Hidden Horrors of Tooth Decay in Children

You'd wonder at some horror stories sometimes – how can tooth decay cause such a havoc in a child's life?!? I'd hear stories of children getting confined in the hospital because of complications of tooth decay. Even to some extent that a child with leukemia died because of infection on his teeth. And the parents couldn't simply believe it. How can tooth decay do that especially on children when they are just baby teeth? But it does happen. The horror stories are true.

How Tooth Decay Happens

Tooth decay happens when bacteria in the mouth produces acid that eat away at a tooth. Acids are produced as the bacteria in plaque interact with fermentable carbohydrates in food. The acids attack the teeth for about 30 minutes more after eating. Minerals will be lost from the tooth, resulting in its cavitation. Over time, as this process repeats and there are no balancing forces to remineralize the tooth, the acids will destroy the tooth enamel (outer covering of the tooth), resulting in tooth decay.

Pain

If the eating away of enamel is not stopped, the acids will continue to eat away more tooth structure. It will eventually get deeper into the hypersensitive dentin. This will result in pain. If the decay reaches the pulp, which is the blood supply and the nerve supply of the tooth, then this will result in severe pain. This is the kind of pain that will make your child howl and wake up your child in the middle of the night. When that happens, YOU will not be able to sleep as well!

Poor quality of life

A child in pain will obviously lead to a poor quality of life. Like Jenga, tooth decay causes consequences that are detrimental for a child.

A child in pain has difficulty eating, so they are picky eaters. They choose the food they can eat – they like soft foods and avoid tough ones like meat; or they'd rather drink milk than chew their food. Since these kids need the nourishment for proper growth and development, they end up small for their age and/or malnourished.

A child in pain also has difficulty sleeping because of the pain. A child who lacks sleep gets to be cranky. They cannot focus with their tasks at hand. They end up irritable and have difficulty following instructions. They don't perform with their full potential. In the long run, they end up with low grades because they don't do well with their schoolwork; and they have frequent absences because of frequent toothaches.

Abscess

When the decay has reached the center, bacteria can now enter the pulp. Since this is its source of blood supply of the tooth, it can kill the tooth and bacterial toxins can now take over on this tiny space. Over time, as these toxins build up, infection may spread out from to the bones supporting the tooth. This infection results in a collection of pus (made up of dead tissue, live and dead bacteria and white blood cells) and cause swelling of the tissues with the tooth.

This abscess, if untreated can lead to more complications.

Serious illness

Tooth infections can be dangerous. Since they are located on the head, it has a close proximity to the brain, heart, airway, etc. Sometimes, you wouldn't think that it cannot happen to your child. But lately, we see more and more children getting more serious complications because of tooth decay.

For example, an extreme severe complication of tooth decay is Ludwig's Angina – when there is an excessive amount of pus, the infection can spread as far as the throat. This can make breathing difficult and the patient would definitely need to be admitted in the hospital. This is a life threatening emergency.

In some cases, high counts of tooth-decay causing bacteria (Strep. Mutans) can migrate to the throat and cause what they call a Strep throat (sore throat) especially since both are caused by the same bacteria. Long standing strep throat can lead to rheumatic fever – an inflammatory disease that may develop after a streptococcal infection. If a child has a bad attack of rheumatic fever, it may cause permanent damage to their heart valves, called rheumatic heart disease.

For children with heart conditions, tooth decay can cause infective endocarditis – a rare, life-threatening inflammation of the lining of the heart muscles and its valves caused by bacteria. Bacteria found in tooth plaque may multiply and cause gingivitis. As gums become inflamed, it will bleed easily especially during toothbrushing, flossing and certain dental procedures that cause gum bleeding. When gums bleed, the bacteria can enter the bloodstream and can affect the inner lining of the heart and its valves. This is Infective Endocarditis. Some recent studies suggest that these blood clots released on patients with gingivitis can induce heart attacks especially for those ages 40 and above.

In the 24 years of my practice, I've had patients who've had other complications stemming from their severe tooth decay like brain abscess, rheumatoid arthritis, and meningitis.

What makes it more sad is decay and infection on teeth are easily preventable. So it's important for you to take care of your teeth and your children's teeth. Start prevention young so they can carry this onto their adulthood.