Protecting Oral Health of Children and Adolescents

Many people think of periodontal (gum) disease as an adult problem.  However, studies indicate that nearly all children and adolescents have gingivitis, the first stage of periodontal disease.  Advanced forms of periodontal disease are more rare in children than adults, but can occur.

Types of periodontal diseases in children

Chronic gingivitis is common in children.  It usually causes gum tissue to swell, turn red and bleed easily. Gingivitis is both preventable and treatable with a routine regimen of brushing, flossing and professional dental care.  However, if left untreated, it can eventually advance to more serious forms of periodontal disease.

Aggressive periodontitis can affect young people who are otherwise healthy.  Localized aggressive periodontitis is found in teenagers and young adults and mainly affects the first molars and incisors.  It is characterized by the severe loss of alveolar bone, and ironically, patients with this condition generally form very little dental plaque or calculus (tartar).

Generalized aggressive periodontitis may begin around puberty and involve the entire mouth.  It is marked by inflammation of the gums and heavy accumulations of plaque and calculus.  Eventually it can cause the teeth to become loose due to severe alveolar bone loss.

Periodontitis associated with systemic disease occurs in children and adolescents as it does in adults.

Conditions that make children more susceptible to periodontal disease include:

• Type I diabetes
• Down syndrome
• Kindler syndrome
• Papillon-Lefevre syndrome

For example, in a survey of 263 Type I diabetics, 11 to 18 years of age, 10 percent had overt periodontitis.

Signs of periodontal disease

Four basic signs will alert you to periodontal disease in your child:

 

Periodontal Disease Runs in the Family

Periodontal disease may be passed from parents to children and between romantic partners.  Researchers suggest that the bacteria that cause periodontal disease may be passed from one person to another through saliva.  This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.

Genetics may also play a major role in the onset and severity of periodontal disease.  Researchers found that up to 30% of the population may be genetically susceptible to developing severe periodontal disease.  Therefore, if one family member has periodontal disease, it is a good idea for all family members to see a periodontist or dentist for a periodontal disease screening.

Adolescence and oral care

Evidence shows that periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene.  Children who maintain good oral health habits up until the teen years are more likely to continue brushing and flossing than children who were not taught proper oral care.

Hormonal changes related to puberty can put teens at greater risk for getting periodontal disease.  During puberty an increased level of sex hormones, such as progesterone and possibly estrogen, cause increased blood circulation to the gums.  This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque.  During this time the gums may become swollen, turn red and feel tender.

As a teen progresses through puberty, the tendency for the gums to swell in response to irritants will lessen.  However, during puberty it is very important to follow a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care.  In some cases, a periodontist or dentist may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.

Advice for parents

Early diagnosis is important for successful treatment of periodontal diseases.  Therefore, it is important that children receive a periodontal examination as part of their routine dental visits.  Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of systemic disease.  A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.

Many medications can dry out the mouth or pose other threats to oral health.  Be sure to tell your periodontist or dental professional about any medications your family members are taking.

Monitor your family to see if anyone has the habit of teeth grinding.  Grinding your teeth can increase the risk of developing periodontal disease, in addition to causing cracked or chipped teeth.  Periodontists or dentists can make custom-fitted night guards to prevent teeth grinding at night.

The most important preventive step against periodontal disease is to establish good oral health habits with your child.  Here are some basic preventive steps to help your child maintain good oral health:

• Establish good oral health habits early.  Prior to tooth eruption, use a moistened baby wash cloth to wipe around your child’s gums, palate, cheeks and tongue daily.  After tooth eruption, you can begin brushing his or her teeth.  When a child is able to expectorate (spit), you may use a pea-sized portion on the brush and press it into the bristles so your child will not eat it.  Large amount of fluoride, which is an ingredient in toothpaste, is toxic, especially to young children.  Once the gaps between your child's teeth close, it's important to start flossing.
• Serve as a good role model by practicing good oral health care habits yourself.  Young children especially like to mimic their parents.
• Schedule regular dental visits for family check-ups, periodontal evaluations and cleanings.
• Check your child's mouth for the signs of periodontal disease, including bleeding gums, swollen and bright red gums, gums that are receding away from the teeth and bad breath.

If your child currently has poor oral health habits, work with your child to change these now.  It's much easier to modify these habits in a child than in an adult.  Since your child models behavior after you, it follows that you should serve as a positive role model in your oral hygiene habits.  A healthy smile, good breath and strong teeth all contribute to a young person's sense of personal appearance, as well as confidence and self-esteem.

A portion of the above information has been provided by the American Academy of Periodontology (AAP).  The AAP is the professional organization for periodontists - specialists in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants.  Periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.