Addressing Tooth Decay in Young Children: Common Concerns and Solutions

What are the issues related to cavities in children?

1.
Is there a regulation in the National Health Insurance that limits the number of teeth that can be treated to a maximum of two?
2.
Since the fillings do not last long, should we continue to treat the cavities, or should we leave them alone and take care of them properly when the permanent teeth come in?
3.
Recently, for the past month or two, there has been a bad odor in the mouth (similar to the smell of goat's milk), which persists even after drinking goat's milk a long time ago or brushing the teeth.
Is this related to the cavities, or could it indicate a health issue? Thank you.

Q Ma, 30~39 year old female. Ask Date: 2008/01/28

Dr. Zhuang Suhui reply Dentistry

1.
The number of dental fillings covered by health insurance varies by region.
For example, in Taitung, a maximum of three teeth can be filled at one time.
I'm not sure about other regions, but there are more factors to consider for children.
Some children may have difficulty keeping their mouths open for long periods, and others may not cooperate well.
Filling too many teeth at once can sometimes lead to negative feelings in children.
2.
The filling of front teeth can often be challenging due to the varying shapes of cavities, which may result in fillings that do not hold.
If you feel uncertain about the original dentist, you can seek a second opinion from another dentist, as different practitioners may have different approaches.
It is best to fill cavities, as untreated decay can trap food particles and worsen the condition, unless the child is close to losing that tooth.
3.
If cavities are not properly treated or if brushing is inadequate, it can lead to the accumulation of debris, causing bad breath.
Of course, systemic issues cannot be ruled out, but the simplest approach is to first address oral health problems.
If oral issues are resolved and bad breath persists, then other systemic concerns can be considered.

Reply Date: 2008/01/28

More Info

Addressing tooth decay in young children, particularly in the context of bottle-feeding, is a common concern among parents. The situation you described, where your child has experienced recurrent cavities in their front teeth, raises several important questions regarding dental care and treatment options. Let's address your concerns one by one.

1. Insurance Limitations on Dental Treatments: In many healthcare systems, including those in the U.S., there may be limitations on the number of teeth that can be treated in a single visit, especially for young children. This is often due to the need to manage the child's comfort and anxiety during dental procedures. However, the specific regulations can vary by state and insurance provider. It is advisable to consult your dental provider or your insurance company to clarify any limitations on the number of teeth that can be treated at once.

2. Continuing to Fill Cavities: The decision to continue filling cavities in primary teeth (baby teeth) can be complex. While it may seem futile if the fillings are not lasting, it is essential to consider the following:
- Functionality: Primary teeth play a crucial role in a child's ability to chew and speak properly. If cavities are left untreated, they can lead to pain and infection, which may affect your child's overall health and development.

- Timing of Replacement: If the cavities are small and the child is due to lose the teeth soon, some dentists may recommend monitoring rather than aggressive treatment. However, if the cavities are significant, it is generally advisable to treat them to prevent further decay and complications.

- Oral Hygiene: It is vital to maintain good oral hygiene practices, including brushing twice a day with fluoride toothpaste and limiting sugary snacks and drinks, to help prevent further decay.

3. Persistent Bad Breath: The presence of persistent bad breath, especially with a specific odor like that of milk, can indeed be related to dental issues such as cavities or gum disease. Cavities can harbor bacteria that produce foul-smelling compounds, leading to halitosis (bad breath). However, other factors could also contribute to bad breath, including:
- Diet: Certain foods can cause temporary bad breath.

- Oral Hygiene: Inadequate brushing and flossing can lead to plaque buildup and bad breath.

- Health Issues: In some cases, systemic health issues can manifest as bad breath. If the odor persists despite good oral hygiene, it may be worth consulting a pediatrician to rule out any underlying health concerns.

Recommendations:
- Regular Dental Visits: Ensure your child has regular dental check-ups. The dentist can monitor the condition of the teeth and recommend appropriate treatments.

- Fluoride Treatments: Ask your dentist about fluoride treatments, which can help strengthen the enamel of the teeth and reduce the risk of cavities.

- Dietary Modifications: Limit sugary snacks and drinks, especially before bedtime. Encourage water consumption and healthy snacks.

- Oral Hygiene Education: Teach your child the importance of brushing and flossing. Make it a fun activity to encourage compliance.

In conclusion, while it may seem overwhelming to manage your child's dental health, proactive measures and regular communication with your dentist can significantly improve the situation. If you have concerns about the effectiveness of treatments or your child's overall health, do not hesitate to seek a second opinion or consult a pediatric dentist who specializes in treating young children.

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