Teeth and Public Health
Lots of kids aged 1 and a half and above are now getting general anesthesia—for their teeth. It's more evidence that emphasizing health care treatment solutions over public health can lead to terrible outcomes.
Starting five years ago, children's cavities in the U.S. increased in incidence for the first time in 40 years, according to an article by Catherine Saint Louis in the March 6, 2012 edition of The New York Times. And now many toddlers are showing up at dental offices with six, 10, even 16 cavities at a time. Whole new surgical suites have been created so that some kids, who fight normal dental work, can be knocked out with general anesthesia.
Just to remove cavities. Some 2-year-olds are getting root canals and crowns.
Why is this happening?
Reasons to Worry
Many parents—apparently across all social classes—no longer brush their children's teeth, let alone floss them. Since most kids are incapable of doing dental hygiene well until age 6 or 7 or later, parents must do the job. To be truly effective, parents need to brush their kids' teeth at least twice a day.
But there are many other reasons why cavity rates are increasing, including:
1. Use of bottled water. Canards against fluoridated water persist. Many parents do no trust their local water supply. Kids who don't get fluoridated water—and fluoridated toothpaste—get more cavities.
2. Sugar and snacks as universal soothers. Kids who are tetchy, nervous, or irritated are frequently handed fruit drinks and "snacks" to calm them down. Many of these snacks are nothing more than sugar particles surrounded by starch, creating the perfect environment to produce cavities. The more frequent the snacks and sweet drinks, the worse the cavity formation.
3. Making sugar cheap. High fructose corn syrup shows up in children's Tylenol and in seemingly virtually anything they can ingest. The group at UCSF and UC Berkeley, headed by pediatric endocrinologist Robert Lustig, has strongly argued cheap HFCS is leading to an epidemic of childhood obesity.
4. Premature development of "adult" authority. In the past, children had their teeth brushed by parents—whether they liked it or not. Now many parents, facing stiff toddler resistance, do not wish to fight with their kids to perform basic brushing. After all, there are operating suites that can handle the problem instead. And according to dentists, there are some parents who truly prefer that type of resolution, as they wait for their children's "emotional maturity" before making them accept a twice daily toothbrush.
Why Teeth Matter
Teeth are critical to health. Period.
If kids have lots of cavities, you end up paying more than dental bills. In later life those teeth will be more prone to decay, periodontal disease, and different forms of inflammation.
We know now that periodontal disease means more heart disease later in life. It may also mean much more than that—perhaps a tendency to other chronic diseases as well. People all over the world brush and floss their kids' teeth. They do it even if the kids don't like it, because it has to be done.
This public health problem is soluble:
Kids need to have their teeth brushed twice a day.
Sugary snacks should be replaced by whole foods or water.
High fructose corn syrup should not be government subsidized so it no longer remains such a cheap, quick source of calories.
Kids should not be bombarded by thousands of ads each year—on TV, games, and the Net—pushing sugary foods of all kinds.
We have an epidemic of childhood obesity. In its wake comes more sleep apnea; more behavioral problems; more diabetes early and later in life; more high blood pressure, heart disease, and stroke.
And sick, non-functioning teeth make eating difficult, incite future chronic disease, and cause pain, discomfort, and poor appearance. If our health care system really was designed to improve the health of the population, the scandal of rapidly building large operating suites for children's dental work would not occur.
We need parents brushing their kids' teeth. We want healthy children—not more general anesthesia.