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Rotting toddler teeth targeted by pediatricians, dentists

Dan Hatten

Your average American’s teeth may be whiter and straighter than they were a generation ago, but for very young children, tooth decay is still one the biggest health problems. 

Dentists and pediatricians are meeting this week at the University of Washington to find ways to reverse the trend.

Overall, cavities are declining. On the other hand, Joel Berg who teaches dentistry at UW and runs a pediatric dentistry center at Seattle Children's, sees kids as young as age 18 months every week for oral surgery.

"For preschoolers it's actually gotten worse in the last couple of decades. There are more cavities, there are more kids coming into emergency rooms with swollen faces, because they have an infection that’s gone beyond the tooth."

Sometimes kids end up with a toddler version of a root canal, and some have metal caps put on their teeth. Berg says what really bugs him is how preventable it is.

Regular visits are crucial

You probably think of cavities more as a nuisance than a health threat, and that’s true if you see a dentist regularly.

In theory, kids are supposed to start seeing a dentist at age one. Among poor children, even after years of outreach, still fewer than half the kids do by age six. That’s why dentists have been training pediatricians and family doctors to look for tooth decay. Toddlers are seeing the doctor a dozen times in the early years, getting their shots and so on.

Berg says doctors can check for warning signs, such as:

"Do they have white spots? The earliest signs of cavity forming, a white spot [on a tooth], where we still could actually treat it with things like fluoride."

The pediatrician can then send the child to a dentist. Doctors can also teach parents about the dangers of all-day snacking.

"It's not about the quantity of sugars but the frequency … and knowing that if a kid is constantly exposed to sugar, that's going to put them at great risk for a lot of cavities."

Crackers, fruit leathers … even a sippy cup with milk or juice can be bad, if a child is snacking all day long.

A doctor training program run by the Washington Dental Service Foundation has been expanding at UW School of Medicine. There’s also a national push to make dental screening a required part of the training for all family doctors and pediatricians.

This week’s symposium in Seattle, on July 28-29, focuses on ways doctors and dentists can work together. (Anyone interested in attending should contact Sara Paul,, at the Center for Pediatric Dentistry.)

Tips for parents:  If written tips aren't working for you, this video from Atlanta shows a pediatric dentist at work.

Not-so-fun Fact:

  • In fiscal year 2009, 43% of Medicaid-insured children under age 6 years in Washington state accessed dental care.  That means the majority of kids in that group, 57%, didn’t access any dental care.
  • Back in 1997, only 22% of Medicaid-insured children under 6 years accessed care.  So, access has clearly increased, but there’s more work to be done.

- (courtesy of Dianne Riter, Washington Dental Service Foundation, from numbers supplied by the Washington State HRSA, 2009)

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Keith Seinfeld is a former KNKX/KPLU reporter who covered health, science and the environment over his 17 years with the station. He also served as assistant news director. Prior to KLPU, he was a staff reporter at The Seattle Times and The News Tribune in Tacoma and a freelance writer-producer. His work has been honored by the American Association for the Advancement of Science (AAAS) and the Knight Science Journalism Fellowships at Massachusetts Institute of Technology.