April 24, 2024

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Priscilla Serrano did everything she could to keep her child’s teeth clean and healthy. She rubbed his gums twice a day with a finger brush when he was 3 months old. She brought him to the dentist before his first birthday. She weaned him off a bottle early, gave him healthful snacks, avoided juice, brushed his teeth twice a day, and even flossed for him.

But despite her best efforts, Daniel still developed two cavities before his 6th birthday.

“I was kind of devastated. You work so hard to prevent any of this, and then you see your child in pain,” said Serrano of Long Beach. “I was in denial at first. I was like, ‘No, I did a good job.’ But I finally accepted.”

At the time of year described by dentists as the scary season for teeth — a Halloween holiday laden with sticky, sugary treats — children’s dental care takes on a sense of renewed urgency. The stakes couldn’t be higher in California, where the health of little teeth is sobering.

A dental hygienist holds open the mouth of a stuffed animal so a young boy can learn good teeth brushing habits.

Dental hygienist Elizabeth Valdivia, right, holds a stuffed animal so that Armani Allen, 2, can learn good teeth brushing habits as he his held by his mother, Nicole Nelson, at the Children’s Dental Health Clinic in Long Beach.

(Allen J. Schaben / Los Angeles Times)

California ranks among the worst states when it comes to pediatric dental disease. A national survey from 2020-21 found that 14.8% of the state’s children ages 1 to 17 had decayed teeth or cavities in the past 12 months studied — ranking 47th out of 51 among all the states and the District of Columbia.

“We’re really pushing for prevention because we don’t want to go down the line of having cavities, oral pain, possible infection and spread of infection,” said Dr. Abrey Daniel, a dentist with the Oral Health Program at the Los Angeles County Department of Public Health. “Sometimes parents may just do a quick brush and not even notice that cavities are forming.”

Nationwide, more than half of children develop cavities by the age of 8, usually because of poor nutrition, bad hygiene habits or a lack of dental care. Other factors include drinking water without fluoride, inadequate saliva flow and genetics; even a child with good dental habits can develop cavities.

As with so many health issues, children from socioeconomically disadvantaged families are most at risk. The California Department of Public Health’s 2018-19 Smile Survey of third-graders found that children from communities of color and Spanish-speaking households are more likely to experience tooth decay. Latino children had the highest rates, with 72% having experienced some sort of tooth decay, compared with 40% of white children. Black children had the highest rate of untreated decay at 26% — almost twice the rate of white children.

Throughout the state, many low-income children have limited access to dental care, fresh fruits and vegetables, and fluoridated tap water, said Dr. Ryan Huang, the dental director at the South

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