Too Much Bottled Water Hard on Baby Teeth

ATLANTA, May 1 -- Cavities are on the increase among the pre-school set, indicates a report from CDC.

Twenty-eight percent of children ages two to five had decay in primary teeth in 1999 to 2004 versus 24% when data were collected for the 1988 to 1994, reported Bruce A. Dye, D.D.S., M.P.H., of the CDC's office of dental epidemiology at the National Center for Health Statistics.

The report analyzed data from the third National Health and Nutrition Survey (NHANES III 1988-1994 and NHANES 1999-2004).

In an interview, Dr. Dye said that in addition to long established risk factors such as sugar-laden snacks, sugary drinks, and poor oral hygiene, another likely contributor to the increased cavities among toddlers was the increasing use of bottled water.

The addition of fluoride to municipal water supplies began in the 1950s and by the early 1970s its impact was apparent as tooth decay rates declined significantly.

Dr. Dye said community fluoridation programs have increased in recent years so that the number of communities served by the CDC's fluoridation project is greater than ever before, but consumption of tap water is down.

As tap water consumption decreased, bottled water consumption increased, he said. Bottled water, he noted, is often promoted as healthier and more natural than tap water, but he said that it usually doesn't contain fluoride or other important minerals.

And even people who rely on tap water often add "purifying" filters to the tap or to ice water dispensed from refrigerators. In some case "these filters also capture fluoride and other helpful minerals."

Another factor that contributes to decay in primary teeth is the practice of "putting a child to bed with a bottle, often a bottle that contains what we consider cariogenic liquid such as juice or formula."

Babies and toddlers who demand a drink at bedtime should be given water, "preferably tap water," to take to bed, Dr. Dye said.

And he reminded clinicians to instruct parents on the proper way to supervise toddler in tooth brushing. "Children up to age five do need parental supervision and help in brushing teeth to make sure that all surfaces are properly brushed," he said.

Other findings from the oral health report included:

• Among children ages six to 11 the prevalence of tooth decay decreased from 25% to 21% and among adolescents the decrease was even greater-from 68% to 59%.
• Thirty-one percent of Mexican American children ages six to 10 had tooth decay in permanent teeth versus 19% of non-Hispanic white children.
• Three times as many children in poor families had untreated tooth decay as children from families with incomes above the Federal poverty line.
• Among adults the rate of severe periodontal disease decreased from 10% to 5%.
• Among those 65 or older the percentage with edentulism decreased from 34% to 27%
• There was a slight decline in the number of adults who said they had a yearly dental checkup-60% down from 66% in 1988-1994.