Dentists are finding themselves with some very young patients — 18 months old — with a very large amount of cavities — 11, 12 — by anyone’s standards. The New York Times reports that more young children are getting 6 to 10 cavities in their baby teeth and that some dentists are recommending surgery under general anesthesia. As Dr. Megann Smiley, a dentist-anesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio, observes, while going to such lengths to fill cavities in the teeth of children who haven’t yet entered preschool might seem like “putting a match out with a fire hydrant,” the reality is that who of us, child or adult, wants to have twelve holes drilled in their teeth and twelve fillings filled?
Dentists attribute the increase in tooth-aching toddlers to, says the New York Times, a lack of parental effort to get small children started on a twice-daily regimen of brushing and flossing. The dental clinic at Nationwide Children’s Hospital saw some 2,525 children in 2011, an increase of 6 percent from 2011. The average age of the patients is 4 and they each have 4 to 6 cavities. While children of lower socioeconomic status do tend to get more cavities, the toddlers in need of lots of dental care are from families of all income levels.
Pediatric dentists attribute the increase in cavities in young children to too many snacks too often and too much juice, especially at bedtime; giving children bottled water than tap water, which is fluoridated in many states; and a “lack of awareness” that infants as young as a year old should be examined by a dentist and assessed for future cavity risk. Dentists also say that letting kids have sippy cups can lead to tooth decay. Parents themselves need to “do the tough love thing” and insist that children embark on a daily brushing and flossing routine, no matter how many tears or how much whining.
The costs are notable. General anesthesia can cost $2,000 – $6,000, based on how many teeth are infected and on your insurance. General anesthesia does have its risks — nausea and, more rarely, brain damage or death — but a very young child may simply not be able to sit still while having multiple cavities filed. Some dentist offices have equipment such as a papoose board, in which a child is immobilized from head to toe under velcro straps, but seeing, and hearing, a weeping little one in such a device is likely to be quite painful for all parties.
I’m actually familiar with all of these procedures: While my teenage autistic son Charlie has learned to sit in the dentist chair for basic cleanings and fluoride treatments, we had him go under general anesthesia to have a cavity filed and x-rays taken (Charlie did not like the papoose). Charlie has actually had very few cavities; he has very particular eating habits and does not eat candy, doesn’t like juice and eats a lot of fruit. We started teaching him to brush his teeth when he was a toddler, figuring that his tendency to be locked into habits and routines would mean that if we started him early on dental care, he would stick to it and, so far, he has.
The New York Times points out that more than a few studies have “shown that even children who undergo general anesthesia to treat dental decay end up with cavities again” — it’s never too early to insist that brush, brush, brush your teeth, you must.
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