Kids’ teeth troubles? You can’t always blame the parents
Parents are used to copping the blame for their children’s health, but sometimes problems with teeth have another root cause. The trick is knowing what you do next.
As parents, we are often inundated with unsolicited advice, judgment, and opinions about how to care for our children. When it comes to dental health, parents can feel even more under siege. Aren’t poor diet, inadequate cleaning, and missed dental visits to blame for all dental problems? The short answer is no. While these are important factors in maintaining oral health, we have an increasing body of evidence that poor dental health is also due to genetics.
The role of genetics in dental defects
Many parents are unaware that genetics can play a significant role in their child’s oral health. A common condition affecting up to 20 per cent of the population is enamel hypomineralisation. It is a genetic condition that results in soft and chalky enamel that means the tooth/teeth can break apart as soon as they come into the mouth. This is not due to a lack of parental care but rather an underlying genetic condition.
While the exact cause of this condition remains uncertain, research suggests it is influenced by epigenetics – environmental factors interacting with genetic predisposition. However, we are still not exactly certain what these factors are. It has predated modern medicine and plastics according to archaeological studies. We can see twins with one severely affected and the other not. Even the same type of teeth in the mouth can be affected differently. So it is still a bit of an unknown.
How genetic factors can cause decay
Recent studies have identified genetic variations that influence the risk of developing dental decay. These genetic factors can affect the composition of enamel, saliva production, immune response and the oral microbiome, all of which contribute to cavity formation.
We are beginning to form a complex, multi-factorial picture with possible multiple genetic mutations resulting in a predisposition to decay. We have known for some time that gum disease has a large genetic component so it is probably not surprising that dental decay would as well.
Understanding these genetic components can help to shift the focus from parental blame to proactive management and tailored prevention strategies.
Environmental and prenatal factors
In addition to genetics, environmental and prenatal factors contribute to pediatric dental issues. Certain medications taken during pregnancy, premature birth, low birth weight, or other medical and genetic conditions can influence the development of a child’s teeth. These factors are usually outside a parent’s control and can set the stage for dental problems even before the child is born.
Shifting the narrative from blame to facts
Blaming parents for their child’s dental issues overlooks the complexity of the problem and adds unnecessary stress to an already challenging situation. As a pediatric dentist, I daily see really well-meaning parents who take great care of their children and end up with oral health issues.
It is unique that we blame parents for poor oral health and deny the child healthcare in a first-world country. If we applied the same approach to other medical issues, the consequences would be disastrous. Imagine the impact on patients with type 2 diabetes, high blood pressure, cardiac disease, or those requiring joint replacements. These are commonly modified by weight and an inactive lifestyle. Not always – genetic factors play a part, but a large part could be preventable. But we don’t decline these patients’ necessary treatment or place significant financial burdens on them to address the problem.
Instead of blaming parents, we should focus on education and support. By recognising the congenital and environmental contributors to dental health we can create a more compassionate and effective approach to prevention and treatment. If we can promote earlier dental visits and more prevention we may be able to avoid extractions and hospital visits down the track.
We also need the federal government to recognise that the piecemeal approach to dental care in Australia is not working. It ends up costing more in the long run both financially and holistically for our society. Our children are suffering the most. Investing in our children’s oral health sets them up well for life, reducing the risk of severe dental issues, lowering long-term healthcare costs, and promoting overall wellbeing.
Practical steps for parents
While some dental issues cannot be avoided, parents can take proactive steps to support their child’s oral health:
- Seek early dental care: schedule a dental visit around the age of one year. Early dental attendees can have 3.5 fewer extractions and fillings as a child.
- Discuss family history: inform your dentist about any family history of dental problems to help identify potential risks early.
- Monitor for signs of trouble: be vigilant about spotting issues such as discolouration, sensitivity or misalignment that may indicate underlying problems.
- Focus on nutrition: a balanced diet rich in calcium, vitamin D, and other essential nutrients supports strong teeth and overall oral health. Reducing sugar is also crucial.
- Promote good habits: teach your child proper brushing and flossing techniques. Ensure you are using a toothpaste with at least 1000ppm of fluoride (many children’s toothpastes in Australia are under this).
Parents are often their own harshest critics, especially when it comes to their child’s health. When around 20 per cent of pediatric dental issues stem from genetic factors, it’s clear that not all problems are preventable. Instead of assigning blame, let’s advocate for greater awareness, early intervention, and compassionate support. By doing so, we can help children achieve healthier smiles and give parents the reassurance they deserve.
Dr Tim Keys is a pediatric dental specialist in public and private practice. He is also the head of advocacy and policy for the Australasian Academy of Pediatric Dentistry.
