Responses to 'Silver Tooth' Enlightening

Dental care

Responses to last week's column about my youngest son's silver tooth, or "cap," have been enlightening. I've learned many things:

I shouldn't be afraid of fluoride.

My kids' cavities might be my fault.

Then again, maybe not.

My son drinks too much juice.

And, most important, I'm not alone.

There are a lot of silver teeth out there, and even more fillings. I know because mothers wrote me to say, "me too" and "I'm glad I'm not alone," but also because I've seen it for myself this past week.

Like a pregnant woman who suddenly thinks everyone else -- from celebrities on magazines to virtually every single person she passes at the store -- is also pregnant, I have noticed a great many silver teeth since my son got his. Everywhere I look: Cavities! Decay! Silver! While talking to people, I've reflexively inspected their teeth and noticed every flash of color coming from their molars.

Interestingly, however, I've quit seeing my son's silver tooth. That's the good news for other mothers out there grieving over new metal in their child's mouth. At first, all I could see was the dreaded tooth. It was a searchlight coming from his mouth. How could anyone not notice? Now I've nearly forgotten about it. Or maybe the silver has simply dulled.

In any case, outside of mothers commiserating with me, I also received messages from seemingly every pediatric dentist in the world. No, not really. But I did have a lengthy conversation with a pediatric dentist, Dr. Jonathan Shenkin, based in Augusta, Maine, who saw my column and contacted me. Shenkin put my mind and my guilt at rest, but he, like my own dentist, still won't allow me the comfort of falsely believing there isn't more I could have done.

"You just didn't know all the information when he was a baby," Shenkin says. He adds that most parents don't.

Shenkin believes parents often see the dentist too late. That is, after the age when they could have received the basic information they need to ensure good oral health and avoid dental treatment down the road. Preferably, children should go to a dentist when they are 1-year-old, or 6 months after their first tooth erupts.

There's more. Did you know most children should start using fluoride toothpaste when they are 2-years-old? Did you know that 44 percent of children don't brush their teeth twice a day and that more than 50 percent of them will have cavities by the time they are in second grade? Did you know that brushing your teeth isn't enough to prevent cavities?

Shenkin is on a mission to educate parents and, perhaps more important, the medical community -- gatekeepers of health information for most children -- about basic preventative dental care before cavities appear. He says that filling cavities without correcting behaviors is like cutting limbs off diabetic patients and then saying, "Look at how good we are at treating diabetes."

The keys to good oral health, he says, are brushing twice a day with fluoride toothpaste and limiting sugar intake.

I complained that mornings are crazy and I can't always be sure my boys have brushed their teeth. "That's like putting a bicycle helmet on your child 50 percent of the time and then being surprised when they have an accident," he said. And the twice-a-day routine should begin as early as possible, like when the first tooth appears.

But baby breath smells so good, I said. I never thought their mouths could be dirty. Plus, I told Shenkin, in my 12 years as a parent I had begun to think fluoride was poison. There are so many warnings about not letting kids swallow it and only using a pea-sized amount. I let my children use "training paste" too long for fear they might die from the fluoride.

Shenkin said that before a child can spit, using a pea-sized amount of toothpaste is enough and safe.

Maybe my kids' teeth are just soft, I said, trying to cheer myself up.

Shenkin says there's no such thing. For most people, personal behaviors and hygiene are the sole causes of tooth decay. There is no evidence to support naturally occuring, cavity-prone teeth.

I sighed. So I messed up, I said.

"But you didn't know," Shenkin said again, echoing my dentist's thoughts. Shenkin says it is the system that fails, not necessarily the parents. "If no one told you to get your child vaccinated and then he got sick, would you say that's your fault? Or is it the system's fault?"

I'll go with "the system" because it makes me feel better.

Children's dental health, or the lack of it, is taboo in the culture of motherhood. Maybe that's because none of us really know what we're doing, and also because we're ashamed of the outcome -- cavities. Shenkin hopes to change that by educating providers and the public.

But that won't fix my son's silver tooth, which he will have now until he's 11 or 12. The damage to his teeth was already done, long before I first took him to the dentist too late, at 3-years-old. Now I live with the silver reminder coming from his back molar.

Still, my son doesn't care. One day he smiled up at me, shrugged, and said, "Well, at least it's not a wooden tooth like George Washington."

Yes. There is that.

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Navy wife Sarah Smiley is a syndicated newspaper columnist and the author of Going Overboard: The Misadventures of a Military Wife (2005) and I'm Just Saying (2008). She has been featured in the New York Times and Newsweek, and on Nightline, The Early Show, CNN, Fox News and other local and national news outlets. Her liferights were optioned by Kelsey Grammer's company, Grammnet, and Paramount Television to be made into a half-hour sitcom. Visit www.SarahSmiley.com for more details. To contact Sarah, you can also visit her Facebook page.

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