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The Pediatric Group Blog

Dr. Helen Rose and her colleagues at the Pediatric Group offer sound advice and commentary on todays most pressing children's health issues.

The Pediatric Group Blog

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Most recent posting below. See other blog postings in the column to the right.

Look Ma, No Cavities!

December 04, 2009 By Peter E. Gibson

Look Ma, No Cavities!

(How to keep your child free of tooth decay)

by Richard Holstein, D.M.D., FADH – Princeton Pedodontics

In this age, in this country (and particularly in the Princeton area), there is no reason for a child to have tooth decay!

This is not a pipe dream. With common-sense parenting and knowledge, you can raise your child to be dentally healthy without being “deprived”.

Tooth decay is a disease, mediated by two factors: bacteria and sugar. Everyone has bacteria living in their mouths. Certain strains of these bacteria love to metabolize (eat) sugar (especially sucrose). They produce acid from the sugar; the acid dissolves the tooth structure, and causes caries (tooth decay). It’s really that simple. Now, how do we prevent this from happening?

Before we begin, you should understand that EVERY child is different (even within the same family). The types and quantities of bacteria that each child supports are unique to him/her – that’s the “nature” part of the equation. The “nurture” part is what that child eats, and how well he/she is cared for. You can directly influence bacterial growth by controlling what (type, how much, how often) your child eats. You will occasionally hear someone say that their child has “soft teeth[i]” – that’s just not true, and is a convenient excuse for lack of care. You CAN control this process.

Very shortly after you eat something with sugar, the decay process begins. This applies to parents as well as children, just in case you thought you were immune. The extent of damage is dependent upon type of sugar[ii], the amount of time it remains upon the teeth, and the quantity of decay-forming bacteria[iii].

Things that are BAD to eat (we won’t call them “food”) are sweet and sticky. They become wedged between the teeth and in all of the grooves, feeding the bacteria that live there, until they are removed or decompose. Sweet cereals can often be found in children’s mouths days after they eat them, even when they brush. Remember that the brush does not clean between the teeth. The more sticky (“retentive”), the longer they remain, and the more difficult they are to remove. (Dentists sometimes use Jolly Ranchers to remove crowns from teeth; think about it.) Sweet cereals, “granola bars”[iv], “pop tarts”[v] and “fruit rollups” are at the very top of the list for causing tooth decay. They all offer little, if any, nutritional value and are harmful to your children. In a global sense, these cause much more tooth decay than “candy”[vi]. These can easily be avoided, and should always be considered harmful to your child. They should be banned from schools (along with sodas and other sweet snacks). So many wonderful alternatives exist[vii] that are healthy. Your children WILL eat, and probably love these, if your raise them that way. This is where PARENTING comes in.

Less retentive sweets, like ice cream, jello, etc., are usually less harmful – as long as they are removed quickly. A healthy child who eats Halloween candy for two days (and brushes and flosses) – and then throws the remaining candy in the garbage (where it belongs) – will suffer little consequence. The child that eats a little every day (particularly at bed time, after having hidden it in his/her sock drawer), will probably have tooth decay. Frequent drinking of “juice” or “sport drinks” may also cause/accelerate tooth decay[viii]. The child that already has cavities developing will see these getting much bigger, much faster, with ANY sugar intake[ix]. Parenting, once again!

So, limiting the type and amount of sugar intake can reduce tooth decay! The other major factor is Oral Hygiene[x]. Ideally, your child should have his/her teeth cleaned after every meal. That is usually not achievable, but brushing at least two to three times a day is absolutely necessary to disrupt harmful bacteria and remove food from accessible tooth surfaces. Be sure to brush AFTER breakfast, BEFORE bedtime, and following any afternoon snacking, if possible. We strongly advise that parents floss the teeth of their younger children, and make sure that their older progeny do this. It’s generally a good idea to floss together – set an example for your child while you assist with refining flossing technique[xi].

A tooth that is damaged by tooth decay will never be the same. Even our best achievements in dental restoration pale in comparison to a healthy tooth. Many of you already, unfortunately, know the consequences of not taking care of yourselves. You will have happier, healthier children, and relatively insignificant dental expenses, if you do your jobs well. Be sure to have your child(ren) see a qualified Pediatric Dentist on a regular basis, just as you see your Pediatrician. We are both passionate about children’s health, and will work with you to make their lives as happy and healthy as possible.

[i] There are RARE conditions in which tooth enamel can be defective. This does not apply to the average child.

[ii] The worst is sucrose

[iii] Primarily Streptococcus Mutans

[iv] Generically, they are “stuck together” with sugars of varying kinds.

[v] …again, in the generic sense

[vi] Which I do not endorse either, but which is unavoidable and is to be monitored carefully.

[vii] …such as fruits, vegetables, etc.

[viii] …not to mention the statistic on Diabetes

[ix] …a really good reason for regular dental check ups.

[x] Tooth brushing and flossing

[xi] And keeping yourself from needing Periodontal procedures while you’re at it.