Dr. Samir Vinod Sampat, M.D.S.
Consultant Pediatric Dentist
“Every tooth in a man’s head is more valuable than a diamond”.
–Miguel De Cervantes
What is Dental Caries?
Dental caries is a devastating form of disease that affects the dentition of toddlers and children irrespective of age, race, sex and social strata. It is a microbial disease due to various causes which ultimately lead to cavitations and foul smell. It is often characterized by initial white spot lesions which later turn brown and break the entire tooth structure leading to poor esthetics and reduced self-esteem in children.
Is it harmful, if not treated properly?
If left untreated, caries causes pain and discomfort which affects eating, talking, sleeping, and playing. It leads to malnutrition and poor physical development. Loss of frontal teeth at an early age affects speech articulation and vocal patterns. Early extraction of teeth causes psychological trauma to both parents and child. Children who have caries in milk teeth are likely to develop caries in permanent teeth as well. Treatment of caries is time consuming because the cooperative capacity of babies and children is usually less and sometimes requires the use of high dose-full body anesthesia.
So, what causes these cavities in my child’s teeth?
These lesions are produced from the interaction of multiple factors like caries causing microorganisms, fermentable carbohydrates from diet and susceptible tooth surface.
• Breastfeeding: Prolonged Breastfeeding especially at night causes caries. If the oral cavity is not cleaned at this time, milk gets pooled around teeth and remains constant over a period of time thus making them more susceptible to decay and growth of harmful bacteria.
• Bottle feeding: Bottle feeding has been a cause of caries and this is mainly because of the stagnation of the bottle contents in the mouth. The use of bottle feeding should be discontinued by 1 year of age and child is encouraged to drink from cup.
• Substrate: Sugar predominant food products are the main culprit for causing caries. Frequent consumption of sugar rich and fructose syrup food should be avoided.
• Susceptible tooth/host: Newly erupted teeth in the oral cavity are more susceptible to caries as they are still in process of maturation and do not have the adequate capability to fight against microbes.
• Cariogenic microorganisms: Mother or the care giver is main source of supply of these bacteria into the mouth of the infants. Transmission occurs by saliva sharing behaviors like kissing, sharing food and eating utensils, cleaning pacifiers with tongue, sharing spoon between children and should be avoided.
• Syrup: Syrups used in ill children contains sugar also causes caries.
• Oral hygiene: Caries is higher in those children who do not brush their teeth at bed time. It is seen that children who brush their teeth regularly (twice daily) with a fluorinated toothpaste have considerable reduction in the incidence of caries.
Important tips to parents
• Milk teeth are as important as permanent teeth as they help in chewing, speech, esthetics and also help for smooth transition to permanent dentition.
• Repetitive consumption of any liquid containing fermentable carbohydrate including fruit juices from bottle should be avoided. Parents should encourage infants to drink from a sippy cup as they approach their 1st birthday and weaning should be done by 2 years of age.
• Parents giving children fruit juices should dilute the contents by addition of water and limit the quantity to 4 to 6 oz of fruit juices during meal per day. Fizzy soft drinks should be avoided as they are acidic and has added sugar in it.
• Infant should not be put to sleep with bottle; night breast feeding should be avoided after the 1st primary tooth begins to erupt.
• Cleaning of gum pads of infants with clean damp cloth and brushing of teeth using finger brush should be encouraged.
• The first dental visit of your child should be within 6 months of eruption of 1st milk tooth and no later than 1year of age.
• Children occasionally have to take medications that contain sugar to increase its palatability. It is advisable to brush their teeth or to rinse the mouth after administration of medicines.
• Mother should avoid saliva sharing behavior like sharing of spoons, utensils, kissing, cleansing pacifier with mouth etc. to reduce transmission of caries causing microorganism amongst children.
• Chewing a cube of Cheese and xylitol chewing gum after meals decreases caries in children.
• Application of topical fluoride and fissure sealants in primary teeth should be done by dentist.
• Parents should take their child to dentist regularly (every 6 months) for routine monitoring and treatment when needed.
Prevention is the gold standard in management of any disease. Early guidance and prevention therapy will help not only to prevent occurrence of the disease but also avoid the complications and cost caused by its hazards. Let us together strive and give better oral and general health to our children.