In which I felt the need to respond

I saw this on my twitter feed today:

I tried to embed it here: Tenn. reporter gives parents good tips to protect their kids' teeth from decay #Dentalisfundamental @karennazorhill— CDHP (@Teeth_Matter) February 5, 2014

..and got excited. A paper from my home state was highlighting children’s oral health – particularly applicable since February is National Children’s Dental Health Month. But then I read the article, linked here, and was sadly disappointed.

If you have nothing better to do with your day, my response that I emailed to Ms. Hill is pasted below:

Ms. Hill,

First I would like to thank you for highlighting the importance of children’s oral health for the Chattanooga community. Early childhood caries (cavities) is the number one chronic disease affecting young children and establishing a healthy mouth promotes overall well-being.

I am concerned that parts of your article are inadvertently dismissive of the current recommendations by the American Academy of Pediatric Dentistry and the American Academy of Pediatrics that children see a dentist by age one and do not fully emphasize the importance of dental care for children:

The entire anecdotal section about Dr. Joseph Brogden’s interaction with his grandson is not applicable to many patients. Dr. Brogden is a general dentist and unfortunately is disseminating and reinforcing false, outdated information about children’s teeth (as quoted by his daughter as saying: “…it really isn’t necessary to get kids to the dentist too young. After all, baby teeth do fall out”). The reason that we currently recommend children seeing a dentist at age one is because all too often when they are seen at three, four, five years old or later, they already have cavities that need to be fixed. Sadly, emergency room visits for children because of tooth pain are on the rise and dental disease contributes to thousands of lost school days each year.

Cavities in baby teeth can quickly spread to the nerve of the tooth and then into the bone which can damage developing adult teeth and cause life threatening infections. Many times this necessitates having the baby tooth pulled, and then it no longer holds space for the permanent tooth that will come in when the child is 11 or 12, which can cause crowding. Young patients are particularly challenging as highlighted by your article. Children do not often want to sit in a dental chair and fixing even small cavities on their baby teeth before they get larger is often impossible. Without good preventative measures, it is often necessary that children have surgery under general anesthesia or sedation to fix their cavities, which comes with its own set of risks.

By seeing a child early and often, dentists can help parents prevent cavities and monitor a child’s growth and development. Dr. Charles Ankar highlighted helpful hints that are useful for parents, but I’m afraid that the consequences of not following these guidelines were not forthcoming in your article.

Quotes from parents saying that going to the dentist is both difficult and a waste of time and money is unhelpful for the general public (“I thought it was a total waste of time and money and put Shad and I in a power struggle of ‘you must sit for the dentist’ that we just didn’t need. I won’t take Knox for many years, unless, of course, there is something that needs to be checked out”). For some children, going to the dentist is difficult, but so is getting necessarily immunizations from their pediatrician. Pediatric dentists are dentists who have gone to dental school and then completed an additional two years of training afterwards, and are a good resource for scared kids. They have been trained in techniques to help familiarize children to the dental environment while providing age appropriate care. I was disappointed that you did not include any pediatric dental specialists in your article. As for early visits being a “waste of money”, it is much cheaper to see a dentist for preventative cleanings and exams than to fix cavities (especially under general anesthesia) or be seen in the emergency room for tooth pain.

Again, I am very thankful that children’s oral health is being highlighted by the media, so I do not mean for this letter to be disparaging. I am only concerned that the importance was not properly conveyed. The answer to the question posed in the title of your article should have been a clear, unequivocal “age one” in order to prevent undue morbidity, and rarely but tragically, mortality. February is National Children’s Dental Health Month, when the American Dental Association raises awareness about developing good habits for a lifetime of healthy teeth. This however this is clearly an important public health issue that needs to be addressed year round.


Elise Sarvas, DDS

Pediatric Dental Resident and Master of Public Health candidate at the University of Washington and Seattle Children’s Hospital in Seattle, Washington

Native of Oak Ridge, Tennessee

2 thoughts on “In which I felt the need to respond

  1. HI  Glad you sent a reply  !!!   Just a note how did you like the Super Bowl and did you go to NY for the game ???

    • We loved the Super Bowl! Very proud of the Seahawks! No, we were in Seattle (which has been a lot of fun – there was a parade downtown today) because I was on call. Would love for a repeat of this next year!

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