Hawaii's Silent Epidemic

pc: http://www.fmsdental.com/early-childhood-caries/

Can you guess the most common, most chronic disease among children? 

That’s right, it’s tooth decay, more specifically, Early Childhood Caries or ECC. 

The CDC reported that 28% of pre-schoolers have experience tooth decay, that’s over 4 million children nationwide!  Sadly, our state, our home, the beautiful state of Hawaii, has some of the worst oral health outcomes for children.  Our high rates of dental caries are over twice the average reported for children living on the mainland. It was reported that that Hawaii received an oral health grade of “F” and was “awarded” the worst performer among the 50 states due to its lack of oral health preventive strategies combined with the lowest rate of fluoridation of any states.

 As a dental professional but more importantly as someone born and raised in Hawaii, it saddens me that this is such a prominent problems affecting our islands.  Water fluoridation may never be an option thus we must look for alternatives to combat this problem.  Education is where I believe the effort must be applied.  Educating our children in the classroom, at pediatrician visits, anywhere where learning takes place.  But more importantly educating parents.  Helping parents understand and learn to practice proper dental care that they can pass on to their children and be positive examples of excellent oral hygiene habits for the next generation.  So please, visit a dentist, learn and practice proper dental care and together we can minimize ECC and keep Hawaii smiling for generations to come!!!

 1.        What is Early Childhood Caries (ECC)?

Defined by the American Dental Association, Early Childhood Caries, also known as “Baby Bottle Tooth Decay,” is when a child has at least one missing, decayed, or filled tooth surface in any of the 20 primary teeth.

Dental Caries is a chronic infectious disease caused by bacteria that breaks down sugar into acids which erode teeth over time. 

2.      What are the risk factors of early childhood caries?

 For any age level, one of the main risk factors is poor oral hygiene.  Allowing bacteria and plaque to accumulate, sets the perfect environment for dental caries formation. Diet also plays a huge role in the development of ECC.  The amount of sugar in meals should be monitored but more importantly the consumption of sugar between meals, aka. “SNACKS”.  Sugary snacks and drinks should be limited and substituted with nutritious foods can help make teeth strong and healthy.

 Finally the number one risk factor for the development off ECC, is prolonged exposure of the teeth to sugary fluids.  In other words, putting sweet drinks like juice and even milk, in sippy cups or milk bottles and then allowing the child to go to sleep.  This in turn basically creates a sugary buffet for cavity-causing bacteria.

 3.      What are the consequences of ECC?

The care of a child’s teeth should not be overlook just because they are “baby teeth” and not permanent.  Pain and infection can occur if the decay is extensive. 

 If left untreated, ECC can sometimes affect and damage the permanent teeth developing underneath.  Also, children with ECC are more likely to develop caries in their permanent teeth if changes are not made early on.

 4.      How can ECC be prevented?

1.     Oral hygiene is very important.  Parents should brush their children’s teeth at least twice daily with an age-appropriate toothbrush and fluoride toothpaste. 

a.      For babies a clean, wet washcloth should be used to wipe their gums after every feeding

b.     After age 2, fluoride toothpaste can be introduced, a pea-size amount should be used

c.      SUPERVISION!!! Be sure to supervise and assist, make sure all surfaces are being brushed

2.     Diet

a.      Monitor and minimize sugar consumption (candy, juice, soda, etc.) Also high carb foods like chips, crackers that tend to stick to teeth, these foods break down into the same sugars that bacteria feed on

3.     Avoid putting children to bed with juice or milk in baby bottles or sippy cups.

a.      Minimizing exposure = minimize ECC

b.     Try water as a healthy alternative.

4.    Visit a Dentist!

a.      Taking your child to the dentist is a great way to learn proper dental habits.  Also it is a great time to begin establishing a level of comfort between your child and a dental office!

References

Mattheus D, Shannon M (2015) Oral Health Outcomes for Children in Hawaii: Not Much to Smile About. J Dent Probl Solut 2(2): 034-037. DOI: 10.17352/2394-8418.000014