Toxic Stress

by on February 13, 2012

in Uncategorized

Memories of Pain

Q: I am the grandmother of a 9month old boy who seems to be constantly crying. My daughter, now a single mom, left an abusive situation a few months ago. She has a habit of soothing our grandson at night by placing a bottle in his mouth. It seems to work, but I am concerned it may damage his teeth. It cannot be good for a baby to be crying all the time.

A: It is absolutely correct to be concerned about the two issues you mentioned—a baby who is perpetually stressed out and the risk of damage to his teeth caused by soothing him with a bottle.

In January 2012, the journal Pediatrics (The official scientific journal of the American Academy of Pediatrics) published a landmark document on the topic of toxic stress and its impact on a child’s developing brain.

Toxic stress is defined as ongoing stress or pain way beyond what is tolerable. The prolonged production of stress hormones literally changes both the physiology and anatomy of the brain. The amygdale, hypocampus and prefrontal cortex areas in the brain especially are at risk. The persistently elevated levels of stress hormones can disrupt the developing architecture of these and other parts of the baby’s brain. There is great concern that permanent damage may ensue.

Not all agree that chronic pain caused by untreated caries can lead to toxic stress. Recently when I suggested there is a link I was told by Harvard (via a letter to the Editor published on Feb 11, 2012 inThe Calgary Herald, a paper I write for) that it is simply not so. They took me to task. Yet many dentists will disagree with Harvards response—they have published data which may make Harvard think twice when they see no link between toxic stress and untreated caries.

One of the most common chronic infectious diseases and a cause of toxic stress  in children under age 5 is early childhood caries (ECC) It was formerly known as “bottle caries”. ECC causes tooth decay of baby teeth and according to Dr Len Smith, an influential Calgary Pediatric Dentist, it affects up to 28% of children. Sadly almost one in 4 of these patients never get any treatment. This is a common cause of toxic stress

The reason these babies don’t get treated early  is simple and yet profoundly frustrating: too many pediatricians are not properly trained to recognize ECC. In addition, the recommendations of the Canadian Dental Association (CDA) are not followed by many dentists who mistakenly tell parents to bring the child in for  a dental check up after age one (The CDA recommends that by age one all children should have a dental check up)

If left untreated ECC, a condition which can easily be prevented if guidelines were more closely followed, may lead to chronic pain, malnutrition, sleep disturbances and the swallowing of pus due to a draining dental abscess .

That is why  pediatric dentists in London Ontario have become passionate at educating the public about recognizing and treating ECC. On February 4, 2012 dentists in the London, Ontario area provided free oral health checks to patients between the ages of 6-18 months. The website provides more resources on this topic.

Dr Smith recommends that prevention begins at birth by wiping off gum pads after each feeding with a cloth and water and that once teeth erupt, all surfaces must be cleaned. He even suggests flossing if the teeth are touching. It is important to avoid putting babies to bed with a bottle that has sugar containing fluids. Also a soother should not be dipped in honey or sugar.( See videos on titled goodtoothdr)

A baby who is in chronic pain due to undiagnosed ECC is at risk of being abused or shaken. If settling a baby exposed to toxic stress can be accomplished by using a bottle at night, one can see how a vicious cycle may be perpetuated.

If a child with ECC needs dental surgery under anesthesia to repair the damaged teeth, it requires taking up valuable Operating Room time in a children’s hospital—for a condition that is simple to diagnose by a pediatric dentist and 100% preventable.

The early detection of ECC has led to collaboration between pediatric dentists and pediatricians. But it has also become increasingly relevant to the baby’s future brain development.

In Canada the Canadian Pediatric Society’s section of Community Pediatricians are planning future educational project with Canadian Pediatric Dentists.

An increasing number of experts now feel that it’s a form of neglect when ECC goes undetected and untreated. It is great to breastfeed for as long as possible and  to read books and use Omega 3 supplements to support early brain development.  To miss ECC and leave it untreated when the toxic stress associated with that may impact the developing brain for life, is a serious mistake.



Comments on this entry are closed.

Previous post:

Next post: