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| Volume 1, Issue 15 | JANUARY 2004 |
| Inside This Issue | |||||
| 1 | Oral Health of Children | ||||
| 2 | Updates and Announcements | ||||
Medical Information Fact Sheet
Dental caries, also known as tooth decay, has been reported by The Centers for Disease Control and Prevention, as one of the most prevalent infectious diseases of our nation’s children. Dental caries are five times more common than asthma and seven times more common than hay fever in children. It is estimated that more than 40% of children have tooth decay by the time they reach kindergarten. Healthy teeth and gums are essential to a child’s overall good health. If a child’s teeth develop diseases or do not develop properly, this can ultimately result in poor nutrition, painful and dangerous infections, problems with speech development, and problems with self-image.
Definitions and Causes of Tooth Decay:
Dental caries is a progressive disease that often begins in very young children and is one of the most common of all disorders, second only to the common cold. Decay is a result of the interaction between the bacteria that are normally on our teeth and the sugars that are in our everyday diet. The bacteria convert all food into acids. Bacteria, acid, food debris, and salvia combine in the mouth to form a sticky substance called plaque that adheres to the teeth. Plaque is most prominent in the back molars, just above the gum line on all teeth, and at the edges of fillings. Plaque that is not removed from the teeth mineralizes into tartar. Plaque and tartar irritate the gums, resulting in gingivitis and ultimately periodonitis.
Plaque begins to accumulate on teeth within 20 minutes after eating and if the plaque is not removed routinely (i.e. brushing and flossing daily), then tooth decay starts. The acids in plaque dissolves the enamel surface of the tooth and create holes, otherwise known as cavities. Cavities are usually painless until they grow very large and destroy the nerve and blood vessels in the tooth. If left untreated, a tooth abscess can develop. This untreated decay also starts to destroy the internal structures of the tooth (pulp) and ultimately results in the loss of the tooth.
Most cavities, fortunately, can be discovered in the early stages of decay during routine dental checkups. The surface of the tooth may be soft when probed with a sharp dental instrument and pain may not be present until the advanced stages of tooth decay. Dental x-rays are another tool to help detect cavities before they are visible to the eye. Unfortunately, once a tooth begins to decay the area of the tooth affected by the decay is destroyed and does not regenerate itself, however the progression of cavities can be stopped by treatment.
Treatment often can preserve a tooth and early treatment is less painful and less expensive than treatment of extensive decay. The goal of treatment is to preserve the tooth and prevent further complications of decay.
A filling in the tooth is a process were the decayed material is removed (usually by drilling) and replaced with a restorative material such as silver alloy, gold, porcelain, or composite resin. Porcelain or composite resin most closely match the appearance of a natural tooth, and may be preferred for the front teeth. Many dentists consider silver alloy and gold stronger and are often used on the back teeth. Crowns are used if decay is extensive and there is limited tooth structure, which may cause weakened teeth. Large fillings and weak teeth increase the risk of the tooth breaking. The decayed or weakened area is removed and repaired. A covering jacket or “cap” (crown) is fitted over the remainder of the tooth. Crowns are most often made of gold, porcelain or porcelain fused to metal. A root canal is recommended if the nerve in the tooth dies from decay or from a traumatic blow. The center of the tooth, including the nerve and pulp, is removed along with the decayed portions of the tooth. The roots are filled with a sealing material and a crown may be placed over the tooth if needed.
Proper dental hygiene practices done early and properly are the first line of defense in preventing dental problems in the future. Oral hygiene is necessary in preventing cavities and decay. These practices consist of brushing at least twice a day and flossing daily. Regular dental exams and cleanings are recommended every six months and x-rays may be taken yearly to detect possible cavity development in the high-risk areas of the mouth. Dental sealants are used to prevent cavities. Sealants are a thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents the accumulation of plaque in the deep grooves of these vulnerable surfaces.
Sealants are usually applied on the teeth of children, shortly after the molars erupt, and can dramatically reduce the risk of tooth decay in children.
Fluoride is often recommended to protect against dental caries. It has been shown that individuals who ingest fluoride in their drinking water or by fluoride supplements have fewer dental caries. Fluoride ingested when the teeth are developing is incorporated into the structure of the enamel and protects it against the action of acids. Topical fluoride can also be recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include the application of topical fluoride solutions as part of a routine dental visit checkup.
Baby bottle tooth decay is a dental condition that can destroy the teeth of an infant or young child. The upper front teeth are the most susceptible to damage, but other teeth can also be affected. This condition is caused by the frequent and long-term exposure of a child’s teeth to liquids containing sugar. These liquids include milk, formula, fruit juice, sodas, and other sweetened drinks. The sugars in these liquids pool around the infant’s teeth and gums, feeding the bacteria that cause plaque. Every time the child consumes a sugary liquid, the acid attacks his/her teeth, which after repeated exposure, allows the tooth decay to occur and ultimately resulting in decay. Parents and caregivers should be especially concerned with giving an infant a sugary drink at nap or nighttime. During sleep, the flow of salvia decreases, allowing the sugary liquid to pool around the child’s teeth for an extended period of time. Baby bottle tooth decay can cause painful toothaches, which can hinder eating. Severely decayed teeth can become infected and may need to be extracted. If the child’s teeth are infected or lost too early due to the decay, the child may develop poor eating habits, speech problems, crooked teeth, damaged adult (permanent) teeth, or yellow or brown permanent teeth.
The risk of baby bottle tooth decay not only applies to bottle fed babies but also to breast fed babies. Nursing-pattern dental decay is related to the extended and repetitive feeding times and prolonged exposure of the erupted teeth to the bacteria and acids in the mouth. Parents sometimes do not realize that their baby’s teeth are susceptible to decay as soon as they appear in the child’s mouth. By the time the decay is noticed, it may be too late to save the child’s teeth. However, this decay is avoidable and preventable by knowing how to protect the child’s teeth. It is recommended that infants should not be put to sleep with a bottle containing a sweetened liquid. If the child refuses to go to sleep without a bottle, simply fill it with water and nothing else. Parents are encouraged to have infants drink from a cup as they approach their first birthday. Infants should be weaned from the bottle or breast between 12 and 14 months of age. After each feeding, parents should wipe the child’s teeth and gums with a damp washcloth or a small soft toothbrush to remove the plaque. Parents should begin brushing the child’s teeth as soon as the first tooth appears. Flossing should begin when all the primary teeth have appeared, usually by age 2 to 2 ½ years of age. Regular dental visits should begin around age 1 so that any problems can be detected, treated early, or more importantly avoided completely.
Birth to 6 months
- Clean mouth with gauze after feedings and at bedtime.
- Ask your pediatrician or pediatric dentist about fluoride supplements.
- Regulate feeding habits.
6 to 12 months
- First tooth should appear; time to see the pediatric dentist for an exam.
- Begin to brush teeth after each feeding and at bedtime with small, soft-bristled brush.
- Wean from breast or bottle by first birthday.
12 to 24 months
- Follow schedule of exams and cleanings recommended by pediatric dentist.
- Start using pea-sized portions of fluoridated toothpaste when child is able to rinse.
American Academy of Pediatric Dentistry. (2001, November 17). The Pediatric Dentist. Retrieved on January 13, 2004 from the World Wide Web: http://www.aapd.org/publications/brochures/peddentist.asp.
California Dental Association. (2000, March 9). Baby Bottle Tooth Decay. Retrieved on January 13, 2004 from the World Wide Web: http://www.cda.org/public/cch2fs.html.
California Dental Association. (2002, October). Implementing an Infant Oral Care Program. Retrieved on January 13, 2004 from the World Wide Web: http://www.cda.org/member/pubs/journal/jour1002/infant.html.
Medline. (2003, October 22). Dental Cavities. Retrieved on January 13, 2004 from the World Wide Web: http://www.nlm.nih.gov/medlineplus/ency/article/001055.htm.
HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!
We would like to congratulate Michelle Haynes on her promotion to Senior Public Health Nurse. She will be at the Arlington Office on Hole Ave.
Congratulations!!!!
Editor: Kristen Thompson, PHN
Contributors: William Chavez, PHN, MBA, Assistant Nurse Manager and Judy Earp, MHA, Director of Public Health Nursing.
