FIVE YEARS OLD AND TOOTH­LESS

Weaned on sweet drinks, this boy didn't drink plain wa­ter till he was three. His fam­ily share their trau­ma­tis­ing ex­pe­ri­ence with EVELINE GAN.

Young Parents (Singapore) - - Contents -

Weaned on sweet drinks, this boy didn’t drink plain wa­ter till he was three. His fam­ily shares their trau­ma­tis­ing story.

At an age when most kids would have started los­ing just one or two milk teeth, five-year-old Jasper (not his real name) will be en­tirely tooth­less by the time you read this.

The kinder­gartener has such se­vere tooth de­cay that al­most all his milk teeth have rot­ted down to the gums and are be­yond re­pair, ex­cept for a few lower front teeth.

The den­tist would have ex­tracted his de­cayed teeth via surgery per­formed un­der gen­eral anaes­the­sia. Jasper’s gums would also have been stitched up due to the sheer num­ber of teeth in­volved.

By shar­ing Jasper’s hor­rific tooth de­cay ex­pe­ri­ence ahead of his surgery, his fam­ily hopes to raise aware­ness on se­vere den­tal caries in young chil­dren. They have asked to re­main anony­mous due to the stigma in­volved.

“We’ve known about his tooth de­cay for some time but were still shocked (to learn that he would have to re­move al­most all his teeth). We are also very wor­ried about what would hap­pen af­ter the surgery. I was told he might be in pain for some time,” says Jasper’s fa­ther, Michael, 30, a sales ex­ec­u­tive.

While rare, such ex­treme cases of tooth de­cay are not un­heard of. Last year, the Na­tional Den­tal Cen­tre Sin­ga­pore (NDCS), a re­fer­ral cen­tre for the treat­ment of se­vere tooth de­cay, saw six young pa­tients who re­quired all 20 baby teeth to be ex­tracted.

NDCS saw more than 1,800 new child pa­tients last year, of whom 106 chil­dren had more than 10 baby teeth ex­tracted in the op­er­at­ing room.

Dr Bien Lai, a con­sul­tant at the pae­di­atric unit, restora­tive den­tistry at NDCS, has even en­coun­tered a 11-month-old baby whose both up­per cen­tral in­cisors (top front teeth) were de­cayed all the way to the gums.

In ba­bies and young kids, den­tal caries de­vel­ops due to mul­ti­ple fac­tors, Dr Lai ex­plains. Some causes in­clude drink­ing milk in a bot­tle at bed­time, not brush­ing teeth af­ter milk feeds, eat­ing sweet­ened food and drinks too fre­quently – all of which had led to Jasper’s se­vere tooth de­cay. The road to ex­treme tooth de­cay Dur­ing the early years of his life, Jasper spent long pe­ri­ods of time over­seas, trav­el­ling from one for­eign city to an­other, while his fa­ther took on var­i­ous job stints.

The fre­quent changes in his every day rou­tine meant that oral hy­giene was over­looked and of­ten the last thing on the minds of his par­ents, who were strug­gling to make ends meet.

As a baby, Jasper was bot­tle-fed. While he loved his for­mula milk, he es­pe­cially dis­liked plain wa­ter. To quench his thirst, he was given sweet­ened drinks be­tween his milk feeds.

“To pacify him at night, he was given a milk bot­tle, which wasn’t re­moved af­ter he had fallen asleep,” shares his grand­mother, Hui Ling, 60, who is cur­rently one of Jasper’s main care­givers.

Jasper be­came so ad­dicted to milk and sweet drinks that he did not drink any plain wa­ter un­til he was around three years old.

Shar­ing how her grand­son would refuse to drink wa­ter even when thirsty, Hui

Ling ad­vises par­ents and care­givers to think twice be­fore in­tro­duc­ing sweet drinks to their ba­bies and tod­dlers.

“There’s a ten­dency for care­givers to en­tice ba­bies and young chil­dren to drink more flu­ids by sweet­en­ing their drinks with­out re­al­is­ing that once you start, it’s re­ally hard to stop (the habit),” she says.

By the time they no­ticed that Jasper’s teeth were turn­ing black from de­cay around the age of three, Hui Ling knew they had to put their foot down to wean him off the milk bot­tle and sweet drinks. It took al­most a year be­fore he could fi­nally ac­cept plain wa­ter will­ingly.

“We started by di­lut­ing his sweet drinks, and grad­u­ally in­creas­ing the amount of wa­ter un­til he could fi­nally ac­cept drink­ing plain wa­ter,” she shares.

They also stepped up ef­forts to brush his teeth more fre­quently, but the dam­age was done. When asked why the fam­ily did not take Jasper to see a den­tist at the first sign of tooth de­cay, Hui Ling says they had been “ig­no­rant” of its po­ten­tial con­se­quences.

Back then, Jasper was also strug­gling with some speech de­lay and learn­ing is­sues, so oral hy­giene was not a pri­or­ity, she adds.

Jasper be­came so ad­dicted to milk and sweet drinks that he didn't drink plain wa­ter un­til he was about three years old.

“We did not re­alise the sever­ity of his tooth de­cay as he did not com­plain of any pain at all, and con­tin­ued to be ac­tive and well,” Hui Ling shares.

By the end of last year, how­ever, the fam­ily could no longer ig­nore the red flags when Jasper started com­plain­ing of tooth pain and re­fus­ing food. That spurred his grand­mother to take him to see a pae­di­atic den­tist in pri­vate prac­tice.

“The den­tist couldn’t han­dle him although he was sup­posed to spe­cialise in pae­di­atric den­tistry. When he fi­nally saw Jasper’s rot­ting teeth, he re­ferred him to a ter­tiary den­tal cen­tre, which is more equipped to han­dle se­vere tooth de­cay in chil­dren,” says Hui Ling.

When the sec­ond den­tist found that most of the teeth could not be sal­vaged, Jasper was sched­uled to un­dergo surgery to ex­tract them. How­ever, the surgery ap­point­ment was can­celled twice when he came down with fever. When all teeth are be­yond re­pair Tooth de­cay is typ­i­cally treated with fill­ings, pulp treat­ment, crowns and ex­trac­tions. Teeth are usu­ally re­moved when there is se­ri­ous in­fec­tion in the gums and bone, and when they are de­cayed be­yond re­pair, Dr Lai shares.

In cases where all teeth are to be ex­tracted, the child will need to ad­just to bit­ing with the gum pads and be on a soft diet un­til new teeth grow, she says. Speech may also be tem­po­rar­ily af­fected.

“How­ever, in this kind of se­vere case, where the teeth are de­cayed all the way to the gums, most of the teeth are al­ready in a dev­as­tat­ing state for a pe­riod of time and the child may have al­ready ad­justed to chew­ing the root stumps,” says Dr Lai.

Ad­di­tion­ally, the early loss of baby teeth may lead to mi­nor space is­sues for growth of the adult teeth, she says.

But once in­fected teeth are re­moved, the child will be re­lieved of pain and in­fec­tion. “Some chil­dren may even eat bet­ter than be­fore,” Dr Lai says.

Hui Ling is con­cerned that her grand­son’s school­mates will tease him af­ter the surgery, but shares that she is far more wor­ried about him adapt­ing to a soft diet and the lack of teeth af­fect­ing his speech.

“Get­ting him to take his meals daily is try­ing enough, and we’ve spent a lot of time train­ing him to eat a va­ri­ety of food. I’m wor­ried that the pain af­ter the surgery will undo ev­ery­thing and he’ll stop eat­ing,” she says.

For now, Hui Ling is train­ing Jasper to adapt to a softer diet of rice and soup to pre­pare him for the post-surgery re­cov­ery.

The fam­ily has also dou­bled their ef­forts in pre­vent­ing fur­ther in­fec­tion of the de­cayed teeth by not giv­ing him sweet drinks and hav­ing him gar­gle with salt wa­ter reg­u­larly, which seem to have worked to con­trol the sever­ity of his toothaches.

Think­ing about his son’s se­vere tooth de­cay fills Michael with re­gret. If he could turn back time, he would have re­stricted Jasper’s in­take of sweet drinks and treats, and en­sured that he brushed his teeth reg­u­larly, he says.

He ad­vises other par­ents not to take their chil­dren’s milk teeth for granted and to go easy on the sweet treats.

“We should not in­dulge our kids. Short-term hap­pi­ness will al­ways lead to long-term prob­lems,” he says.

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