Your doctor speaks II; Prevention of Tooth Decay in Childr

The University of Illinois Medical Center campus in Chicago percents your doctor speaks during this series doctors in the colleges of medicine dentistry pharmacy nursing and graduate college at the University of Iowa and I will discuss the latest advances in cancer and heart research. Painless dentistry psychiatry nursing care and modern drugs. All of these and more will be presented on your doctor speaks. Your host for this series is Jack Reed AMA coordinator of public service radio and TV programming for the University of Illinois Medical Center campus and champagne Urbana. This is Jack remembering another program that we do with members from the University of Illinois Medical Center campus in Chicago. Our guest today is Dr. Donald or assistant professor Peter topics children's dentistry that is and universe on College of Dentistry. I want to talk about dental decay and it's preventing in children. And Doctor Are

we better explain. Well I've already indicated Peter that if you're still a mystery but could you talk a little bit tell us a little bit more about this particular specialty and why it's really not necessary why does it seem to be such an emphasis on people down ticks now. Well Jack basically paedo doesn't exist in terms of its formal training and this has been outlined by the American Dental Association is counseling dental education and I subscribe to by most of the states in the United States is a two year especially training program following the backer of dental surgery degree for example a man completes his preventive training which is anywhere from two to four years and then four years of dental school. And then he takes two years of additional training in children's dentistry. The question is often asked well is it really necessary my dentist does a wonderful job with children. And that's quite true. Many men today particularly with our training programs epidemic colleges are able to do a

tremendous job with children. The paedo dynast however has a little more different emphasis on the child patient. For example he's trained very well in the area of treating the handicapped child. This is the child with handicaps such as cerebral palsy or perhaps a mentally retarded child or perhaps a child who has severe emotional problems and can't be treated in the normal office routine. Consequently the paedo Dynasty's trained in the area of hospital dentistry for example taking the child to the hospital and under a general anaesthetic completing all of their work. This adapts particularly well for example to the spastic child who for the comfort of the child himself would find it very difficult to sit in and routine dental chair for any period of time. Then too there is a tremendous amount of emphasis on pediatric diseases. A lot of emphasis on the growth and development both normal and abnormal of the child. And these children that the people Dennis does see are usually these type of

children. And by the same token a Petone has does see the so-called normal child too. Well he must have home other training besides that I try to. Say that the that this is his only claim to fame is the fact that he can handle handicapped children and he must have extra training and then the I'm going to the normal has been to one of the many I talk about that comment. Then the then the general practitioner does. Yes he has a lot more training in certain areas especially young children very young children and in their problems and now with some of the decrease in dental decay the paedo Dynasty emphasis has shifted very greatly to the area of intercepting orthodontics where he can intercept a tooth coming in the wrong position so to speak at a very early stage and avoid some of the problems involved in orthodontics in the future this is what we term at the University of Illinois as a growth and development he has a goes into great detail and growth of development not only of the

child and the child's emotions but also in terms of the child's skull his dental apparatus and the teeth right. Where do they get the name Peter tonics. Well it's I guess I have to go with that. I keep getting away speaking Keith. It comes from Pete and meaning child and Dot meaning tooth or the children's teeth essentially just as one who thinks you get it when you explain it like that it comes out nicely. But people say that's a fact Doctor. No I sorry about that. Back door there's been I think a lot of at least I've been seeing the newspaper and television and on radio a controversy over dental decay and one statement which I have read I'm going to read it which I have written down here indicates that a look a is an infection and then a fact you have indicated is you self and along with this one study showed that a group of children who were allowed to eat candy all again and they wanted

didn't develop any significant number of cavities. Now what does this point prove if for years Dennis and I STILL are saying today that they shouldn't be eating candy because Candy causes cavities seem to be a contradictory statement. Well Jack basically dental decay is an infection and I elaborate on this a little bit. There's been some very interesting studies and these went way back many years ago. And what these men were able to demonstrate long ago was the fact that if you had a tooth alone and saliva you wouldn't get decay. And if you had two alone and sugar alone you wouldn't get decay. But when you add bacteria you begin to get dental decay. This began the indite bacteria as being one of the causative organisms of dental decay. This went a little further. Men began to study certain types of bacteria and they

found that they could take bacteria from one tooth and seed it onto another tooth and develop a cavity. So this move over to another. Yeah I would actually move over and migrate the what. One of the terms in vogue is seeding the bacteria would seed from one tooth to another and you get a new cavity. Then some work came along which demonstrated that you could transplant or trance transmit this decay from one animal to another. So this fits the classic definition of of an infection something of bacterial origin which can be transmitted or transplanted from person to person or from area to area. So with this in mind we like to think that we'd like to control the infection. But now let's get to the study and Candy there have been some studies which have shown children who are allowed to freely eat candy wouldn't develop significant amount of decay. But these children have essentially been children from fairly isolated populations with good oral hygiene. Children that have been

instructed well in brushing their teeth and so on. But probably the classic study along these lines came out of Sweden and a group of Swedish investigators went into a little town called Vic home and in the poem they allowed children in the entire town. Who took part in a study to eat candy and sweets and sugars in a very particular manner. They gave these children sayable sugars. They gave these children rather tacky sugars and they gave them some very sticky Carmel's no goody goody hand. They excuse me when I allow the children to come in and be examined and they would change their diet. And the interesting finding in the study was that they could actually control the amount of dental decay that these children had by the type of sugar they ate and when they ate it. This now incriminated the fact that the free fermentable carbohydrates available from these candies and sugar solutions were contributory to dental ek. But it

became more significant because they could show graphically that when the child ate between meals for example he had a much higher incidence of decay when he ate sticky gummy Chewy Carmel's and candies. That would adhere to the tooth structure and we would have the same response. They could control the child they could increase its decay or decrease it at will just by changing the type of candy and free from animal carbohydrates he consumed so the candy is really a copper in this particular area. If it's abuse that is if it's abuse kids abuse nothing. Well not really Candy is fine if it's a dessert I think. But as I should too quickly. Very quickly her like right after you walk out to your budget he bet you eat the candy. Well it's been demonstrated Jack that dental decay acids will reach their peak my peak I mean that there's enough acid forming to edgy mammal to begin. I care about this area within 10 minutes after consuming carbohydrates and I was mighty.

Now you have stated that not only is an infection not as dental again it is an infection and you say it is there's a defect the treatment of children's teeth in how in what way. Well very dramatically Jack. When the child's about 6 years old as you know we begin to get the so-called six year Mahler's or the first permanent mowers and also the permanent central incisors those nice big teeth up in front and if the child has several open cavities in his baby teeth. These bacteria will seed right over onto these developing and erupting permanent teeth. It's also been demonstrated that the tooth as it erupts into the oral cavity is most susceptible to decay so it behooves the parent to to make sure that all the decay is cleared up in the baby teeth at the time from the teeth come in or you're just asking for a perpetuation of an infection. Before I ask you I'm sure all baby could be feel them. How soon could you bring

your child to feed the dentist. Or. Well Jack oral hygiene is just like hygiene anywhere else in the body and not it's not going to think of the work you know that is ok I love it. Well of the people down there at the general dentist but the important thing here is that oral hygiene goes along with hygiene and the rest of the body. And some men say they like to like to see the child just about the time he's completely toilet trained. This is around age three shift now is that towards perhaps a little younger age group. But when the child is around age 3 He has his full complement of baby teeth. He's developed an absent of socially that he has the ability and the dexterity to begin to perform his own personal oral hygiene. By the same token it's at this time that the astute dentist can examine the child's teeth and perhaps begin to evaluate in terms of any developing male position of the teeth or other developmental anomalies. We're going to go back to the question I originally asked Got since you're going to lose a baby do you

anyway. Most people view on the soon to be prevalent 20 years ago my mother fell into the taking care of the baby. They're going to fall anyway and are going to have new teeth coming in a primitive humans or one mother with a baby. Think my doctor. Well Jack I think from the development of our theme that dental decay is an infection it becomes obvious we don't want an infective process in the mouth. But by the same token nice teeth aren't just a certain size. They aren't they're all measuring exactly the same all being pearly white. Any truth size varies somewhat with the individual and the distances between these teeth are very critical. So it becomes pretty obvious that if a child has a cavity and loses a part of this tooth structure he's going to lose a little bit of that space that Mother Nature intended him to have. Consequently the preservation of these baby teeth is not only to eliminate the infection that may be present which could cause problems with the permanent teeth but also to maintain the proper amount of spacing that the child has a

permanent teeth rely very heavily on the proper amount of space from the baby teeth in order to get into the right position. So it's been known for it does behoove one to take care of the baby live. Child knocks out the first two teeth baby teeth. You know I'm running out of falling he should go see you soon. Dentist make sure that boy no problems could curve us from several standpoints because apparently they're also under these baby teeth. We'd like to see if there is any injury or damage. Here's a $65000 question and the parents who are listening this program are going to be asking you this and I've asked many dentist about this and I've gotten many different answers so now it's your turn to come up with your answer. Is there a proper way for a child to brush his teeth. Jack every child develops differently in terms of his his own muscular coordination. We all know that some children are right handed some are left handed some walk early some can throw Very well I ran across a four year old the other day that was a

reader. And these things kind of things astound you because each child has his own particular individual potentiality by the same token each person and child has their own particular habit patterns. I don't know I get up in the morning and put on my right shoe first I guess maybe I should break this habit and put my left one on first. Yeah I like it. By the same token I'm right handed and I'm. I miss certain areas in my mouth that I'm aware of and I have to concentrate on these. So with a child it merely to instruct the child to scrub his teeth up and down from gum 2:58 example is an entirely adequate. We like to take each child and tailor an individual tooth brushing technique for the child for the child. Certainly enters a few very simple ways to do this. Now we have some dyes available. There are Red Cross and eyes. We call them disclosing tablets or disclosing solutions. A child can come into the office have this disclosing solution painted on his teeth and its water soluble and washes off readily and it

will stain the amount the food debris that's left behind on the child's teeth. So if you a child comes in and you stain his teeth and you see one particular area of the mouth that the stains very heavily It's follows very logically the child's missing this area he might be doing a bang up job everywhere else but missing one particular area. So by reinforcing the child's own neuro muscular patterns by saying now look Johnny the next time you brush your teeth you begin right over here where you left all this red stuff. The child will begin to brush his teeth in a little more logical sequence he'll perhaps overcome the fact that he can't turn the tooth brush quite as far as he should or that he can't move his wrist quite as far as he can. Oh you you Dennis are so so astute nowadays. Too bad he didn't have that when I was a child. My teeth don't get you. Why should why why when should a aged child brush his or her teeth.

Is there a particular time issue you should start a child or brush their own teeth for instance I assume parents would brush the children's teeth up to a particular point and I went to the child pick this particular procedure or practice upon itself. Will Jack when you look again at each trial is tremendous in doing individual variation and I think the parents if they're instructed properly and are willing to take the time to ask the dentist to show them the proper way of brushing their child's teeth can supervise for a period of time and ascertain whether or not their child has the proper neuro muscular coordination to have brushes auntie. You certainly wouldn't expect a 2 year old for example to take up a large adult sized toothbrushing going into an impeccable job. But by the same token you may expect a 5 year old child to do a good job. After all he's throwing balls and writing and using pens and he's developing So a lot of hand and finger control so he should be able to do

a good job. This burden I believe is strongly on the parent's shoulders to learn from their dentist exactly when and how the child should brush their teeth. When you want something done you go to the expert in this case of a parent wants or Jordan's teeth to be protected. You go to the person that knows this is their dentist. How important is it diet in controlling dental decay. Well Jack as I indicated particularly from this classic Swedish study you know that those we've you know carbohydrates have been pretty definitely incriminated as causing a market increase in dental decay particularly if they're consumed immediately after a meal or between meals. Now what does this mean to the parent. Well you know these these kids burn up a lot of energy and they require a lot of snacks. And I'm not going I'm one who listens to Beethoven in public and goes home and listens to The Beatles. I was watching my

own children the other day and my little four year old made no less than 12 trips into the kitchen during the course of an afternoon looking for snacks ferreting out little goodies to eat. And this is a normal. Oral habit pattern with most younger children and particularly their act even are burning up a lot of energy and require that you pick up. So if the parent can begin to realize how many exposures the child has to sugars in any form particularly these fermentable carbohydrates they can begin to assess a little bit more what dietary measures they should take take. A good example of this Jack would be a child who has a frog before breakfast a stack of wheat cakes covered with syrup and some juice. Then for a mid-day snack he would have a cup of cookies and a glass of milk and at lunch time he might have a peanut butter and jelly sandwich followed up again by a few cookies and an afternoon snack of say a chocolate covered

donut a bottle of pop. It's instantly apparent that this child was getting a lot of sugars and then if there are a lot of hidden sugars put in for example Boston baked beans that are made with brown sugar for example the child is having so many frequent exposures to fermentable carbohydrates that you would expect his decaying incidence to rise very drastically. Can you give any suggestions or help to parents talk to avoid these pitfalls in diet areas. Francis what would be good snacks for children. Well at the University of Illinois we encourage very strongly the use of detergent food snacks by detergent I don't mean soapy but I mean is a food that's very abrasive and coarse and yet will satisfy the child's oral needs in oral requirements. High on the list of these are slices of carrot slices of celery apple slices because they not only will

satisfy the child's demands for a little snack but also they're coarse enough and abrasive and up at the lacked as a sort of an artificial tooth brush they'll clean off food debris and any residual foods that are packed around the necks of the teeth. Popcorn popcorn is fairly good we have a problem with the husks though getting lives underneath the gum tissue. But we do encourage the fruit and vegetable groups and I have to eat you know something other than you know make a little popcorn and much sweet isn't butter on my back and a big problem again. Well sorry about that folks. But anyway a parent should be aware of this particular problem and about the diet and you know you can't keep cabinets at all and running around as you say snacking How can you keep tabs on what's one of the best means of this area prevention is Farai one of the best means of prevention and now and again Jack from a public health standpoint the fluoridation of community water

supplies to not optimal level is without a doubt the most effective means that we have today of the Riddick raising the amount of dental decay figures anywhere from 40 to 60 percent of been reproduced over and over again in huge populations by this I mean a 40 to 60 percent reduction in dental decay. The people of Chicago for example had the benefits of fluoride for some nine years now and it's reflected in the amount of decay that the children in the city of Chicago have. It's cheap it's economical it's safe and it's extremely effective. What if. Parent would like to happen as a as a comparable floride applications of the output on a child's teeth can this be done end of song. How long how often should the treatment his be done or Jack topical fluoride snow we have ever again been demonstrated to be extremely effective in a strange thing happens. These fluorides are additive to the benefits that have already been received through water fluoridation water fluoridation isn't

effective in reducing decay once the tooth is completely formed but once a tooth is in the mouth it's in the dentist province to apply topical fluoride to the children's teeth. And again we're talking in figures of 30 35 percent reduction in dental decay so between water fluoridation and topical fluoridation we're up in a pretty high percentage that we're reducing the k up in the area of 60 70 80 percent. That's been my earlier. Now of course the question comes back from those who are against the use of fluoride it's going to harm the teeth. Is this true. There is absolutely no mechanism by which floor I think light topically to the tooth can harm a tooth that's already been exposed to water fluoridation. It's again a very safe extremely effective means of reducing dental decay. The mammal is already formed and the application the fluorides to this will in no manner reduce the effectiveness of the

beauty of the teeth. It will only increase their resistance to dental decay and acids. So there is really no harm or no problem at all. No there's one thing you want to spell because many people have this erroneous idea and unfortunately ran out of time. And this is always the case. We have an interesting program on our topic today has been in dental decay and it's prevention in children. Our guest has been Dr. non-A or assistant professor Peter about ticks which is children's dentistry at the Universe Online College of Dentistry. You have just heard another in the series your doctor speaks produced by the University of Illinois Medical Center campus in Chicago in cooperation with this station during the series. Such topics as cancer and heart research painless dentistry psychiatry nursing care and modern drugs will be presented on your doctor speaks. Your host for this series is Jacques Rogge camera

coordinator a public service radio and TV programming for the universe their own AI Medical Center campus and Champaign Urbana. This program was distributed by the national educational radio network.