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Dr. Tayloe Article - Bottles, Sippy Cups and Rotten Teeth

Posted: 12/03/2012

Bottles, Sippy Cups, and Rotten Teeth

I probably see at least one preschool child a week in our practice who has ruined their top four front teeth because their parents have allowed them to have a baby bottle in bed and/or to go everywhere with a sippy cup containing juice, milk, soda, or kool aid.  Many of these children require sedation or general anesthesia so that a dentist can clean up as much of the tooth decay as possible, in hopes that the children's permanent teeth will be healthy.  We have concerns that  general anesthesia may not be good for the brains of preschool children.  And, each one of these major dental treatment procedures costs thousands of dollars.

I attended a very encouraging meeting of local health professionals earlier this month at our hospital.  Attendees included dentists, pediatricians, oral health staff of the local health department, care coordinators for the state Medicaid program, and consultants from the UNC School of Dentistry.  The purpose of the meeting was to assure that all professionals and support staff who interact with children and families are working together to assure optimal oral health for our children.

For the past 15 years, pediatricians, family physicians, nurse practitioners, physician assistants, and nurses have implemented the Into the Mouths of Babes program, under the leadership of the UNC School of Dentistry and with the support of the Medicaid program.  Through this evidence-based initiative, health professionals have performed oral health examinations on children between the ages of 6 months and three years, provided oral health education for families, applied fluoride varnish to the young children's primary teeth up  to six times before the children are three and one-half years old, and referred children with early dental disease to dental professionals.  Dental cavities in elementary school children have declined by 40% since the onset of this very effective program.

In spite of our efforts to prevent early dental disease in children, we continue to see an unacceptably high number of children who need aggressive treatment for early dental decay.  We must do a better job making sure that all families implement preventive health habits that assure healthy teeth for all our children.  The key oral health habits for families include:

1.  Never have your baby or young child be put to bed or fall asleep while drinking from a bottle or a sippy cup.  Always hold your baby for all bottles.

2.  Require young children to sit at the dining table for all meals and snacks.   Do not allow children to eat or drink unless they are sitting at the dining table.

3.  As soon as the first tooth comes in, begin cleaning the teeth twice a day (at bedtime and after breakfast) with a "tiny smear" of fluoridated toothpaste.

If all families could adopt these simple but important recommendations, many of our children would be spared the pain and suffering brought on by early tooth decay, and our health care system could save millions of dollars each year.

David T. Tayloe, Jr., MD,

Goldsboro Pediatrics, PA

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