Trouble in a Cup Tooth Decay in Young Children Is On the Rise

Tooth decay among children is on the rise. And some experts say sugary foods and drinks are to blame — even in the youngest set.

The American Academy of Pediatric Dentistry (AAPD) emphasizes that not just diet itself, but the frequency and duration of oral exposure to foods and drinks with large amounts of sugar, should be considered when it comes to preventing tooth decay and cavities in children.

“Most parents know that they need to watch what their kids eat and make them brush regularly. Unfortunately, many are not aware that letting kids sip on sugary drinks for hours or putting them to bed with a bottle of milk can be just as harmful,” said Dr. Philip Hunke, AAPD president. “These habits can expose teeth to sugar for extended periods of time, increasing the risk of tooth decay.”

While fluoridation and improved oral hygiene have resulted in fewer cavities overall among Americans in recent years, cavities in young children are on the rise. According to a recent report by the Centers for Disease Control and Prevention, the incidence of cavities in children ages 2 to 5 increased 15.2{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from the early 1990s to this decade, the only child and adolescent age group to exhibit increased tooth decay.

Most parents today are well aware of the importance of taking care of their children’s teeth, the AAPD says, so it comes as a shock during checkups to learn their toddlers have cavities. The main culprit, however, may not be food or drink at all, but a simple cup.

The Dreaded Sippy Cup

Because sippy cups prevent spills, they’re often used by children for long periods of time over months and years, rather than as a transitional drinking device, a purpose for which they were intended.

“Sippy cups were created to help children transition from a bottle to drinking from a regular cup, but they’re too often used for convenience,” said Hunke. “When kids sip for extended periods on sugared beverages, they’re exposed to a higher risk of decay. Sippy cups should only contain water unless it’s mealtime.”

Children, he explained, shouldn’t sip on sugary drinks or munch on sugary foods for extended periods of time. When a child drinks beverages other than water, they should be served in a can or glass, and consumption time should be limited. And no matter what kind of cup they use, sugary drinks should be taken away after a reasonable amount of time.

In addition, the AAPD recommends that children should not go to sleep with bottles, as even milk can cause tooth decay. If a child absolutely needs a bottle to sleep, it should contain water only.

Hunke views the misuse of sippy cups as just the symptom of a larger issue — the fact that many parents wait too long before taking their children to the dentist for the first time. The AAPD recommends that a child’s first dental visit occur shortly after the first tooth erupts, and no later than the child’s first birthday.

“The first-tooth visit lets the pediatric dentist check for proper oral and facial development, see if the teeth are growing in properly, and detect early tooth decay,” said H. Pitts Hinson, former president of the AAPD. “It also gives the dentist a chance to walk parents through a complete program of home dental care for the child.”

But according to the 2005 National Survey of Children’s Health (NSHC), only 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of 1-year-olds and 23.8{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of 2-year-olds had been taken for a preventive dental care visit in the past year.

At the first visit, a pediatric dentist typically provides information about proper sippy-cup use as part of the presentation of a complete program of preventative home care. The dentist also checks the child’s teeth to make sure they’re developing properly.

“Studies show that children with poor oral health perform worse in school and have less success later in life,” Hunke said. “Establishing the right oral care habits early helps get kids headed on the path to a lifetime of good oral health.”

And it’s not just toddlers missing out; surveys suggest that only three out of every five children visit a dentist at least once a year. While parents may avoid taking a child to the dentist to save money, the AAPD notes, studies show that children who have their first dental visit before age 1 have 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} lower dental costs in their first five years than children who don’t — and perhaps better overall health, too.

For example, a study in Pediatric Dentistry showed that children with cavities were significantly more likely to weigh less than 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of their ideal body weight. Meanwhile, some research suggests that improper oral hygiene as a child may contribute to health problems later in life, including higher risk of heart disease and stroke.

Sound Bites

Of course, diet itself remains crucial to oral health in children.

“Nutrition is a very important part of oral health,” said Rebecca S. Reeves, a registered dietitian and president of the American Dietetic Association.

“Parents should encourage their children to enjoy a balanced variety of foods. Optimize kids’ health with snacks that are high in whole grains, such as pita bread or baked tortilla chips, and which include some protein, like bean dip, peanut butter, or yogurt. Space snacks far enough between meals so children’s appetites aren’t spoiled. With snacks as with meals, limit your children’s intake of added sugars.”

With candy, the time of exposure can be as damaging as the sugar itself, and sucking on candy for a long time is another way that kids can risk tooth decay. The AAPD says sweets should be limited, and children should always brush afterward — along with after every meal, when possible.

Dentists typically also encourage fluoride use in young children, particularly at a time when many families drink only bottled water, most brands of which are not fluoridated like public water supplies are.

“Proper preventive care, fluoridation use, and a balanced diet are key to the oral and overall health of every child,” Hunke said. “Tooth decay, if left untreated, puts these young children at increased risk for pain and infection, which can lead to missed school, lost sleep, and loss of appetite.”

The AAPD also encourages parents to take good care of your own teeth — not only because studies show that babies and small children can catch cavity-causing bacteria from their parents, but from a need to mold children’s habits by setting a good example.

After all, moms and dads don’t drink out of sippy cups.