Dear Doctors: We have a family health situation going on, and it’s all about teeth. Our 15-year-old son has never been what would term an enthusiastic toothbrusher, but we all recently had a checkup and he has apparently a dozen cavities! Some of them are small, but my husband is furious as we have no insurance coverage and this comes out of the family budget. He is threatening to take his cell phone away. My daughters had a couple of cavities each, but our son beat them by 6 times. I did find candy wrappers under his bed, but of course, he has ‘no idea’ where they came from. What can we do to prevent it from reoccurring?
Answer: Your situation isn’t that unique especially in the mid-teen years and with kids undergoing orthodontics. Firstly, statistics on healthcare are often from the USA, but generally, ring true on our side of the border. Oral care is usually about cause and effect. Ignore it, and it deteriorates. High-carb, high-sugar foods that are left on and in between the teeth form plaque, cling to the teeth and produce acid. This dissolves the enamel and you now have a cavity. The harmful behaviour is often done out of parents’ watchful eyes, and every school has a corner retail store relatively close by. Teachers tell us that kids with pockets full of candy are a problem occasionally in classrooms. Certainly, teenagers source much of it with their own spending money so mom and dad are blissfully unaware. In the USA, just a few short years ago (2015- 2016) over 60% of kids aged 2-19 had cavities. That has now fallen to 43%, and it is somewhat demographic-dependent. A significant number (13%) had untreated cavities, which contributes to toothaches and teeth loss. The ratio of cavities was worst with older kids (where your child falls in). The American Academy of Pediatrics has been encouraging that children begin dental care when their baby teeth emerge, and this has had a positive effect.
Economics does dictate a role here. Healthy food is expensive, as is oral care for some families. Living near a dentist’s office is also a factor in some children not seeing a dentist as often as they need. Overall, fewer kids are getting cavities so the dental health care authorities are encouraged. In your situation, unless your son has a specific health ailment it is probable that neglect is the cause. We saw one teenage boy with 23 cavities once, and his father was livid too! Nothing short of parental vigilance is likely to prevent reoccurrence if a child is sucking on sweets during the day, and most importantly at night. It’s a struggle with older kids put on your sergeant major hat!