PAGD Keystone Explorer Fall 2021

14 www.pagd.org Q dentistry issues Caries in children act like a different disease than we see in adults. Under a microscope, it is the same strep. mutans eating carbohydrates story, but when you step back and see a two-year-old with decay in every back tooth, you have to think, “Those teeth just erupted last month. How did this happen?” After re- storing these young children, often with sedation or general anesthesia, studies reliably reproduce that these children will return with recurrent decay in these same “fixed” teeth (Almeida 2000, Tate 2002, Foster 2006). Parents are frustrat- ed and blame soft teeth. Dentists are frustrated and blame restorative tech- nique or materials. Kids are frustrated and lose motivation for their homecare when they continue to miss the “No Cavity Club” membership. Traditional recommendations to brush, floss, and restore do not solve the early childhood caries disease. Nutrition is king, specifically frequency and duration of carbohydrate consumption (Gustaf- sen 1954, Warren 2009). I would suggest we all know this by now, but find it hard to change in our patients. If dieting were easy, I would make my ideal weight by New Years. But it is hard. Food is a basic need, modified by habits, emotions, and culture. The connection between nutrition and oral health is an equalizer from Center City Philadelphia to John- stown. All children need their parents to offer nutritious food in a way that develops healthy habits. Food insecurity, meaning the inability to always afford sufficient food, makes this harder. Statewide in Pennsylvania, one in seven children experience hunger. In some Philadelphia neighborhoods, one in three residents experience food insecurity. The COVID-19 pandemic has only exacerbated the problem. Serving as Clinic Director for the Department of Pediatric Dentistry and Community Oral Health Sciences at Temple University Nutrition and Pediatric Dentistry “Traditional recommendations to brush, floss, and restore do not solve the early childhood caries disease. Nutrition is king, specifically frequency and duration of carbohydrate consumption.” Maria Cordero-Ricardo, DMD, MS, MPH