Cavities in Preschoolers on the Rise

Dentists are now seeing so many preschoolers with cavities and even severe tooth decay (6 to 10 cavities or more) that there’s been “a huge increase” in little kids who need general anesthesia for dental procedures, including tooth extractions, crowns and even root canals, The New York Times reports.


Yet with the right care, rotten teeth—and having to send two-year-olds to the hospital for costly and painful dental surgery—are largely preventable. What’s behind this scary trend?


Soaring Rates of Tooth Decay in 2 to 5 Year Olds


The Centers for Disease Control and Prevention (CDC) sounded an alarm five years ago by reporting the first rise in 40 years of kids with cavities in their baby teeth. The largest spike was found among 2 to 5 year olds. In that study, the CDC reported that 28 percent of kids in that age group—of all income levels—had cavities, compared to 24 percent in a study conducted between 1988 and 1994.  Overall, 42 percent of kids ages 2 to 11 had cavities in their primary teeth, and there was also a significant jump in the number of cavities (or fillings) per child. What’s more, many of the kids had untreated decay, which can be extremely dangerous. Since then, the problem has only gotten worse, according to pediatric dentists around the US.


A Dangerous but Often Overlooked Health Threat


Featured in original Times article, Melody and Mathew Koester didn’t worry about their son Devon’s oral health until Melody noticed that that the then 18-month-old had discolored teeth. ““I had a lot on my mind, and brushing his teeth was an extra thing I didn’t think about at night.”  Dentists report that some parents don’t brush their toddlers’ teeth because their kids get fussy or cry. But tooth-brushing twice a day can spare preschoolers the much worse pain of the dentist’s drill. For Devon, his parents’ mistake resulted in a trip to the OR, as The New York Times reports:  "In the surgical wing of the Center for Pediatric Dentistry at Seattle Children’s Hospital, Devon Koester, 2 ½ years old, was resting last month in his mother’s arms as an anesthesiologist held a bubble-gum-scented mask over his face to put him under. The doctors then took X-rays, which showed that 11 of his 20 baby teeth had cavities. Then his pediatric dentist extracted two incisors, performed a root canal on a molar, and gave the rest fillings and crowns."


A Perfect Storm of Cavity Risks


Parents who don’t brush their toddlers’ teeth are just one reason for the cavity epidemic. Preschoolers are also grazing on sugary snacks more than they used to, while babies and toddlers are often put to bed with bottles of fruit juice or milk, a recipe for tooth decay that can lead to a condition called “bottle mouth,” in which sugars from juice or milk eat away at the enamel of the teeth, causing discolored, pitted, or pocked teeth. Severe cases of bottle mouth can lead to cavities or extractions of rotten baby teeth.  Furthermore, bottled water is more popular than ever, and parents are now feeding it to their kids instead of opting for fluoridated tap water that can help defend against cavities.


How serious are cavities in baby teeth?


While some parents don’t think it matters if kids get cavities in their baby teeth, decay can lead to serious complications in children who haven’t yet gotten their permanent teeth, including tooth abscesses, tooth loss, chewing problems, severe pain, and life-threatening infections.  It’s possible, though rare, for children to die from untreated dental infections, as the tragic case of Deamonte Driver illustrates. Last year, the 12-year-old died after an infection from a decayed molar spread to his brain.


What’s the best way to prevent cavities in baby teeth?


Dental care should begin even before a baby’s first tooth emerges. Dentists recommend wiping your baby’s gums with a damp washcloth to clean off cavity-causing bacteria.  After the baby has one or more teeth, brush them with a soft child’s toothbrush or wipe them with a gauze pad. The American Dental Association recommends taking kids for their first dental visit at age one. The dentist can instruct you on the best brushing and flossing methods (start flossing as soon as your child has at least 2 teeth that touch.)