Dr. Len Smith establishes foundation to promote childhood oral health
Friday, 10 June 2011 00:00

len-smith---webEvery year in North America close to 4.35 million children are born. Fortunately, through the miracle of creation, the science of genetics, and the loving care of parents, most of those little babies grow up to be healthy, thriving adults.
If there are signs of illness, however, no effort and no expense will be spared to give that precious new life the finest care and treatment possible.
But there seems to be one significant exception. It’s called ECC – Early Childhood Caries.  Rotten, diseased teeth.
That condition, says Calgary pediatric dentist, Dr. Leonard Smith, is the single most common chronic childhood disease in North America and it is getting worse, not better.



Calgary pediatric dentist, Dr. Len Smith, shown in his office, has been raising alarm bells over the issue of early childhood dental decay, which he says leads to other serious health problems as children grow up.

In a paper he wrote, Dr. Smith quotes a U.S. National Center for Health Statistics
finding that “the incidence of dental carries in children 2 through 5 years of age has increased significantly, from approximately 24% in their 1994-1998 data to 28% in their 1998-2004 data.  This figure may reach 40% by the time the child reaches kindergarten.”
Many in the Calgary community know Len Smith as a pretty affable, easy-going individual. But get him talking about early childhood caries – rotten, diseased teeth – and he can start banging the table.
The problem is not that children’s teeth can’t be fixed – they can and Dr. Smith and his other dental colleagues do it routinely. The problem is not money because the dental profession does have programs to provide dental care pro bono to needy families.
“The most prevalent attitude is that they are only baby teeth, so we can wait and fix the problems later,” he said. And the guilty parties are parents, other health professionals, and even dentists.
Both the Canadian and American Dental Associations recommend that you clean your child’s teeth daily and book their first dental appointment before the child’s first birthday. However, when Calgary’s Avenue magazine did a survey a couple of years ago, they found that 65 per cent of Alberta dental offices reported telling parents there was no need to bring children in until their third or fourth birthday.
And the problem only gets worse from there because what researchers are finding is that caries in infants is a gateway to a host of other potential illnesses, including toxic stress and even proper neurological development.
Dr. Carol Berkowitz, the past president of the American Academy of Pediatrics, states that, “As a doctor, I see the impact of poor oral health on children’s overall health and well-being.  If the teeth are decayed, if the mouth hurts, it affects the ability of the child to eat and if they don’t eat properly they don’t grow, the brain doesn’t grow and they don’t develop.  They don’t gain weight and are more susceptible to infections.”
Dr. Smith points out that “the mouth is the gateway to the body and if it is not in good shape, the rest of the body is not in good shape either.”
The irony is that adult teeth in North America are healthier than ever. Yet despite the work of some dentists, pediatricians and medical researchers establishing the link between early childhood caries and the overall health of the individual, awareness of this issue is spreading with only glacial speed.
To help push it along, Len Smith formed a foundation several years ago to raise the alarm bells, to educate parents and other professionals, and to raise funds for further research into the long-term health implications of ECC.
Called Healthy Mouth, Healthy Child, the foundation is a non-profit charitable organization dedicated to eradicating Early Childhood Caries (ECC), the most common of childhood chronic diseases. (The website is www.stopecc.com)
Healthy Mouth, Healthy Child is incorporated separately in Canada and the United States, but administered by a common board of directors, comprising the leading experts in fields related to infant and child oral health and its ramifications for healthy brain and body development.
If you want to scare yourself, go to the website at www.stopecc.com and click on the button for “A Visual Guide to ECC,” a graphic explanation that was authored by Dr. Smith. It presents a map of the effects of caries on the infant and its family. It shows, for example links between caries and obesity, sleep deprivation, behaviour problems, poor school performance, neurological development, tooth decay and abscess, family stress, and even neglect and abuse.
“We see the issue of neglect and abuse all the time. Several times a year we practically have brawls in our office between parents over children’s teeth. There is no question in my mind that at least some of the cases of serious physical abuse of infants stems directly from tooth decay.
“The child has painful caries and cries a lot.  That puts stress on the parents . . . somebody snaps . . . and takes it out on the infant,” he says.
While we are repulsed by violence against infants, what society and the medical profession often fail to recognize is that abuse is not just a physical pain at the moment, but can have long term debilitating effects on the developing child.
In what is referred to as The ACE Study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permenente’s Health Appraisal Clinic in San Diego, it is shown that pain, neglect and abuse in infants produces what is called Toxic Stress.” And what current research indicates is that Toxic Stress can impair the connection of brain circuits, increase stress hormones to suppress the body’s immune systems, cause deficits in learning and memory, and produce lifelong levels of stress that will keep people miserable and unhealthy for most of their lives.
All this from a rotten baby tooth.
Dr. Smith has raised his concerns with politicians, with health professionals and members of his own dental fraternity. And while most everyone seems to get the connection between ECC and the bundle of negative effects on children’s lives, the world of change is still ruled by inertia.
“I don’t have much time for bureaucracy,” he says, “so I set up this foundation as a way of getting the word out that this serious childhood problem is entirely preventable.
“Not everyone in the dental professions is ready to push this just yet, but there are pockets of individuals in Canada and the United States who are doing good work on this issue. We have to do much more research to scientifically prove all those negative health risks for children with caries.
“Ultimately, this is a mother-dentist issue so we also have to do a better job of raising awareness and providing better education at the parental level. We have the knowledge and technology to fix these dental problems.
“We just need more people to understand that a painful tooth in an infant, if it is not treated promptly, is like sentencing someone to an unhealthy life.  A healthy mouth  does lead to a healthy life.”


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