Infant Decay
(This article is written in response to an E-mail from a concerned
mother.)
The most common reason for decay in young children 3 years and
younger is "milk bottle mouth". This is caused by putting a
child to sleep with a bottle containing milk, formula, or juice. Parents don't
realize it but there is a great deal of sugar in these seemingly healthy things.
There is enough sugar to cause severe decay over a period of time. I
recommend substituting a sugar-free beverage (like sugar-free Kool Aid) in your child's
bottle.
Having your child "put to sleep" to have the work done.
I have never seen a child under 3 years old (in my 28 years of experience)
that could tolerate having dental work while fully awake. I recommend some kind of
sedation or general anesthesia. The key word, however, is SAFETY!!
Here in California, we have had some tragic cases of death of small children in
dental offices. It has caused the state to pass laws making it illegal for a dentist
to use even oral medications to sedate a child unless they have received special training
and licensing.
Questions to ask before allowing your child to be sedated or put
to sleep:
Is my child going to be sedated (made sleepy but able
to be aroused) or given general anesthesia (be "put to sleep" so that they can
not be aroused)? [The reason for this distinction is that sedation is usually
safer that general anesthesia.]
Who will be administring the sedative or anesthetic and what is their
training? [Here in California, we have dental anesthesiologists who are dentists
that have received extensive training in anesthesia and that is all they do. The
dental anesthesiologist gives the medication and then monitors the child with
sophisticated monitoring equipment while the treating dentist performs the dental work.
This is the safest technique but because two dentists are involved, it is
expensive. It is possible for a general dentist or a pediatric dentist to be trained
and licensed to administer the medication, monitor the patient, and perform the dental
treatment - this is in fact what oral surgeons do all the time.]
What kind of safety precautions are used and what kind of monitoring
equipment is used to insure my child's safety? [As I stated above, the state of
California now requires that monitoring equipment be used even for oral sedation.]
Should I have the dental work done?
How important are baby teeth? Baby teeth are more
important than most parents realize. They act as space maintainer for the permanent
teeth. If they are lost prematurely, it can result in crooked permanent teeth.
If cavities in baby teeth are not taken care of, abscess and infection can result.
Your child could go through terrible pain and damage could be done to those
important permanent teeth.
How much dental work should I have done? This is
a harder question. If the cavities are small and the parents can drastically reduce
sugar, sometimes treatment can be delayed. Waiting until the child is 6 months to 1
year older can make a huge difference in the need for sedation or anesthesia. On the
other hand if the cavities are large, delay can result in pain and infection. The
parents have to rely on the dentist to help them to decide what is best for their child.
Should I allow the dentist to use "restraints" on my
child? I am afraid that I feel strongly about this question. There
are some dentists that use a "straight jacket" to immobilize the child so that
treatment can be performed. This can and does psychologically harm the child and can
result in severe dental phobia. I have seen many adults that have dental phobia
caused by this kind of treatment. This should only be done in extreme cases of pain
and infection when the use of sedation or general anesthesia is impossible.
