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Take care of children's teeth, gums
Health advice
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The most common chronic childhood disease, dental caries is five times more common than asthma and more prevalent than chronic bronchitis in children. Left untreated, caries may affect the growth of adult teeth, resulting in poor dental health and disease in adulthood. Caries can lead to infection, pain, abscesses, chewing problems, malnutrition and gastrointestinal disorders and can affect speech and articulation.
Like many chronic diseases, the risk factors of early childhood caries also contribute to childhood obesity and malnutrition. Children with poor dental health may also experience associated symptoms, including inadequate nutrition, poor self-esteem and problems with speech development.
The timing of the eruption of a child’s first tooth is largely influenced by genetics, but what happens after that is most often due to the type — or lack of — dental care a child becomes accustomed to. Dental decay is one of the most common chronic infectious diseases among U.S. children and is the No. 1 cause of school absenteeism in the United States.
Dental decay is an infection of the tooth and this condition is preventable even when there are risk factors that contribute to the condition. Four things are necessary for decay and cavities to form:
• a tooth
• bacteria
• sugars or other carbohydrates
• time
When teeth come in frequent contact with soft drinks and other sugar-containing substances, the risk of decay formation increases. Low-income children have twice as much untreated decay as children in families with higher incomes. Poor nutritional and dental care habits, infrequent visits to a dentist and lack of exposure to fluorides contribute greatly to their incidence of decay.
This preventable health problem begins early with 28 percent of children between the ages of 2-5 already having decay in their baby teeth.  By age 8, approximately 52 percent of children have decay. And by age 17, dental decay affects 78 percent of children.
Even children and adults who are at low risk of dental decay can improve their risk and stay cavity-free through frequent exposure to small amounts of fluoride. This is best accomplished through drinking fluoridated water and using a fluoride toothpaste twice daily. Children and adults at high risk of dental decay may benefit from using additional fluoride products, including dietary supplements. This is especially true for those children who do not have adequate levels of fluoride in their drinking water. Mouth rinses and professionally applied gels and varnishes are other options that can prevent decay.
Parents know that they need to watch what their kids eat and make them brush regularly but many appear to be unaware that letting kids sip on sugary drinks for hours or putting them to bed with a bottle of milk can be just as harmful. Tooth decay and the resulting problems of pain, dental dysfunction, being underweight, and the resulting poor appearance from bad teeth can greatly reduce a child’s capacity to succeed in their educational and social environment.
According to present recommendations of the American Academy of Pediatric Dentistry, the first visit to the dentist should be when the first tooth comes in, usually between 6 and 12 months of age. The recommendation used to be that a child see a dentist at 3 years of age but because so many children have cavities by the time they start kindergarten, AAP now suggests that high-risk children see a dentist six months after their first tooth erupts or before they are 12 months old.
So when should the first visit be? If your child doesn’t have any high-risk factors for developing cavities, such as sleeping with a cup or bottle or walking around all day with a cup of juice, and if his teeth seem to be developing normally, then you can probably wait until your child is older. But ask your pediatrician to check his teeth at each visit and get his recommendation.
To prevent tooth decay, parents need to:
• Maintain a healthy diet for the family.
• Make sure water is readily available and encourage the use of fluoridated water. If your family buys bottled water, check the label for the fluoride content.
• Limit the number of between-meal snacks and choose nutritious foods that are low in sugar when snacks are provided.
• See that everyone brushes their teeth thoroughly twice a day with a fluoride toothpaste that has the American Dental Association’s Seal of Acceptance.
• Assist younger children and oversee older ones as they floss or use another kind of interdental cleaner daily to remove plaque from under the gums and between teeth.
• Schedule regular dental visits for checkups and cleanings.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.
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