CORAL GABLES, Fla. — At 4 years old, Kylie Metcalf needed a dentist big time.
A trip to the tooth doctor revealed a cavity count of 11.
"I was shocked," says mom Kristi Metcalf, while sitting with her daughter, now 5, in the waiting room of Corona, Calif., pediatric dentist R. James Richardson II before a routine checkup. "We brushed and flossed since she was little."
For Haley Moscowitz, 3, a recent visit to Richardson also found tooth decay. Two cavities meant two fillings for the pint-size patient.
"She's only 3. It seems so young," says mom Christine Moscowitz, while holding her daughter's hand as Richardson discreetly gave Haley an injection of "sleepy juice."
Kylie and Haley represent a trend as cavities in the preschool-age crowd are on the rise.
While cavities decreased in permanent teeth, a new study shows 28 percent of 2-to-5-year-old children surveyed from 1999 to 2004 had cavities compared with 24 percent of children surveyed from 1988 to 1994.
For the past four decades, tooth decay in baby teeth had been decreasing. But the latest federal report from the Centers for Disease Control and Prevention provides the first statistical evidence that this trend is reversing, dental experts say.
Reasons for the upswing were not studied, but experts say the pattern shows the preschool-age crowd might be getting too much sugar and not enough fluoride, and is not brushing properly.
Multiple snacks with simple carbohydrates, such as crackers, fruit snacks, pasta and cereal, are also likely contributing to the increase, says Dr. Mary Hayes, a Chicago pediatricdentist and spokesman for the American Dental Association.
"It's this idea of grazing," she says. "With the wrong foods, you are simply allowing the bacteria to thrive and causing an acid attack on the tooth more often."
It's the same story with a child sipping juice all day or going to bed with a bottle.
"You're allowing the bacteria to be happy," Hayes says.
Hayes advises no more than 4 ounces of juice a day. After that, she considers it candy water.
Dr. Bruce Dye of the National Center for Health Statistics says, "Kids are eating more prepackaged meals, less fruits and veggies, and more items that are presweetened."
Experts say another issue contributing to the climb in youngsters' cavities is the growing number of bottled-water drinkers.
Bottled water typically doesn't contain enough fluoride to prevent decay, according to the American Dental Association.
"If you chose not to use fluoridated water, you are removing that chance for prevention and success," Hayes says.
The key is early prevention, experts say. The American Dental Association recommends a child visit the dentist by age 1.
Parents should also help their children brush. Unless children can tie their shoes, they do not have the motor skills to brush properly, Hayes said.
Dentists suggest brushing twice a day. Begin using a pea-size amount of fluoridated toothpaste once the child turns 2 years old.
Family, Pages 37 on 10/24/2007