The festive season is here and it comes with its treats, especially for children who enjoy every single drop of soft drinks, sweets, cakes and all sorts of sugary snacks.
This leaves a lasting mark when it comes to their dental health, leaving many with cavities.
It is not uncommon to find a child as young as two years old with dental caries or cavities. Most of those cavities begin before they even taste their first birthday cake.
Such is the story of Nate Mutiso* (Not his real name), who began experiencing pain and sensitivity while eating, his mother took him to the hospital and the culprit was found to be dental caries.
“I could not understand why my son was not feeding well. I always made him his favourite meals to encourage him to eat but he would leave his plate almost full and that meant I would force him to eat, which was an uphill task,” says Mueni, Mutiso’s mother.
After several visits to the dentist, the affected teeth had to be removed since the dental cavity was huge and had developed a swelling called a dental abscess.
According to Dr Njeri Theuri, a paediatric dentist, dental caries occur in children at a young age between
2-11 years and are cavities caused by bacteria that are always present in the mouth.
The bacteria produce acid that makes holes or cavities in the teeth and this is dependent on time and the flow of saliva.
“The more the child does not brush their teeth, the more likely it is to that cavities will form. The flow of saliva in the mouth also determines the time it will take for the cavities to form,” Dr Theuri says.
She explains that certain foods, such as those that are rich in sugars, are broken down by the bacteria, producing the acid that causes the cavities.
Additionally, she says, improper breastfeeding techniques may also cause dental cavities whereby the mother may breastfeed the entire night but not on demand. This commonly happens with babies who co-sleep with their mothers or where the baby sleeps with the bottle the whole night.
A child who has paediatric dental caries will cry because they are in pain and complain of tooth sensitivity. When a doctor examines the teeth, there will be white opaque lesions or dark spots as the cavities advance.
If the decay is left to progress, a swelling called a dental abscess will form and will be visible on the outer jaw.
According to Dr Njeri, the management of paediatric dental caries starts with simple a filling if the cavity is not very deep, then a pulpectomy and pulpotomy.
Pulpectomy is the complete removal of pulp from the crown and roots of the tooth where the tooth is then filled with material that can be reabsorbed by the body. Pulpotomy is a dental procedure where the infected pulp is removed from under the tooth’s crown to save a severely decayed tooth.
“An X-ray can be done to determine the depth of the cavity and assess whether the tooth would be for a filling, a fissure or root canal treatment and if the cavity is too advanced, then extraction is considered.
They also crown the tooth because once the cavity is deep and root canal treatment or deep filling is done, then the teeth are prone to fracture and have to be protected with a stainless-steel crown or any other material.
In the event of tooth extraction, space maintainers will be used to maintain space for the permanent teeth.
One may wonder why all these management measures are taken instead of simply extracting the tooth since they are milk teeth. Dr Njeri explains that they still want to keep them on until they naturally fall off when the permanent teeth are ready to grow.
According to the Ministry of Health, the first Kenya National Oral Health Survey 2015 found that more than 46 per cent of children aged five years had dental caries, and more than 90 per cent of the total population had periodontal disease or gum disease while dental fluorosis affected more than 41 per cent of the children.
The survey indicates that these numbers are due to poor oral hygiene and sugary diets.