The Gospel of the Toothbrush; Or, How Many Teeth Does Your Child Have (Left)?

March 6, 2012, 11:37 am

Just when you thought that middle-class parents had reached the limits of ignorance, the New York Times reports today that children under the age of five are showing up at the dentist’s office with a dozen or so cavities.  Some need the kind of extensive repair that is usually characteristic of people my age. One little darling featured in the story had 22 cavities, and was due for a root canal — at the age of two and a half years.  Go read it here.

My first thought was, well, these are probably parents working 3-5 jobs between them: things like toothbrushing just fall through the cracks as Mom and Dad pass each other in the hall like ghosts between day shift, night shift and swing shift.  But apparently not. The kid with the root canal?  Mom is described as a homemaker and Dad is in IT. Homemaker is not an easy career, I’ll grant you, which is a reason I checked the “historian” box after college instead of “baby machine.” But isn’t part of the job description of the stay-at-home-Mom “Take care of the kids?”

OK, so Mom is tired at the end of the day.  Or she thinks the old man took care of it while she was washing a Valium down with a Manhattan cooking dinner. But no person interviewed for the story said, “Gee, I’m so wrecked at the end of the day I forget to brush my own teeth.”  This epidemic of tooth decay is apparently caused by:

  • parents claiming that nobody told them to brush their children’s teeth (did anyone explicitly tell you to feed them?);
  • it upsets children to have their teeth brushed and it is just a very unpleasant way to end the day;
  • it upsets children even more to go to the dentist and have their teeth cleaned;
  • the mouths of children are bathed nonstop with waves of that healthy, healthy fructose-filled fruit juice that ensures 200 calories per sippy cup and a mouthful of sugar to boot;
  • when children aren’t drinking juice, they are drinking unfluoridated bottled water.

What to do, what to do?  By the time they get to the dentist these kids are in terrible pain, and are also convinced that not going to the dentist is a basic human right decreed by the Founding Fathers. On top of this, they need dental repair that is surgical in nature, the kind usually reserved for someone who has been held in captivity for the last two decades.

My favorite solution to working on a spoiled and terrified patient was the dentist who immobilized a child by strapping her to a board while she shrieked and wept (those parents deserve every ounce of guilt available, don’t they?) More often, dentists are using general anesthesia (that smells like bubble gum — because everything should be about candy, shouldn’t it?) to do what would count for some of us as a lifetime’s dental work in one long, grueling expensive session.  I guess when a parent finally notices a child’s teeth are falling out, you don’t want to take any chances said parent won’t return to get the job finished. As one pediatric dentist pointed out, “if any of us tried to get 12 teeth treated, we wouldn’t think that’s small.”  No sh!t, Shirley.  I had my first root canal at the age of 52, and was sufficiently cowed by the experience that I’ve been flossing (an act of self care that repels me) daily every since.

The message is that through avoiding daily unpleasantness, parents are creating dental calamities.  Here are some questions that the article doesn’t answer, however:

  • Why should someone have to tell a parent to brush a child’s teeth?  Do these parents brush their own teeth?  Enquiring minds want to know.
  • Don’t the children have really bad breath if their teeth are rotting in their heads?  Does no one get close enough to them to find out?
  • When did parents only engage in child care activities that pleased their offspring?
  • Are there other hygiene issues? Are these children bathed regularly?
  • Under what conditions does not engaging in basic care to the extent of your child’s teeth turning brown, becoming painful,cracking and falling out, and requiring root canal before the child is of school age not count as severe child neglect?
  • When do these parents think that regular toothbrushing should begin?  When the children get their adult teeth?
  • Does the capitulation to children’s desire not to brush their teeth bear any relation to other things not being taught in the home that have a later impact on child development?

Booker T. Washington would say that it does. I can’t help but recall that passage in Washington’s Up From Slavery (1901) in which the founder of the Tuskegee Movement extolls the toothbrush as the hallmark of civilization and a basic tool for human progress. In that book and throughout his life Washington preached his belief — otherwise known as “the Gospel of the Toothbrush” – that dental hygiene was the key to all other forms of success. In describing the deplorable physical state in which many of his rural students arrived to begin their education, he noted that the first step was to give a student a toothbrush and demonstrate its proper use.  “In all my teaching I have watched carefully the influence of the tooth-brush,” he wrote, “and I am convinced that there are few single agencies of civilization that are more far-reaching.” As the Tuskegee News reported today, February is not just Black History Month, it is also Children’s Dental Health Month.  Can this be a coincidence?  I think not. As the article explains:

When he came to Tuskegee no student was allowed to stay who did not utilize a toothbrush. In some cases it might be the only thing a student brought with them when they came to start school. Sometimes students did not initially understand that each person needed to have his or her own toothbrush, but they quickly learned their lesson.

“With few exceptions, I have noticed that, if we can get student to the point where, when the first or second toothbrush disappears, he of his own motion buys another, I have not been disappointed in the future of that individual,” wrote Washington, recounting one episode where he was inspecting rooms with a lady principal. “Absolute cleanliness of the body has been insisted upon from the first.”

So pediatricians, here’s an idea:  as new mothers and fathers are on their way out the door, hand then a toothbrush and a copy of Up from Slavery. It could save those children a lot of grief down the line.

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