Oral hygiene is an integral part of being a healthy individual, especially for newborns and infants. Early Childhood Caries, formally known as baby bottle decay, is a silent epidemic that can lead to major health problems in the child’s development, but it’s rarely discussed in mainstream medicine. Dr. Leonard B. Smith is a pediatric dentist who’s dedicated a large part of his career to educating the world’s caregivers about the importance of taking preventative measures to avoid this chronic disease.
Human beings are complex individuals made up of multiple systems that are connected to keep us healthy. Oral hygiene is the gateway to overall health, especially in newborn babies and infants.
Early Childhood Caries (ECC), formerly called baby bottle decay, is the most common, chronic progressive, infectious disease in children 5 and younger in North America.
It has been defined as “the presence of 1 or more decayed (non-cavitated or cavitated lesions), missing or filled tooth surfaces in any primary tooth in a child less than 6 years of age. In children younger than 3 years of age, any sign of smooth-surface caries is indicative of severe early childhood caries (S-ECC),” according to Dr. Leonard B. Smith.
Early childhood caries must be viewed as a major public health issue, rather than just an oral health issue. The National Center for Health Statistics reports that the incidence of this infectious disease in children between 2 and 5 years of age involves 28% of them or approximately 5 million children in North America and that 23% of those or approximately 1.2 million never receive any treatment!
“That is 1.2 Million children suffering toothache, sleep deprivation and malnutrition for weeks, months or years! These children are truly neglected and/or abused. They are seriously emotionally and physiologically stressed.
These realities are truly sad and beg the question as to why this is happening. Dental caries is the easiest disease to prevent at nearly no expense to the family. The sad truth is that the general public does not hear, does not read or more importantly does not believe what we, as Professionals, are trying to teach: ECC is a disease that is about more than just baby teeth!”
“Early Childhood Decay is a major issue that has extensive health implications, especially for infants. There’s an attitude that exists, unfortunately, that has most individuals believing that baby teeth aren’t that susceptible to dental disease because the teeth are going to fall out, when that’s the complete opposite of the reality.”
Dr. Smith discussed how ECC has always been a major problem that’s only gotten worse as his career progressed.
“I’ve been in dentistry since the 70’s, and back then dental disease in children wasn’t as big of an issue as it is today. The sugar intake of kids today is exponentially higher than it used to be, making a larger population of young children more susceptible to things like decay and ECC.
As I grew in my career, I learned more and more about how large of an issue dental disease in children is in the US. The CDC released data within the past few years that showed 28% of kids have experienced some form of dental disease, and of those kids 23% never received treatment. Part of the reason is because there’s not a lot of discussion over the seriousness of this problem when it comes to a child’s development.
Millions of families cope with this issue every year, and if you look at specific populations and their social status, you’ll see that certain population’s experience this at a much higher level due to a lack of access to affordable healthcare.”
Dr. Smith explained how “Early childhood caries (ECC) is a major oral health problem, mainly in socially disadvantaged populations, affecting infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups.
ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. The upper front incisors are usually the first ones to develop decay – often on the back of those teeth and along the gums – at the front. If the disease continues, caries can progress, leading to complete destruction of the crown.
The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases.
The major contributing factors for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image.”
It was previously known as baby bottle decay, and has been declared a serious health issue by the CDC, but it’s a worldwide issue, especially in parts of the world where water isn’t safe to drink.
“Tooth decay and ECC is a Chronic disease in North America, Canada, underdeveloped countries and dysfunctional families. Sugar intake, juice and similar are huge contributors to decay, water is always a better option. My goal is to expose this silent epidemic and focus on solutions.”
There’s a major socioeconomic connection to this issue as well. Women with children who have suffered from domestic abuse and who are forced to live in poor conditions/shelter’s, don’t have the financial means or ability to fully take care of themselves or their children, especially when it comes to their oral hygiene.
Children of lower socioeconomic status are also more likely to have a diet of cheaper food and sweets because that’s what’s most affordable in this country, making it almost too easy for ECC to appear.
Modern day dentistry has definitely seen an increase in education regarding ECC, however, this education exists mainly in populations of high socioeconomic status. Families of a lower status don’t have the access or the funding to learn and treat oral abnormalities that can lead to more serious health issues.
When left untreated, children can become malnourished, due to the pain they experience when eating. If this is happening during the early months and years of the child’s development, the brain will start to think that the pain is normal, but overall, their bodies aren’t going to be able to fully function properly, which can complicate their overall development.
As a child continues to grow untreated, the amount of cortisol, stress hormones, in their body will cause constant fatigue and physiological damage. If a child only ever knows pain and suffering for their first few years of life, emotionally, they’re going to tend to become much angrier and resentful of the pain they’re experiencing.
Beyond that, as the child continues to get older, they’ll become more susceptible to illnesses like heart disease, diabetes, non-alcoholic liver disease, and more. So when it comes to our kids’ oral hygiene, it’s important to prioritize all of the preventative measures when they’re babies, the same way you prioritize a specific diet to help them grow.
Dr. Smith has dedicated a large portion of his career speaking at various conferences and publishing informational booklets in various languages to spread awareness over this worldwide issue. His main goal is to educate as many families as possible about the seriousness of this disease and the major health implications it carries.
“More than anything, I need the public to have a better understanding about the importance of oral health for all children, adolescents, and adults, because dental disease in children is about more than just baby teeth! It’s about their wellbeing and health, something all parents want to protect.”
Dr. Smith also explained the societal implications that ECC carries if left untreated. Families who don’t treat their children’s ECC, or any other form of dental abnormalities, are considered neglectful and abusive due to the lack of medical treatment that their children require.
“The desperate mothers who are not able to get the oral health care for their child tend to turn towards ulterior methods of treatment that won’t require them to go to the doctor.
Some parents have given their child alcohol in a bottle to settle their desperate crying due to toothache, which the baby then deems to be normal as they have experienced the pain at such an early age, and then the mother provides pain meds like aspirin, Tylenol, ibuprofen etc., but over time they don’t help so pain meds containing a narcotic are used – all of which sets up an addiction potential to the medication – leading to the desire for more potent and potentially lethal drugs such as opioids, that I don’t believe has ever been looked at.”
This is part of the reason that Dr. Smith’s main goal has always been to educate and spread awareness regarding this disease and the preventative measures anyone can take to protect their child’s oral health.
One of his goals is to create an age specific oral health educational program that would be exclusively available online, so families and professionals around the world can have access to it and learn about the serious consequences of this illness. Implementing this program in schools will give kids and their families the opportunity to learn without feeling overwhelmed by medical visits and costs.
“Some individuals don’t view dental issues in young children and infants as serious because the teeth are going to fall out eventually anyway. I think that, combined with the fact that as adults we’re presented with numerous options for replacement teeth should one of our adult teeth fall out (dentures, etc.), causes oral health and hygiene in general to be taken less seriously than other sectors of medicine and health.”
“What people don’t understand is that each individual tooth has its own blood and nerve supply. The blood vessels connect to the vessels in our skull, which then connects to more major vessels in the body. So an infection in the mouth, whether it’s tooth or gum, can travel to anywhere in the body.
The literature has reported cases where a child has died due to a brain abscess that was initially caused by a tooth abscess. The human body is complex, but heavily connected, making it easy for something that seems as harmless as a cavity to turn into a much more serious issue.”
Dr. Smith is involved with two major non-profits working towards his goal of education and providing solutions for children with ECC. The Society for A Healthy Mouth Healthy Child (Alberta) and the Foundation for a Healthy Mouth Healthy Child in the USA, both founded by Smith.
“Both foundations are sister organizations, based in Canada and the US. What I hope to do through these organizations is to raise money that will cover the cost of creating educational programs.
I think it’s important to make people aware that this is a very serious disease. Prevention begins at birth, parents should clean their babies gums with a cloth and water after every feeding; utilize a moistened sponge to wipe the mouth after each feeding as this aids in the removal of residual food that is left on the surface of each tooth.
Once the teeth begin to erupt into the mouth around 6 months of age, it’s imperative to clean all surfaces of each tooth following each feeding, neglecting this measure causes 90% of ECC cases, but staying on top of these cleanings can also reduce your child’s risk of ECC and other oral abnormalities by up to 90%.”
The public needs to be informed and the awareness needs to begin to spread. Being a parent or guardian is one of the hardest jobs in the world. There’s so many things you’re supposed to know and learn, but at the end of the day I think most caregivers just want to have a happy and healthy child, so taking preventative measures that will take care of your child’s mouth is essential in guaranteeing that that’s exactly what they’ll be.
If you have any questions or comments about ECC, the preventative measures you can take to protect your child, and the extensive work Dr. Leonard B. Smith has done to educate the world on this epidemic, you can contact him through email@example.com
Eric Mastrota is a Contributing Editor at The National Digest based in New York. A graduate of SUNY New Paltz, he reports on world news, culture, and lifestyle. You can reach him at firstname.lastname@example.org.