The Canadian Dental Association recommends that children see a dentist within six months of their first baby tooth appearing or by age one, whichever comes first. Monday’s study in the journal Pediatrics showed less than two per cent of children had seen a dentist by 24 months.
Those most in need of dental care were least likely to receive it, researchers found based on a survey of 2,500 families in Toronto with children around four years of age.
Low family income, bottle use during the day or night beyond 15 months of age and drinking a lot of sugar-sweetened beverages were associated with increased risk of getting cavities, Dr. Jonathon Maguire, a pediatrician and researcher at St. Michael’s Hospital in Toronto and his co-authors found.
"We see a lot of children that have pain and suffering and long-term consequences from poor dental health," Maguire said. "It’s really heartbreaking."
The complications of poor dental health in children are significant, including pain that can lead to difficulties eating, poor nutrition and poor growth, difficulties sleeping, difficulties with behaviour, infections and low self-esteem, said Dr. Anne Rowan-Legg, a pediatrician at the Children’s Hospital of Eastern Ontario who wrote a position statement on oral health.
"There’s a common misconception that cavities in early teeth that later fall out are not an issue," Rowan-Legg said. "But we do know that kids who get cavities in those early teeth are far more likely to develop disease later on."
The most common surgical procedure in pediatric hospitals across Canada is extracting teeth in preschoolers, Rowan-Legg noted.
While preventive dental care for young children isn’t part of Canada’s universal health-care system, Maguire feels it makes sense to include it. About one third of Canadians have no dental insurance.
When Haley Sabatine brought her 19-month-old sons, Rowan and Nate, in to see Maguire, she was surprised to learn it’s time for the boys to see a dentist.
"Now I do see the reason why," Sabatine said. "Parents need to know how important it is to get their children’s teeth looked at even at an early age."
Maguire suggested training physicians to do a better job of examining teeth and said dentists should receive more pediatric training in dentistry school.
Rowan-Legg imagines the role of the family doctor or pediatrician to provide counselling and education to parents, such as on prolonged bottle use and avoiding sugary drinks, and to do a preliminary assessment to judge a child’s risk of dental disease. If any potential problems are spotted, then the child can be sent to a dentist.
Families participating in the study were surveyed between September 2011 and January 2013.
The study was funded by the Canadian Institutes of Health Research and St. Michael’s Foundation.
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