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Tooth cavities, not colds, are the most common childhood disease.

The incidence of early childhood cavities appears to be on the rise with recent research indicating that children are getting more cavities at an earlier age. One study found that more than 25 per cent of children in North America have had at least one cavity by age four.

Cavities, or tooth decay, are caused by a bacterial infection linked to acid produced by food that sits on our teeth and between our teeth. Adults are quite familiar with cavities and the fillings that fix them. But children, even young children, are not immune from having tooth decay. In fact, says Dr. Geoff Smith, a pediatric dentist in St. John’s NL, roughly three per cent of all children will develop a cavity in early childhood.

That is one of the main reasons why both the Canadian Dental Association and the American Dental Association recommend children visit the dentist by age one or by the arrival of their first tooth, whichever comes first. The visit will help achieve a number of important things.

First, it will enable the dentist to examine your child to see if there are any problems. It will also give you a chance to ask questions about a wide range of oral health-related issues—everything from the use of sippy cups to thumb sucking. That first visit is also a great time to introduce your child to the importance of oral health care and to help them become comfortable with visiting the dentist’s office.


Catch oral health problems early

The dentist will examine your child and may take x-rays to get a look below the surface. A history will also be taken so the dentist gets the broadest sense of what may be happening in your child’s mouth—and more. Dr. Smith points out that some oral health conditions may be an indication of another medical problem. “Basically anything that you identify and fix can have an impact on long-term health,” he says.

Some children, for instance, have a condition known as enamel hypoplasia, or “chalk teeth,” which occurs when the tooth’s enamel doesn’t form completely. This may be a sign the child is not getting necessary nutrients in their diet or that another illness has been, or is, at play.

Children with significant tooth decay also tend to be in the lowest 10 per cent of the growth curve, and they often can’t eat or sleep well. “Identifying that child will have an obvious impact (on their health),” notes Dr. Smith.

He points out that many of the cavities in young children come from prolonged use of the bottle or sippy cup. There is a condition commonly called baby bottle tooth decay that occurs when infants and toddlers suck on a bottle of milk or juice over long periods. A domino effect happens: sugars in the beverages feed the bacteria that, in turn, produce acids that then attack the tooth’s enamel. That’s when cavities are formed.

“The recommendation is that the baby bottle be discontinued by 12 months,” says Dr. Smith.

The result is a healthier baby, he notes. “Removing the bottle or sippy cup from the equation will improve nutrition.”

Cavities in young children are also linked to frequent ear infections, a result of the high sugar content of most antibiotics. If your child is prone to such infections, you may want to take the little one to the dentist before age one. Certainly discuss the infections with the dentist during your initial visit.


Talk with your dentist

The opportunity for discussion is one of the main benefits of taking your child to the dentist by their first birthday. Dr. Smith, for example, makes it a point to talk about fluoride toothpaste and fluoride supplementation, diet, the health of the mouth’s soft tissues and problems arising from thumb sucking or pacifier use. Other common topics include:

• How to best care for your child’s mouth now and as they grow </>

• How to prevent accidents that could damage the face and teeth</>

• Teething and other growth signposts</>


It’s helpful to identify your questions before the visit to make sure nothing gets omitted or overlooked when you’re with the dentist. The Canadian Dental Association notes that during the first visit you can also find out if the cleaning you do at home is working.

The first visit is also a milestone visit. “This is an age where you normally don’t expect to find a large number of problems and is a good time to begin the process of introducing the child to the dental environment,” says Dr. Smith.

Many children are quite comfortable with that first visit. It’s novel, and they have a loved one with them. In fact, many experts recommend two adults accompany the child. That way while mom or dad is speaking with the dentist, the little one is engaged and content. Likewise, bringing a favourite toy is a good idea.

That way when the dentist says, “Open wide,” even the youngest patients will feel at ease.


Well positioned

For your child’s first visit, the dentist may opt to use a technique called a knee-to-knee exam that lets both of you get a look inside the mouth.

This technique is done with you and the dentist sitting facing one another. Your child sits on your lap, looking at you. Then you lay the child down with their head in the dentist’s lap. This way the dentist can now look directly into the child’s mouth and you can also see inside as the dentist points things out. This position also allows the little one to see the face of a parent or other loved one as the dentist conducts the examination.



Dr. Smith points out that some oral health conditions may be an indication of another medical problem. “Basically anything that you identify and fix can have an impact on long-term health”

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