Aboriginal babies' tooth decay called 'serious'

More than 90 per cent of young children living in some Canadian aboriginal communities have cavities in their baby teeth, say dentists who are calling for preventive solutions.

Monday's issue of the journal Pediatrics includes a joint position paper by the Canadian Pediatric Society and the American Academy of Pediatrics urging "immediate attention" to the problemof infectious tooth decay in primary teeth in aboriginal communities in both countries.

Dr.Robert Schroth, a specialist in pediatric dentistry at the University of Manitoba in Winnipeg, says he has seen aboriginal children from remote communities with 18 out of 20 of their baby teeth rotting away.

"The crowns have broken away and it's only the little root stubs left and sometimes little draining abscesses," said Schroth, one of the co-authors of the paper.

What used to be called baby-bottle tooth decay is an infectious disease most often caused by a strain of streptococcusbacteria in combination with poor diet habits and lack of oral hygiene that can weaken tooth enamel.

Known in medical and dental circles as "early childhood caries," the condition can be painful and affects a child's ability to chew food, disrupts sleep and causes problems with growth, according to the paper.

Schroth and his co-authors say offering mothers more guidance can help prevent the problem by stopping them from passing on the bacteria that cause tooth decay.

When a baby drops a soother on the ground, for example, a mother shouldn't pick it up, lick it off and give it back to the baby, Schroth suggested.

In Manitoba alone, more than 2,300 children every year under the age of six undergo dental surgery under general anesthesia in hospitals at an average cost of $3,500 each, he said.

The authors also call for:

• Doctors, nurses and community health workers to apply fluoride to kids' teeth to protect them.
• Doctors to use checkups to educate parents and caregivers on proper oral hygiene and diet, including supervised use of fluoridated toothpaste after the first tooth erupts.
• Communities to bridge the gap in access to fluoridated water over the long term. An estimated 45 per cent of Canadians have fluoride in their tap water compared with less than 10 per cent of First Nations people living on reserves, Health Canada estimated in 1998.
• Including dental health in prenatal screening for pregnant aboriginal women.
• Boosting representation of indigenous people in oral health professions.
• Adding oral health training to pediatric and family medicine residency programs.
• Increasing awareness among doctors and other primary care providers that many professional associations recommend comprehensive health care by dentists and an oral health exam within six months after the first tooth erupts or by 12 months of age.

The Canadian Pediatric Society is a national advocacy group that includes nearly 3,000 pediatricians and other child health professionals across the country. The American Academy of Pediatrics includes 60,000 members.