Severe tooth decay top reason for preschoolers' day surgery

About 19,000 Canadian preschoolers per year require day surgery under anesthesia to treat cavities and severe tooth decay, a new report finds.
 
Thursday's report from the Canadian Institute for Health Information looks at the treatment of preventable dental cavities in children under age six.  
 
"Early childhood caries," the technical term for or rotting baby teeth, are generally preventable. If caught early, it's treatable with fillings or varnishes at a dentist's office. But the infectious disease can lead to poor growth, behavioural problems, poor learning and sleep loss.
 
About one in every 100 preschoolers needed day surgery for ECC during the two-year period 2010-11 to 2011-12, the report's authors said.
 
"A major finding of this report is that living in a rural or remote community, a neighbourhood with a high proportion of Aboriginal residents or a neighbourhood characterized by material deprivation is a strong risk factor for day surgery for ECC," the report's authors concluded.  
 
Day surgery rates were:

• 8.6 times as high for children from neighbourhoods with high Aboriginal populations compared with low Aboriginal populations.
• 3.9 times as high for children from least affluent neighbourhoods compared with those living in the wealthiest areas.
• 3.1 times as high for children from rural neighbourhoods versus urban neighbourhoods.  

Treating cavities was the leading indication for day surgery among preschoolers, making up 31 per cent of operations in that age group. Inserting ear tubes was the second most common indication at 19 per cent.   
 
On average, children were put under for 82 minutes to fill or treat cavities and extract teeth. The vast majority, 99 per cent, had general anesthesia for the operation.

The proportion of children having dental surgery seems high to Dr. Bob Schroth, a public health dentist at the University of Manitoba in Winnipeg, commenting on the report's findings.

The Canadian Dental Association recommends that infants see a dentist within six months of getting their first tooth or by one year of age, followed by a dental exam every six months to catch small problems early.

"We really want to promote that first visit no later than one year of age, as a first preventive step, so we can provide important information to parents, give them the tips that they need to make sure their children stay healthy with their teeth," said Schroth.

As for why the recommendation to get teeth checked before the first birthday isn't always followed, the report's authors pointed to a scarcity of dental specialists in northern and rural communities, limited financial resources and private insurance, and difficulty in accessing publicly financed programs and dental providers as possible reasons.

Dentists suggest using water containing fluoride and avoiding sugary snacks, since children with more sugary diets tend to have a more aggressive form, and amount of, harmful bacteria in their mouths that cause tooth decay.