August 19th, 2010
05:26 PM ET

New center aims to curb tooth decay in infants and toddlers

The University of Washington and Seattle Children’s Hospital are teaming to combat the rise of childhood dental disease in the U.S. by opening the first Center for Pediatric Dentistry.  The center will not only provide modern dental care to local children but also seek to raise awareness about early intervention and  preventing disease in first place, says Dr. Joel Berg, the center’s director.

Parents and even many pediatricians aren’t aware of just how early children’s teeth can begin rotting. The center's targeting of tooth decay in infants, preschoolers and toddlers makes it unique, says Dr. John S. Rutkauskas, CEO of the American Academy of Pediatric Dentistry (AAPD).  Rutkauskas tells CNN he believes this center could be a model for other practices.

Berg can’t hide his passion for trying to prevent  tooth decay in the youngest patients.  He sees too many little kids who are too young to sit still, so the only way they can get their cavities treated is by going to the operating room and undergoing full anesthesia.

He says he recently had to refer five children to OR in one day.  Surgery is often the only option if a 2 and a half year old needs 15 teeth operated on – either to get fillings, or have pulp therapy (which is like a baby root canal) or get teeth pulled, he says.

Getting a child proper dental care is essential but not always common, and children in lower-income families often don't see a dentist.  “Almost half of the kids in the U.S. are born into Medicaid [needing government assistance for health care].   Of those children, about two-thirds of them haven’t had regular dental visits by age 6 – but interestingly most of them have all their vaccinations,” Berg explains.

The number of children getting cavities is on the rise, particularly among the youngest.   According to the American Academy of Pediatric Dentistry (AAPD): “Tooth decay is the single most common chronic childhood disease—5 times more common than asthma, 4 times more common than early childhood obesity, and 20 times more common than diabetes.”

The CDC reports more than a quarter of children have tooth decay in baby teeth before entering kindergarten and by the time children are 19 years old, they have had some decay in permanent teeth.

Tooth decay can begin as early as teeth begin to emerge, which happens around 6 months of age.  Tooth decay or early childhood caries, can progress very quickly and lead to a lot of pain for the child and huge medical costs – the cost of fixing cavities in the operating room can run at least $20,000.

The American Academy of Pediatrics (AAP) first began recommending that children find a “dental home” by age 1 back in 2003, according to Dr. Martha Ann Keels, a pediatric dentist at Duke University and spokesperson for the AAP.

Many parents appear to be unaware of new guidelines for children's early tooth care. The current guideline is that children should have had their first dental visit by their first birthday. Previous recommendations called for a child’s first visit to the dentist at age 3.

Keels, who also finds herself treating young patients in the OR, says parents need to be aware of the risks that come with tooth decay.  In the worst case scenarios, Keels says, “Upper abscess teeth can lead to brain infection – lower abscess teeth can lead to heart disease.”

Berg says the pain and suffering kids experience can be enormous . “Children die each year from this," he says. "Fortunately not many, but one is too much.”

Keels and Berg emphasize that all of this is preventable.

One of the goals of the center in Seattle is to give pediatricians a chance to learn how to identify the tots at highest risk for dental problems.  Pediatricians could screen babies' teeth when they come in for regularly scheduled check-ups.  They could also learn about new technologies that would allow them  to find microscopically small decay.  If caries can’t be prevented, catching and treating it as early as possible is the next goal.  For example, one new technology uses fluorescent light. Even if the decay is not clearly visible, it reflects different light waves when there's damage, Berg explains.

Parents also need to know the basics.

“The more parents I can teach how to brush their children’s teeth, the more cavities I can prevent,” Berg says.

The Center for Pediatric Dentistry is scheduled to open on September 1.

soundoff (29 Responses)
  1. Sandi Nagel

    As a Pediatric Nurse for many years, I totally agree and see the need to help parents understand the importance of preventive care. Great job in starting early...

    August 19, 2010 at 22:04 | Report abuse | Reply
  2. JG

    This is the kind of stuff I think the people need more of. Keep it up CNN.

    August 19, 2010 at 23:18 | Report abuse | Reply
  3. Emily Taibl

    This is great! Interesting article... and that is ONE CUTE baby!

    August 20, 2010 at 04:02 | Report abuse | Reply
  4. John Pilmer

    Good dental health for toddlers & adults starts with affordable dentistry. That is why more dental practices are moving to online practice mgt (in the cloud). It keeps client records secure and private. It keep the cost of dental practice lower. It makes interaction with patients more convenient and responsive. Is there any other provider for cloud-based online solutions besides Curve Dental?

    August 20, 2010 at 18:41 | Report abuse | Reply
  5. Nate Mo

    HELLO.... they are just going to fall out anyway. It's important to keep them clean and don't give your kids too much sugar. Teach them good dental habits. Comparing childhood tooth decay in baby teeth to such chronic illnesses as asthma, obesity, and diabetes is a little ridiculous.

    August 21, 2010 at 00:59 | Report abuse | Reply
    • jmg

      Yes, they are going to fall out, but did you not see the part of the article where abscesses can cause brain infection or heart disease & thus kill a child. if the teeth fall out too early, it can cause huge problems with the incoming teeth as the remaining teeth shift to fill in the holes. This is a two part problem – food stamps actually promote a crappy diet that leads to tooth decay because sugar laden processed foods provide more calorie bang for the buck than real food and there are next to no dentists who will take pediatric medicare because the reimbursement rate is so low. i read an article a few years back after that boy died in Baltimore that there are only 2 or 3 dentists in the whole Baltimore area that take it – and if they are out in the 'burbs, the folks most in need will never get there. Not to mention it's not like mom can take a day off work to take her kid(s) in for a checkup because she loses her min wage job for not showing up.

      August 21, 2010 at 08:21 | Report abuse |
    • Annie

      You'd be surprised how much pain and how many long term problems tooth decay can cause


      October 10, 2010 at 22:50 | Report abuse |
  6. studentteacher

    I substitute teach and when I sub for the younger grade levels, it is heartbreaking to see how many of the students have silver teeth. I work in a very poor neighborhood

    August 21, 2010 at 08:28 | Report abuse | Reply
    • good Mom

      Don't assume that because a child ahd silver caps on there teeth that they are poor. Me and my husband do very well for ourselves and we have dental insurance both of our children have or have had many caps due to soft teeth. They both see a pediatric dentist regularly.

      August 23, 2010 at 11:31 | Report abuse |
    • Annie

      soda and juice is probably to blame for those caps.


      October 10, 2010 at 22:49 | Report abuse |
  7. bill

    Nate Mo,

    It's true that they will fall out. Unfortunately, a hole in a tooth (a cavity) is just the culmination of a disease process that begins way before that hole appears. We cannot have the attitude that it's okay becasue the tooth will fall out anyway. With that attitude we miss the fact that all the things that caused the hole in the tooth will still exist after it falls out and will thus affect the new tooth that comes in. Those things include (as you mentioned) frequency of sugar intake, poor oral hygiene, bacteria in the mouth that cause the decay, absence of fluoride toothpaste and fluoridated water.

    They aren't just baby teeth. They are more important than that. We all have to recognize that this is a disease, and one that many people forget can have significant effects on a child's life (try to concentrate in school with a toothache) as well as the lives of adults (you'd be shocked to know how many military cannot be deployed because of poor oral health, see how people react to you in a job interview if you have no or bad teeth)

    August 21, 2010 at 09:47 | Report abuse | Reply
    • adam in WA

      Seattle-area kids are going to benefit measurably from Dr. Berg's center, but throughout the state, kids suffer higher rates of tooth decay than the national average, and it's harder to find a dentist outside metropolitan areas. Still, WA has more dentists per capita than 43 other states. We need a more responsive workforce to reach all kids before lifelong oral problems settle in.

      August 21, 2010 at 14:50 | Report abuse |
    • Annie

      there is a huge imbalance in where dentist are located. some areas are grossly under-served and other areas are just saturated with dentists. We need to get dentist to under-served areas.


      October 10, 2010 at 22:48 | Report abuse |
  8. Ash

    Great article. However I wish it would go more into why so many kids are having issues now. Diet and feeding habits can be the start of all the issues.

    August 21, 2010 at 17:24 | Report abuse | Reply
    • ljcjec

      I agree with Ash. While I think this effort is great, more needs to be done to improve the nutrition of children. Excess sugar intake and insufficient intake of calcium and vitamin D are more responsible for tooth decay than failing to visit the dentist. There is a lot of promising research that indicates that nutrition is even more important than everyday hygiene with respect to dental health. 80% of Americans are vitamin D deficient. This center is going to have to focus on what these children are (and are not) eating and whether they are getting enough time outdoors in addition to providing routine care if the goal is to improve overall tooth health.

      August 21, 2010 at 17:58 | Report abuse |
    • Annie

      agreed. The fact that kids are eating all the time, instead of having three meals and two-three snacks is also a problem as the mouth doesn't get a chance to balance all the acid eating requires. This is very bad for teeth.


      October 10, 2010 at 22:46 | Report abuse |
  9. Rosa Gonzalez

    a very nice idea! It can prevent the little ones nowadays from dental illness.

    September 25, 2010 at 03:06 | Report abuse | Reply
  10. Annie

    great article


    October 10, 2010 at 22:44 | Report abuse | Reply
  11. jenny

    I’m a single mom and I have 2 kids who both needed dental braces. I make just enough to not qualify Medicaid services so I can’t get free Treatment on teeth's beauty. I had to pay over $4800 so that my child can have braces and a beautiful smile. . .She was very scared and timid at school. I couldn’t find anyone in Los Angeles who would do the braces at a normal price so I had to launch find it with free services likehttp://www.healthsouk.com (HealthSouk- the dental discount plan or discounted dentistry) and http://www.1800dentist.com (800 dentist) The first one was free and the second apparently charges the dentist but not me.healthsouk
    – Jenny Thomas

    November 16, 2011 at 03:12 | Report abuse | Reply
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