Oral tradition

For every age group except preschoolers, the incidence of cavities in children has been on the decline. But, according to a 2007 health report from the Centers for Disease Control and Prevention, the prevalence of cavities in kids 2 to 5 has increased 4 percent from a decade ago, going from 24 to 28 percent. And almost 20 percent of kids ages 2 to 3 have at least one untreated cavity.

Why there's a rise among this generation of preschoolers isn't clear, but one theory is that it comes from what they're eating.

"It's probably due to more refined sugars and carbohydrates in their diet and [drinking] bottled water with no fluoride," said Dr. Gregory Mokotoff, a pediatric dentist with Kids First in Fairfield.

Tooth decay, even in baby teeth, is a concern, he said, because "there is a direct correlation between baby teeth health and adult dental health."

Dr. Scott Bialek, president of the Connecticut Society of Pediatric Dentists, who practices in Brookfield, agreed that good nutrition is a big part of good oral health.

"Children are more indulged and there's more sugar in foods than ever before," he said. "We need to educate parents that fast food isn't the best food and they should give kids veggies, not candy bars."

Sweets are the bad guy because foods high in sugars and starches help decay-causing bacteria make acid that destroys teeth.

While Bialek said that "some people have awful baby teeth and great adult teeth" and vice-versa, both dentists agreed that

every child should have their teeth checked around the time of their first birthday.

To help educate parents about good childhood dental care, the American Academy of Pediatrics and Oral-B, with TV personality Joan Lunden as spokeswoman, have partnered in an awareness campaign beginning this month, National Children's Dental Health Month.

The AAP has a section of pediatric dentistry and oral health with pediatric dentists as part of its membership, said Dr. David Krol, AAP spokesman and chairman of the department of pediatrics at the University of Toledo College of Medicine. It's a unique partnership, he said.

"The role of that section is not to just provide dental expertise that pediatricians need to know, but it's an opportunity to join in their advocacy efforts," he said. "That's what I think is fantastic.

"Oral health isn't just a dentist issue or just a pediatrician issue or just a family issue, it's a shared responsibility," he continued. "As pediatricians, we see kids throughout their childhood and there are opportunities to give oral health messages."

A new initiative the AAP and the American Dental Association have is the Home by One program, which promotes the idea that children see a dentist — and find their dental home — by their first birthday. While the campaign is still in the planning stages, Bialek said, Connecticut will be the pilot program.

The first tooth erupts around 6 months of age, said Mokotoff, and by age 1, children have eight to 12 baby teeth.

"What you want is to have that first [preventative] visit by age 1. You want [the child] to have an experience that's not a 'drill and fill,' but an enjoyable first experience rather than one of fear," said Krol. The AAP came out with a policy in 2003 that pediatricians should be referring patients to dentists, but it's taken time to get everyone on board, said Krol. Also, in the past insurance has been a problem, said Bialek. "Traditionally, insurance wouldn't pay for [a dental visit] until age 3," he said. "Now, most insurance will cover age 1." Mokotoff said the first examination is basically looking at the teeth, counting them and brushing them. "Most children have a positive experience and do far better than the parents think they will," he said.

His most important advice to parents: "Make brushing a routine." "Have your child brush twice a day — before school and before bedtime so they go to sleep with a clean mouth," Mokotoff said. "Floss once a day and use a mouthwash once the child can spit out. The age can vary, but it's usually between 3 and 4." The Oral-B Web site suggests that parents make brushing fun, too. For example, sing a two-minute song to encourage brushing for the dentist-recommended time.

For more tips, visit www.oralb.com/kids or www.aap.org.