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March 21, 2001

Dentist Warns Tooth Decay is Contagious Disease

The single most common infectious childhood disease is severe tooth decay, a condition that subjects millions of small children to chronic pain, humiliation and a lifetime of dental disorders, says UCSF pediatric dentist Francisco Ramos-Gómez.

Ramos-Gómez spoke to Merced physicians, nurses and other health professionals recently at the request of Martha Lopez, the nutrition, family and consumer sciences advisor for University of California Cooperative Extension in Merced County. The talks was sponsored by the UCSF-California Program on Access to Care (CPAC).

"We need the support of all local health professionals to end what has become an epidemic of decaying teeth, especially in the minority population," Lopez said. "Often, it is doctors, social workers, Head Start nurses and others who have contact with the children. If they are aware of this problem and check children's teeth, it may prevent the worsening of this horrible, but preventable, problem."

Dental cavities are contagious, like the common cold or flu, said Ramos-Gómez, assistant professor of growth and development. It is caused by a bacterium, Streptococcus mutans, which is passed usually from mother to child by kissing, sharing utensils or any other activity that transmits any minute particle of saliva from one mouth to the other.

The problem is exacerbated by inappropriate feeding practices, poor oral hygiene and lack of fluoride, which together create the ideal conditions for bacteria to produce acids that demineralize tooth enamel and cause cavities.

Serious tooth decay is related to ethnicity and socioeconomic status. Nearly half, 48%, of Hispanic children, 35% to 40% of Asian and African-American children, and 68% of Native American children are afflicted.

Studies have shown that many young, uneducated new mothers have not seen a dentist in five to seven years before giving birth. They carry huge colonies of S. mutans in their mouths. Even before the child's first teeth appear, bacteria passed from the mother begin to colonize the baby's mouth.

The mother may learn to calm the child with frequent bottle-feeding of sugary liquids. "Parents put everything from soft drinks to chocolate milk to molasses in the bottle," Ramos-Gómez said. "We've heard it all."

The liquid pools around the teeth, creating an environment for the bacteria to multiply rapidly and decay the teeth. In time, the decay can cause abscesses and infection can spread to the eyes, throat and brain.

Pain will cause children to cry and fuss in the beginning - they may develop fevers -- but parents and health care providers rarely relate it to the teeth. Pain becomes part of the child's everyday life, impacting speech, eating patterns, school readiness and ability to learn," Ramos-Gómez said.

Some parents may feel it is unnecessary to treat the child's "baby teeth," he said. But the presence of healthy teeth guides permanent teeth in place. Severe decay in early childhood may result in the need for costly orthodontic treatment or the embarrassment of living with crooked teeth.


Janet Warnert, UC Agriculture and Natural Resources

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