Because most children don’t visit a dentist until around age three, family physicians and pediatricians have an important role to play in assessing youngsters’ oral health and educating their parents about tooth decay prevention. Professor of Dentistry Amid Ismail and colleagues surveyed about 2,400 physicians nationwide to find out if doctors consider a child’s risk of developing tooth decay when recommending fluoride supplements. Their results will be presented at the International Association for Dental Research.
Ismail gave doctors a questionnaire that included two case scenarios—one for an upper middle class child with no dental problems, the other for a child in a low-income family with visible tooth decay—and asked what they would recommend.
Of the 1,045 physicians who returned the questionnaire, most had a general understanding of the importance of fluoride in preventing tooth decay. But they failed to base their recommendations on the child’s current needs or risk of developing tooth decay in the future.
“Even though we had two scenarios—one child who doesn’t need much care right now and one who really does need immediate care—their answers were not that different, especially with regard to fluoride supplement use. It was kind of automatic,” says Woosung Sohn, assistant research scientist who collaborated with Ismail on the project. “So we think doctors should be re-informed about how to assess a child’s dental caries (tooth decay) risk before recommending fluoride supplements.”
As a first step, the researchers have developed an educational CD-ROM to help physicians make appropriate recommendations about fluoride use and other oral health matters.
Kids and Cavities—More than a toothache
Children who get cavities in their baby teeth—known as early childhood caries or baby bottle tooth decay—suffer more than just an occasional toothache, a study by pediatric dentistry graduate student Sara L. Filstrup has found. They often suffer loss of sleep, impaired concentration and even a poorer social life.
Filstrup and colleagues interviewed children ages 2 1/2–6 years with severe tooth decay. The children reported that mouth pain frequently kept them awake at night, interfered with their ability to pay attention in school and prevented them from eating. In fact, research shows that such children typically weigh only 80 percent as much as other children their age. Their parents, too, reported that the children’s oral health problems kept them from playing with other kids and disrupted their sleep. When dentists examined the children’s mouths, they found that kids whose parents reported the most quality of life problems had the most severe dental problems.
The children’s tooth decay was treated and the parents were quizzed again four weeks later. “The difference was like night and day,” says associate professor of dentistry Marita Inglehart, who collaborated with Filstrup on the work. “The parents said their kids were happier, could play better and slept through the night.”
Inglehart has submitted a proposal for a three-year study aimed at finding ways to educate parents and teachers about the impact of dental problems on children’s lives. She hopes to create a Web site for teachers and intervention workshops for parents.
“If you tell a parent their child has 61 percent decayed surfaces in the mouth, they’ll say, ‘Um-hmm. Oh.’ But if you tell them, ‘The reason your child can’t concentrate in school and gets bad grades isn’t because they have ADD; it’s because they have a toothache,’ they’ll understand how serious the problem is.”