National Children's Dental Health Month
This year, the American Dental Association (ADA) marks the 60th anniversary of celebrating National Children’s Dental Health Month. Each February, the ADA promotes the importance of regular brushing, diet and dental visits for the dental health of children. There is a great deal of evidence that children with Gastroesophageal Reflux Disease (GERD) are at greater risk for tooth enamel erosion. Stomach acid that is refluxed into the mouth may wash over the teeth and lead to tooth decay.
Toddlers and children with GERD may face barriers to obtaining the home and dental office care needed to monitor dental health and prevent problems. I have conducted a small case study on this issue in my own household. My non refluxer was in her late teens before she had one tiny little cavity. My two refluxers had dental issues that ranged from mild to severe. We faced several key barriers to getting dental care including resistance to tooth brushing and using flavored tooth paste.
I have listed the common problems associated with dental care for children with GERD and some possible solutions.
Yuck, it tastes bad!
Does this sound like your refluxer? Resistance to tooth brushing and flavored toothpaste/mouthwash/fluoride rinse is common for children with GERD. My kids are very wary of a new taste or texture in their mouth. They tell me the toothpaste flavors backwash and mix with acid, causing a really bad taste in their mouth, even hours later.
I always remember taking my refluxer to the dentist and listening as the dental hygienist recited the long list of yummy sounding flavors for the fluoride treatment. Strawberry? Grape? My stomach would rumble with hunger just at the mention of the flavors. But my refluxer was sitting there squirming in her seat thinking, “Strawberry? Yuck! Grape? Not in a million years.” At the end of the long list of flavors, she would pause and say, “Well...I guess the marshmallow didn’t sound too yucky. “ The reality is, while most kids had a hard time choosing just one flavor, she was trying desperately to figure out a way not to choose any of the above!
Try every flavor, color and packaging and hopefully you will stumble upon a brand of toothpaste your refluxer will tolerate. Be sure to supervise the tooth brushing so just a tiny amount is placed on the brush. Look for a soft toothbrush with a small brush. Some children react to the texture of the bristles and feel like they will gag when something is in their mouth.
I don’t want to brush my teeth.
I don’t know too many children who truly look forward to brushing their teeth unless they just got a new Thomas the Tank toothbrush. But the fun only lasts a few days. While your child may have an average interest/motivation to brush, keep in mind that acid may damage the enamel on the surface of the teeth causing sensitivity to eating and brushing. Ask the dentist if there is a child-friendly toothpaste for sensitive teeth. In addition, you might have to have motivate your child with a sticker chart or reward for brushing every day.
I don’t want to go to the dentist!
A child who has experienced months or years of medical treatment for GERD may be resistant to dental treatment. Luckily, a pediatric dentist can offer a child friendly environment with many incentives to cooperate. Our pediatric dentist has a multi level play gym in the waiting room for the younger kids and video games in a separate room for the older kids. The children always come back from a dental check up with a bag full of toothpaste, samples and prizes.
A pediatric dentist will work with you and your child to deal with fear and anxiety about dental procedures, even if multiple trips are needed. Our dentist has been super about pain management, with many options from numbing medicine to light sedation.
We can’t afford dental care.
Dental insurance may only cover a portion of the total cost of dental care. If you are already paying more than the average family for GERD medications and treatments, the burden may be great.
During the month of February, the American Academy of Pediatric Dentistry and other organization sponsor a free dental health screening for children without dental insurance. Further, President Obama, realizing the importance of medical and dental insurance coverage for children signed the reauthorization of the Children’s Health or CHIP insurance program. The CHIP program provides low cost or free medical or dental coverage for children who qualify. Check with your local health department for an application.
The American Academy of Pediatrics trains doctors to screen for dental problems during well check ups beginning with the first tooth. I attended the American Academy of Pediatrics conference last fall and I was impressed with the Bright Futures initiative to provide pediatricians with the information they need to monitor dental health and when to refer a toddler or child to a dentist. If you really cannot afford a dental check up, ask your pediatrician to monitor dental health and alert you to any problems that necessitate immediate care.
Be sure to check out my blogs from April and May 2008 titled, The Reflux Moms Guide to Healthy Teeth, Parts 1, 2, 3 for detailed information on dental issues and GERD.