You bring your toddler to a pediatric dental care office, a little nervous perhaps over whether she will be able to sit still and allow the staff to examine her mouth.  It all goes surprisingly well until the X-rays appear on-screen showing cavities…in half of her baby teeth.  Unfortunately, this scenario is not uncommon these days, as more and more young children are developing serious tooth decay so extensive it often requires surgical intervention.¹ (By the way, opting for X-rays is an entirely different discussion that we’ll save for another time.)

Due to overall improved dental hygiene (and some would include fluoride toothpaste and fluoridated water, but again, that’s a different discussion), the number of cavities in children and adults has declined significantly over the past few decades.  However, in a 2007 Centers for Disease Control and Prevention study, a blip was found in these improvements.  It seems that for the first time in 40 years, the amount of preschoolers who have cavities has increased.² There is also plenty of anecdotal evidence from dentists that these children don’t always have just one or two stray cavities — it’s often a problem approaching the double digits.

While it is difficult to pinpoint one particular reason why this is happening, it is most likely the result of a number of factors combined.  Sugary drinks and snacks are provided by parents and other caregivers throughout the day.  Young children are given a bottle or sippy cup at bedtime to relieve their thirst and relax them, but water is not always the drink of choice. Juices and chocolate milk drinks are often high in sugar.  And the sugars present in these “alternatives” will adhere to the teeth and spend the duration of the night causing decay.

Then there’s the problem of dental hygiene.  Not every toddler wants their teeth brushed, or they demand to do it themselves.  If their teeth are not getting thoroughly cleaned each morning and night, that opens the door to cavities.  And if parents refuse to step up and enforce an after-every-meal mom-or-dad brushes-your-teeth type of rule, they are certainly not going to make Junior visit the dentist as often as necessary, where screams are likely when a stranger attempts to poke around in his mouth.  Oftentimes, these are the parents who will finally bring their child to the dentist only when they notice a problem with the teeth or their child is in pain. And keep in mind, this is 2007 data, so recessionary finances are not the issue. The end result: a multitude of cavities in children and extensive dental damage.

That’s how we end up with a preschooler having to undergo a surgical procedure to restore oral health.  No 3-year-old should need tooth extractions, root canals, or crowns.  This type of dental work usually requires an anesthetic in children so young because it is time consuming and painful and toddlers are not known for their patience or ability to sit still.  To be effective and clean up the entire mess at once, an operating room procedure is usually considered the most efficient option.

But that is hardly without risks.  Nausea and vomiting are common side effects of anesthesia, and though much less likely, there is the risk of brain damage or death.  Kids often experience pain after oral surgery, and there’s a chance of infection.  Costs, too, are an issue, especially with so many families lacking dental insurance.  The price tag for a dental procedure with general anesthesia can be thousands of dollars, depending on the extent of work that needs to be done.

Ultimately, none of us wants to go down this particular road with our children.  To avoid it, make sure your children are brushing their teeth carefully after every meal or take that job on yourself if they are younger than 6.  Have them floss every day.  Using fluoride toothpaste is debatable, but if you’re using it, at least make sure your children are spitting it out rather than swallowing the stuff.   And as for fluoridated water, there are good reasons it’s banned in Austria, Belgium, China, Czech Republic, Denmark, Finland, Germany, Hungary, India, Israel, Japan, Luxembourg, Norway, Scotland, Sweden, Switzerland, and The Netherlands.

Make changes to the foods — and even more so the drinks — that your child is consuming.  Swap out high sugar items and starchy foods that stick to the teeth as much as possible.  Offer healthy natural snacks instead of sugary, processed ones.  Your children might protest initially, but they will get used to the new choices and their tastes will change for the better.  And leave the sodas, fruit punches, and sports drinks off your grocery list permanently.  They are a huge source of sugar in the typical child’s diet and they bathe the teeth in sugar beyond compare — not to mention promoting diabetes.  Once you’ve implemented these strategies, you may just find that not only are your kids’ teeth in better shape than ever before, but their overall health and fitness has improved as well.

¹ Saint Louis, Catherine. “Preschoolers in Surgery for a Mouthful of Cavities.” The New York Times. 6 March 2012. Accessed 28 March 2012. <http://www.nytimes.com/2012/03/06/health/rise-in-preschool-cavities-prompts-anesthesia-use.html?_r=1&pagewanted=all>.

² “Oral Health Improving for Most Americans, But Tooth Decay Among Preschool Children on the Rise.” Centers for Disease Control and Prevention. 30 April 2007.  Accessed 29 March 2012. <http://www.cdc.gov/nchs/pressroom/07newsreleases/oralhealth.htm>.