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	Dr Minh Nguyen

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Leaping into the Future

February may be a short month, but it is a busy month. Not only is it Hot Breakfast Month and Potato Lover’s Month, it is also Children’s Dental Health Month.

Children are our direct connection to the future. One day they will be our teachers and truck drivers; they will be our healthcare providers and our leaders. We owe it to ourselves, our future and our children to provide them with the best health care that we can.

Twentieth century achievement

Dental fluorosis Let us explore a facet of children’s health that has its good side and its bad side: fluoride.

The Center for Disease Control states that fluoridation of water is one of the greatest health achievements of the twentieth century. For 50 years the American Dental Association (ADA) has endorsed fluoridated water as a safe and effective means to prevent tooth decay. The U.S. Surgeon General agrees: Fluoridation is the most cost-effective and safest way to protect a community’s dental health. That is pretty heady praise, but for infants, there is a potentially dark side to this wondrous chemical element.

Infants can fall victim to a condition known as fluorosis. Fluorosis, also called enamel fluorosis, causes the enamel in a baby’s developing teeth to be discolored with brown markings, pitted, rough and weakened. Their teeth are hard to clean. In some cases, fluorosis causes the teeth to have white specks or streaks. Fluorosis is not a common condition, but one of which parents and caregivers need to be aware.

Baby Bottle Recently, the ADA recommended that babies under one year of age should not drink liquids that contain additional fluoride. The danger is that many foods and liquids naturally contain fluoride; thus, a baby likely receives the required dosage of fluoride without adding fluoride to the diet. This means that if you live in an area where the water is fluoridated, "regular" fluoridated water should not be used to reconstitute powdered baby formula or to dilute concentrated liquid baby formula. The Academy of General Dentistry (AGD) recommends using low fluoride bottled water for that purpose. The water will be labeled “purified” or “distilled baby water.” If you have a reverse osmosis filtration system on your home water supply, that water would be safe to use in formula.

If you want to know what the fluoride level is in your water supply, you should contact your local water department or your local health department. You could ask your dentist if he or she has a colorimeter in the office. A colorimeter is a machine that determines the amounts of certain elements and chemicals in certain liquids.

The ADA recommends that children under two years of age should not have their teeth brushed with fluoride toothpaste unless advised to do so by a dentist. This recommendation should be balanced against the fact that your water supply is already fluoridated. If you live in an area with unfluoridated water, then monitor your child's use of fluoride toothpaste. There is a low dose fluoride toothpaste for children to use.

Children over two years old should use only a pea-sized amount of fluoride toothpaste. Have the child spit out the toothpaste, not swallow it. The ADA also warns against children under six years old using a fluoride mouthwash. Younger children have not yet developed the ability to spit; they swallow, naturally. They are likely to swallow the mouthwash rather than spit it out. The ADAs warning could be somewhat misleading. It would pertain to anyone who lives in an area where the water supply is fluoridated.

Some schools have fluoride rinse programs. If your child's school has this program, then monitor the child's fluoride use and intake at home.

Healthy primary teeth

Dental hygiene for children Protecting a baby’s primary teeth will help to ensure healthy permanent teeth.

For children whose primary teeth have given way to their permanent teeth, fluoride is a good friend to have. One way to effectively deliver fluoride to their teeth is with fluoride varnish. Fluoride varnish slowly releases fluoride and promotes tooth remineralization that makes tooth enamel much stronger.

Results from an early 2006 study performed by the University of California San Francisco School of Dentistry indicated that fluoride varnish helps prevent tooth decay. The study was conducted over a two-year period of time. At the end of two years, children participating in the study who didn’t receive fluoride varnish were four times as likely to develop tooth decay as children who received fluoride varnish treatments twice during the year. The results also confirmed the importance of taking a one-year old child who is getting his or her first teeth to the dentist.

As the “godfather” of fluoride toothpaste, Crest* conducted a survey that inquired into 6-11-year olds tooth brushing habits. The results were not particularly good. Sixty-one percent said they brushed one minute or less even though they knew they should brush longer. Forty-one percent of the children brushed one day or less each week. Sixty-seven percent of the children did not brush at least once or more every week before they went to bed.

Child Protection A child’s dental health is critically important. Untreated tooth decay can cause pain and infection that can result in eating, speaking and learning problems. A study conducted by the National Survey of Children’s Health in 2005, reported that 51 million school hours are lost each year to dental-related illnesses.

Protecting children is one of the highest values in many cultures. Because tooth decay is the number one childhood disease, early intervention, prevention and treatment are of utmost concern and priority.

*Crest was the first fluoride toothpaste to receive the ADA seal of approval 40 years ago.