simply sharing foods and eating utensils), routine play (children putting objects in their mouths), and other daily activities. Once the child is infected, the S. Mutans germs create a film on the teeth that contains billions of germs and is hard to remove. When the child eats, the germs "eat" by breaking down the sugars in foods and producing acid as a byproduct within the film. This acid, in turn, removes the minerals from the teeth causing a "chalky white spot" to appear that can become a cavity.
Genetics appear to play a role too, because not all children infected with the germs develop ECC. The condition runs in families, suggesting there is susceptibility to ECC that probably is genetically based. We cannot control child and parent genetics, so researchers are studying ways to control the S. Mutans bacteria. One approach has been to reduce the spread of these germs from parents (especially mothers) by decreasing the number of germs in the adult's mouth. A study of German mothers, who used a germ killing mouthrinse as part of a child dental care program, resulted in their young children having no cavities at 3 years of age.
Daily oral hygiene means proper and daily cleaning of teeth and gums. It is essential to reduce the growth of the ECC causing germs in both parents (or caregivers) and children once their teeth start to come in. To improve this area, much research has focused on making tooth surfaces stronger and treating the "white spot" damage. Studies show that fluoride, when available on a continuous basis, leads to stronger teeth. Children who drink water with appropriate levels of fluoride have less tooth decay, and using a small amount of fluoride toothpaste when brushing the teeth fortifies them. Also, if dental care providers apply higher amounts of fluoride to ECC "white spot" damage in the early stages, it will heal.
Diet control is critical too for managing ECC. A diet high in cavity-causing foods, those with high amounts of sugar or salt, is a prescription for disaster. Much research has focused on bottle feeding practices, because a bottle filled with a sugar-containing beverage and given to a child at naps or bedtime is a main cause of ECC. Under these conditions the sugary solution pools around the front teeth for long periods, allowing germ-produced acid to attack them. In contrast, studies of breast-feeding even for prolonged periods at night have not been linked to early cavities.
Prevention of dental cavities in infants and toddlers is the key. Parents/caregivers can help their children by following these simple procedures.
- Parents and caregivers should get dental care routinely. Reducing the number of germs in their mouths lowers the risk of passing these to a child. As the tooth decay germs are transmitted most easily to children between 19 and 31 months of age, having caregivers rinse daily with a germ fighting solution, especially during this time period, reduces the EEC risk. Consult your dentist for more information on prescription mouthrinses.
- When putting an infant to bed with a bottle, make sure it only contains plain water. Note that many baby formulas and other fluids contain sugar that sets up the environment for tooth decay.
- Limit the amount of sweet and salty foods the child eats, especially between meals. A child's dietary habits often continue into adulthood and eating large amounts of sugary and salty snack foods can lead to lifelong dental problems.
- Clean the young child's teeth and gums daily.
- Before the teeth appear, use a dampened wash cloth to clean the infant's gums.
- As the baby teeth arrive - beginning around age 7 months-brush around each tooth using a soft child-size toothbrush with small (pea-sized) amount of fluoride toothpaste. Limit the amount of toothpaste the child swallows by wiping the excess off the teeth.
- Teach children to clean their own teeth as soon as they can handle a toothbrush, and continue to supervise so teeth are cleaned thoroughly.
- Check a young child's teeth monthly in by lifting the lip and looking for "white chalky spots" at the gumline. If any are found, immediately seek professional care.
- Fluoride is very important for lifelong healthy teeth. Know the concentration of fluoride in the water the child is drinking. The New Mexico Department of Health, Dental Health Program has data on the fluoride content of community water systems. For children drinking private well water, call the NM Dental Health Program at (505) 827-7512 to get a test and report on the fluoride content.
- Begin regular dental visits for the child at age one year. Your dental professional will check for early signs of dental disease. Also it allows your child to become familiar with the dental office.
Enjoy your child! You can't do much about a child catching the flu, but now you have the information to keep your child from "catching a cavity."
For more information you can contact Dr. Walt Wolford at (505) 827-7512 or by E-mail at: waltw@doh.state.nm.us
For more information, you can contact Dr. Walt Wolford at (505) 827-7512 or by E-mail. Dr. Wolford is with the New Mexico Public Health Division, Dental Health Program at the New Mexico Department of Health.
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