Dentists worry whether youngest patients get enough attention

If you’re among those parents who believe baby teeth don’t matter, think again.

Not only do they hold the space for permanent teeth, dentists say baby teeth facilitate speech and, when straight and cavity-free, promote healthy self-esteem in children. Ignoring them can lead to decay and even death.

“A lot of parents are thinking it’s a baby tooth, they will lose it,” said Dr. Rhea Haugseth, who has been a practicing pediatric dentist in Marietta for 32 years. “But even if they can get the pain under control, when they have a toothache, they are not eating or sleeping, so they can’t function very well. Sometimes a parent will see a cavity but they ignore it because they aren’t feeling the pain. Some kids have a high pain threshold, so they don’t complain. But it’s impacting their ability to function in school.”

Bobbi McLure of Kennesaw made the discovery the hard way, she said, when her older daughter Alexis got her first cavity at age 1.

“It didn’t seem like a big deal, but when I took her to see a dentist, she had some pretty bad plaque and a cavity on her front tooth. That surprised me,” McLure said. “I learned very quickly what was important.”

For low-income and minority children, the chances of getting cavities are even greater because they are less likely to see a dentist than other children are, said Dr. Edward Moody, president of the American Academy of Pediatric Dentistry. Even though the Affordable Care Act makes pediatric dental benefits more readily offered, he fears this trend may get worse rather than better.

“Dental decay is the most common chronic disease in childhood, five times more common than asthma,” Moody said. “What is most frustrating for our organization is that most tooth decay is preventable.”

To address the threat of cavities, Moody said the AAPD is launching an educational campaign to arm parents and caregivers with important tools and information to help fight tooth decay.

As part of the initiative, the AAPD recently released its first-ever “State of Little Teeth Report,” which found, among other things, that too few parents are taking their children to see the dentist, too few dentists see children on Medicaid and there is a shortage of dentists skilled in treating children.

A cavity is an infection, Moody said. Left untreated, it can extend to the nerve of the tooth, causing inflammation and ultimately an abscess and even death.

“There was an incident in Maryland where a child died from a dental infection,” he said.

Moody, who practices in Morristown, Tenn., said dentists across the country are seeing a huge increase in the number of children age 6 and younger with cavities.

Although she has been taking her kids to the dentist since 5-year-old Alexis turned 1, McLure said that she repeated the same mistake with her second child Christopher, now 3.

“I attributed that to drinking milk throughout the day instead of just at mealtime,” she said.

McLure said she doesn’t intend a repeat with her youngest child. Instead she will adhere to Haugseth’s guidelines and limit her children’s snacking, assist them with brushing and set her kitchen timer for the recommended two minutes during brushing.

According to the Centers for Disease Control and Prevention, about 60 percent of U.S. children will have had cavities or tooth decay at some point by age 5, including the 40 percent of children who have cavities when they enter kindergarten.

Doctors say the infection can impact a child’s physical and social health. The Surgeon General’s Report on Oral Health estimates that more than 51 million school hours are missed by children across the country each year because of dental or related problems.

Haugseth said rates of tooth decay have been creeping up at least for the past decade.

“This is a silent epidemic because unless the kids are complaining, the decay is growing,” Haugseth said. “Among new patients, I’m seeing a 25 percent increase in decay, especially in kids under 5.”

Why?

Because many parents have a hard time connecting what goes on in their children’s mouths with their overall health.

Both Moody and Haugseth recommend a child’s first dental visit occur as soon as teeth begin to come in and definitely no later than age 1. The old recommendation of age 3 is simply way too late and is no longer accurate, according to guidelines of the American Academy of Pediatric Dentistry, the American Academy of Pediatrics and the American Dental Association.

“That would be a huge step,” Moody said. “I see kids who have 20 baby teeth with as many as 12 cavities all the time. If we see them early, we can talk about how to avoid these problems.”

If someone is in a high-risk group — such as having previous decay or being a member of a low socio-economic group — that patient should see a dentist three or four times a year.

“What’s helped us so much is some insurances and Medicaid recognize that the more we see these high-risk kids, the better we are at preventing complex and costly treatments because decay tends to spread much more rapidly in kids,” Haugseth said.

In addition to regular dental visits, doctors said parents should help with brushing. Unless a child is able to cut his or her own meat, most kids don’t have the motor skills to do a good job brushing their teeth.

“Parents have got to be aggressive and help kids brush, for two minutes twice a day,” Haugseth said. “They can’t take the attitude that these are baby teeth and they’ll come out. Baby teeth are important.”