Thursday 15 March 2012

Rotten teeth on the rise in kids

Dentists stepping up outreach programme to fight worrying trend
By Poon Chian Hui, The Straits Times, 14 Mar 2012

SEVERE tooth decay among children - some needing surgery under general anaesthesia to fix - is on the rise here.

A decade ago, the National Dental Centre (NDC) treated fewer than 500 young patients a year.

Last year, the figure was 1,000.

The rot can be bad: From the NDC's files of young patients seen last month comes the case of a three-year-old with 14 decayed teeth.

The child - still years away from shedding her baby teeth - had pus oozing from the gum above one tooth, where the decay had reached the nerve. Three teeth needed nerve treatment and to be fitted with crowns; another five had to be pulled out.

The NDC has gone on the warpath against the disease, called 'early childhood caries', by stepping up its community outreach programme.

Since last month, its dentists have been delivering lectures to about 200 doctors and nurses from nine polyclinics on spotting preschoolers at risk of tooth decay, and to refer them to the NDC.

By the middle of next year, it will have extended this drive to another six polyclinics and to preschool teachers and parents as well.

These classes cover, for example, the risk factors behind early childhood caries, and how adults can spread decay-causing bacteria to their children by sharing food with them.

Dr Tan Wee Kiat, a senior consultant paediatric dentist in the NDC, said parents' ignorance about dental disease is a key reason why dental health among children is deteriorating.

Letting a child fall asleep with milk bottle in mouth can make matters worse. This is because sugars that occur naturally in milk make a perfect environment for bacteria to multiply. These bacteria convert the milk sugars, called lactose, into lactic acid.

'Imagine, the teeth are continually bathed in acidic elements,' said Dr Tan.

The acid attacks the tooth enamel, making it easier for bacteria to reach the nerve of the tooth.

Data available here indicates that four in 10 children aged three to six have tooth decay.

Also, one in five would have suffered the problem by the time he reaches the age of five.

As a result, these children may lose their baby teeth earlier than they should, which would affect the formation of their permanent teeth.

Poor dental hygiene in childhood can also carry over into adulthood.

Parents are advised to take their children to the dentist as soon as the milk teeth are present - at the age of one. They should also start the tooth-brushing habit early.

Dr Tan said she knows of parents who do not do this until their children are three.

Such good dental habits can go a long way towards preventing the pain of multiple tooth extractions at a young age.

Explaining the reasons for extending the outreach programme to parents and teachers, Dr Tan said: 'I don't ever want to see a parent cry in front of me and ask, 'Why didn't anybody tell me?''

About dental caries

EARLY childhood caries is a form of severe tooth decay affecting young children under the age of six.

In this form of decay, the child's front teeth are usually the ones attacked by bacteria.

The decay can spread rapidly, with the total rotting of the tooth happening in six months to a year.

About four in 10 pre-schoolers here have dental caries.

Children are at risk of the problem if they are frequent snackers, do not brush their teeth regularly or habitually suckle a bottle of milk to sleep. Milk contains naturally-occurring sugars that can foster bacterial growth in the mouth.

Parents should be alerted to the problem if a child complains of pain when biting, or of sensitivity to hot or cold foods or has swollen gums.

Decayed teeth can be fixed with dental fillings and nerve treatment.

But if most of the tooth has already been eaten away by bacteria, it will have to be extracted.

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