RAMSTEIN AIR BASE, Germany -- Being the only pediatric dentist for the Ramstein community is quite a task. Lt. Col. John Kersey and his team stay very busy in the pediatric department and treat children up through age 7 to provide everything from basic exams to complete dental rehabilitation with general anesthesia. We maintain a double-booked schedule and last year we completed more than 1,000 exams, more than 200 sealants, 500 restorations, 80 extractions, 80 oral sedations and 18 Landstuhl Regional Medical Center visits for general anesthesia. It can be a challenge to get an appointment due to the high demand of this field and there are many off-base dentists to choose from if you cannot get regular appointments with this team.

Primary teeth are crucial to the development of children. They allow your child to chew food and to speak. They allow for normal growth of the facial structures and they serve as the placeholders for the permanent teeth to allow them to erupt in the proper positions. Children usually start losing their primary teeth around age 5 and don't finish until around age 12, which is why it is absolutely necessary to take care of them. Early childhood caries is defined as any child under the age of 6 that has one or more cavities and it is one of the number one diseases affecting children but it is completely preventable. It has also been referred to as baby bottle rot. Children are not born with the bacteria that cause decay but are infected early in life by sharing things that go in their mouth like eating utensils and pre-chewed food. ECC is caused by prolonged exposure to sugary liquids and foods including juices, breast milk, milk, sports drinks and sticky candies. The repeated exposure creates an environment perfect for bacteria to breed and cause decay. Carious lesions can spread like wildfire to surrounding teeth and can cause bad breath, unnecessary pain, infections, damage to the developing permanent teeth and speech and learning problems. Most cavities can be treated in the clinic with the help of nitrous oxide (also known as laughing gas) or an oral sedative. If severe enough, it can require complete dental rehabilitation under general anesthesia in an operating room.

Proper brushing and flossing along with diet control can keep these bacteria to a minimum. It is recommended to brush and floss your children's teeth for them until they reach an age of 8 to 10 and can demonstrate the proper techniques needed to maintain a healthy mouth. Use a smear amount of an American Dental Association-approved fluoridated toothpaste twice a day with children who are too young to spit and a pea-sized amount for children that can spit and floss once a day, preferably at night. Have your child rinse with a fluoridated mouth rinse before bedtime and do not allow them to eat or drink after doing this. Reserve sugary liquids for mealtimes and only give water in between. Do not allow an infant with teeth to fall asleep with a bottle or on the breast and if they do, gently wipe their teeth with a damp cloth to clean them. Offer healthy snacks and stay away from things such as fruit roll ups, fruit snacks and sugary hard candies.
If there is a problem with your child's teeth, contact a dentist to get it evaluated. The American Academy of Pediatric Dentistry defines child dental neglect as "the failure by a parent or guardian to seek treatment for visually untreated caries, oral infections and pain; or failure of the parent or guardian to follow through with treatment once informed that the above condition(s) exists." Normal healthy primary teeth are a shade of white and are free from black, brown or orange spots. Check that the gums are free of debris and do not bleed freely to ensure they are healthy. Bright white lines on the teeth along the gum line result from plaque remaining on the teeth for a long enough period to cause demineralization, which is the first step to a cavity. Ignoring the situation in hopes that secondary teeth will come in unaffected is not a good option since having Early Childhood Caries is a strong predictor of decay in permanent teeth.

Regular check-ups and proper brushing keep your child out of harm's way when it comes to the fight against decay. So tell your kids to open up and take a look in their mouths. If you spot anything questionable, contact a dentist to get it checked out. We look forward to seeing you.