Has pediatric dental disease reached silent epidemic level?

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Oral health is an essential component of people’s well-being throughout their life. Unfortunately, dental caries in Mongolian children is high due to excessive consumption of sugar, irresponsibility of parents and lack of health education.

According to a survey, 90 percent of the population suffers from dental diseases nationwide and dental caries is the highest in children among all age groups.

In Mongolia, the first national survey on the oral health status of children aged five, 12, 15 and 18 and adults aged between 35 and 44 and between 65 and 74 was conducted in 2013 and again the next year. These surveys showed a dramatic increase in caries among children as well as complications in adults in both urban and rural areas of the country compared to the study conducted by the School of Dentistry of the Mongolian National University of Medical Sciences in 2008.

In 2021, the “Study of Prevalence and Correlates of Poor Oral Hygiene among School-Going Students in Mongolia” also found the prevalence of poor oral hygiene among students to be 33 percent. Moreover, 90,384 suspected cases of some kind of disease were registered among children aged under 17 through the ongoing nationwide early health screening that started on May 1 this year. It revealed that tooth decay is most common among children. More specifically, as of October 6, 53,178 or 80.6 percent of children aged 6 to 17 suffered from tooth decay.

Doctor of the Family Health Center in 4th khoroo of Bayanzurkh District B.Byambajav clarified, “A total of 876 children aged under 17 came to our hospital and underwent early health screening. Tooth decay is more common among children. Particularly, 76 percent of more than 800 children had tooth decay. Moreover, 50 percent of them have chronic tonsillitis and about 20 percent have poor eyesight.”

These successive studies over the years prove that dental disease in children is becoming a major national concern. That’s why oral experts and researchers are warning that dental problems have reached the level of a “silent epidemic”.

STORES PLACE SWEETS AT CHILDREN’S EYE LEVEL

One of the biggest reasons for dental caries is the high consumption of sweets and sugar. Every holiday, most children are given a gift bag full of products that are high in sugar. Especially during the New Year holidays, as soon as December begins, almost all stores fill their shelves with gift bags, which consist of soda, candy, chips or bakery products. Chips and even 100 percent juice and tea contain sugar. Nowadays, milk and yogurt are also produced with added sugar. Some parents buy children milk instead of sodas thinking of their health but they don’t realize that chocolate and banana milk have high sugar content.

Medical experts say that foods with high sugar content are not food but “poison” for children. However, as more parents turn a blind eye to all of this, there is a risk of tooth decay, diabetes and obesity in children.

Dentist of the Oral Care Dental Clinic B.Bayarmaa informed, “Mongolians celebrate many holidays. During the holidays, children in particular consume a lot of sweets and fruits. Not only tooth diseases but also internal organ diseases, chronic old diseases and appendicitis increase due to this. In other words, children who eat sweets during the holiday are at risk of suffering from all kinds of diseases later on.”

Senior Doctor of the Family Health Center in 9th khoroo of Sukhbaatar District B.Tsetsegmaa also mentioned, “Parents are giving their children a lot of sweets, chips and sodas. It is necessary for parents to pay attention to their children’s oral health all the time by providing food and drinks that protect their health and support their immune systems. Tooth decay is the root cause of many diseases such as heart, kidney and stomach diseases. It is doubtful that a child with dental disease will grow up healthy.”

During New Year’s holidays or on Children’s Day, people can give children toys, books and stuffed animals instead of candy. At least, they should replace candies and other junk food in gift bags with low-sugar dairy products and vitamin-rich products.

On the other hand, most stores do not place sweets above children’s eye level. Stores are exposing children to substantial displays of unhealthy sweets and snack food as children are a significant market for retailers of processed food-stuffs. This forces parents to buy sweets for their children because they are often naive to sophisticated marketing techniques and are influenced to make purchases through pester power.

On top of that, this issue is connected to the fact that children are not properly trained in oral health education from an early age. Parents and preschool education institutions have an important role in instilling good dental habits in children. Specifically, it is the responsibility of parents to have their children’s teeth examined by a professional dentist at least every season, teach them how to brush their teeth correctly and take proper care of their teeth from infancy.

In fact, children are only taught how to brush their teeth, not the details of how to take care of their teeth, the importance of regular checkups, flossing and things that can damage their teeth. Parents and teachers, in particular, need to show children how to properly use dental floss so as not to damage their teeth and gums.

In addition to these reasons, inadequate fruit and vegetable intake, parents smoking near their children and lack of exercise are risk factors for poor oral hygiene among children, according to the “Study of Prevalence and Correlates of Poor Oral Hygiene among School-Going Students in Mongolia”.

‘CHILDREN WITH TOOTH DECAY ARE MORE LIKELY TO HAVE ABNORMAL PHYSICAL GROWTH’

Maintaining good oral health is essential for overall health. Experts believe that more than 200 diseases can be the consequence of dental caries. In other words, cavities may affect the functioning of other organs of children. In specific, oral diseases have a direct impact on the growth and development of children’s body, Professor of the School of Dentistry of the National University of Medical Sciences J.Delgertsetseg highlighted.

She elaborated, “Only one out of 10 children in Mongolia have healthy teeth. If a person has 28 to 32 healthy teeth, he or she is considered healthy. According to the caries index formula, a person with decayed teeth is not classified as completely healthy. It has been confirmed by many studies that children with decayed teeth have delayed growth and development indicators compared to children with healthy teeth. For example, a comparison between children aged three with healthy teeth and those with dental cavities, it was found that those with cavities weigh two kilograms less. An international study indicates that children regained their normal weight six months after treatment and rehabilitation of oral cavity.”

In 2016, she studied how dental caries affect the growth and development of kindergarten-age children in Mongolia. According to her research, children with tooth decay are 1.3 times more likely to have abnormal physical growth and development than children with healthy teeth. In addition, a five-year-old child with healthy teeth had a difference of 1.6 kilograms in body weight compared to a child with decayed teeth of the same age. Meanwhile, their height difference was 0.8 centimeters.

“Weight loss in preschool children is a significant indicator of their health. However, according to the above study, their body weight and height indicators came out very differently. The World Dental Federation confirmed that more than 200 types of diseases and disorders occur in the human body due to tooth decay. Therefore, it means that children with dental diseases cannot grow up healthy,” J.Delgertsetseg underlined.

HARD FOODS ARE NEEDED!

Good oral hygiene – brushing your teeth twice a day – is considered one of the most effective methods for preventing dental caries and other oral diseases. Therefore, in order to reduce dental diseases among children, it is necessary to bring the issue of good dental habits to the policy level.

For instance, Cuba pays a great deal of attention to oral hygiene education from a young age. It prepares television programs on this topic during peak hours with a large number of viewers, giving advice to children on eating less sweets and brushing their teeth properly. Oral health courses are also taught in schools. Professor J.Delgertsetseg explained, “An American scientist said that clean teeth do not get cavities. In other words, if you keep your teeth clean, you will not have tooth decay. Simply put, the more we eat different foods, the more our teeth get dirty. Just as we wash our dishes after eating, we should brush our teeth regularly. Eating too often causes tooth decay.”

“Of course, in order for children to learn to do something, the guidance of an adult is important. It is crucial for parents to clean their baby’s mouth every day once they become six months old. The most important thing is that children should get into the habit of cleaning their mouths. Trying to teach children to brush their teeth after they turn three years old will not be easy because they will not be able to get used to that routine,” she underscored.

She also cautioned that children don’t eat hard foods nowadays and advised parents to give their children hard, chewy foods such as dried curds (known as aaruul). Researcher of the National Center of Public Health B.Oyundari also warned that recently, the consumption of sweets and drinks with high sugar content has increased while the use of hard foods has reduced, which contributes to tooth decay. Due to this, deformities of the face and mouth also occur, she said.

Professor J.Delgertsetseg added, “If you don’t chew well, your teeth can’t do their job. In other words, the natural teeth cleaning process cannot take place. This is known as oral self-cleaning in professional parlance. Even if we don’t brush our teeth after eating, our salivary glands produce saliva all the time. As a result, the tooth surface is washed and cleaned. According to human physiology, the self-cleaning process takes place five times a day and can protect your teeth.”

Based on the current situation, medical experts recommend that oral health promotion programs should be combined with general health promotion lifestyle intervention programs for this target population. National policies and programs also need to be implemented according to the good standards of other countries. Moreover, the involvement of all stakeholders is critical in addressing this so-called silent epidemic.

Misheel Lkhasuren

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