Blam­ing par­ents doesn’t ex­plain den­tal de­cay

Bray People - - LIFESTYLE - DR ROSE-MARIE DALY

IR­ISH chil­dren have par­tic­u­larly high lev­els of de­cay - by the age of five 50% of chil­dren have cav­i­ties and the rea­sons for this are com­plex.

Some of the key con­trib­u­tors to the prob­lem are fre­quent con­sump­tion of sug­ars, poor brush­ing/ not floss­ing, in­ad­e­quate ex­po­sure to flu­o­ride and soft tis­sue fac­tors such as tongue ties which pre­vent chil­dren from groom­ing their own teeth prop­erly.

Re­cently re­search has also shown that there are genes which can lead to a higher risk of chil­dren de­vel­op­ing tooth de­cay be­cause of how we taste food.

Although many par­ents of chil­dren with den­tal prob­lems be­lieve they have in­her­ited weak teeth, this is a myth. We can pass on bac­te­ria to chil­dren through shar­ing tooth brushes and cook­ing uten­sils, lick­ing soothers and kiss­ing. We also share some di­etary habits with our fam­i­lies be­cause and while you could say we in­herit those things, they aren’t ge­netic as they are not passed on through our DNA. How­ever, there are two in­her­ited ge­netic dis­or­ders that cause weak teeth - one af­fects enamel and the other af­fects den­tine (the softer layer inside the enamel). Th­ese con­di­tions are rarely seen in Ire­land but are common in cul­tures with a tra­di­tion of in­ter-fam­ily mar­riage.

In the 1990s a chem­i­cal called PROP (6-n-propy­lth­iouracil) was found to be as­so­ci­ated with food pref­er­ences in chil­dren. Some peo­ple in­herit a gene which gives them the abil­ity to taste PROP and oth­ers do not. So chil­dren can be grouped as “tasters” and “non-tasters”. Tasters per­ceive PROP to be bit­ter. Chil­dren who can­not taste PROP tend to eat more sweet foods and would prob­a­bly be de­scribed as hav­ing a “sweet tooth”. Stud­ies have shown that th­ese “non-tasters” have a lot more tooth de­cay than “tasters”.

One study from Bal­ti­more in the US re­cently showed that when a group of moth­ers were tested for the gene to taste PROP, this could be used as a re­li­able way of pre­dict­ing if their chil­dren would have tooth de­cay or not. In­creas­ingly di­rect to con­sumer ge­netic tests are be­com­ing avail­able to pur­chase on­line. It is now pos­si­ble to pro­vide a saliva sam­ple for com­pa­nies to an­a­lyse our DNA to as­sess who is at risk of cer­tain dis­eases such as can­cer or Alzheimer’s. Many read­ers will have come across the story of An­gelina Jolie who tested pos­i­tive for a gene in­creas­ing her risk of breast can­cer, which led to her hav­ing a dou­ble mas­tec­tomy. It is in­ter­est­ing that as th­ese ge­netic tests be­come more af­ford­able and more avail­able we may be able to learn even more about how we are af­fected by our genes.

So what does all this prove? Firstly this shows that we in­herit den­tal is­sues both di­rectly and in­di­rectly. It also shows that if chil­dren come from a fam­ily where oth­ers in the fam­ily have cav­i­ties, their chance of hav­ing tooth de­cay is higher than for chil­dren from de­cay-free house­holds. It in­di­cates that de­cay is com­plex and there are many rea­sons be­hind the de­vel­op­ment of tooth de­cay.

When peo­ple ask me about the work I do I find there is a ten­dency to judge par­ents of chil­dren with tooth de­cay. How­ever, the rea­sons chil­dren de­velop cav­i­ties is too com­plex to look at their den­tal health in that way.

Ir­ish chil­dren have par­tic­u­larly high lev­els of de­cay.

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