Dental health: Saving Matthew’s smile

dental healthLooking at Matthew’s full set of teeth, it would be difficult to guess that two years ago, he was in danger of losing them all.

Matthew, now 15, has a complicated medical history. It runs the gamut, including pervasive developmental disorder (part of autism spectrum disorder), acid reflux and intermittent vomiting. Additionally, Matthew has sensory issues that make him averse to the feeling of a toothbrush. All of this combined to make brushing Matthew’s teeth a daily battle for his parents Janet and Michael Carco, and sometimes the battle was impossible to win.

Because of Matthew’s intermittent vomiting, at age 12, he weighed only 55 pounds. His parents and doctors knew all calories mattered. They decided to boost his calorie intake with juice several times a day. It seemed like a great solution. Matthew really enjoyed the juice, and it doubled as a delivery system for a bad-tasting nutritional supplement.

But juice is high in sugar and acids, and Matthew’s teeth began to show signs of severe decay. In addition to the sugar from the juice, Matthew’s seizure medication was filled with sugar that stayed on his teeth, even after brushing them before bedtime.

Matthew’s dental rehabilitation

Michael and Janet brought Matthew to Boston Children’s Hospital, where Dr. Man Wai Ng, chief of the Boston Children’s Hospital Department of Dentistry, resolved to save Matthew’s teeth and to keep them saved.

After a dental rehabilitation operation under general anesthesia, which saved his full set of teeth, Ng and the Carcos discussed what changes they could make to ensure that Matthew’s teeth stayed healthy and strong for the rest of his life.dental_health_Matthew_2

Time for change

Those changes included removing juice from his diet once and for all, a change the Carcos were hesitant to make due to Matthew’s need for extra calories.

“He loved his juice. Taking that away from him was big. It’s like his coffee,” says Mike. But Matthew was able to adjust to the change, and the decreased sugar intake made a big difference in his dental and overall health.

In addition to removing juice from Matthew’s diet, Ng prescribed daily servings of fluoride water to build strength and keep his teeth clean. While some towns add fluoride to their water, the Carcos’ hometown of Braintree, Massachusetts, does not, so they buy theirs in packs of eight at the supermarket.

“When he got into the fluoride water, everything started. He got bigger. He was less than 60 pounds before the operation and now he’s about 80,” says Mike. Although the water is an acquired taste, the Carcos serve it to Matthew with the orange Dunkin Donuts straws that he loves, and he has come to enjoy it.

Finally, brushing Matthew’s teeth three times a day with a fluoride toothpaste is crucial to keeping cavities and tooth decay out. The process isn’t an easy one, but Ng’s directions and support have made it work for the family.

Teeth-brushing sessions are programmed into Matthew’s computerized schedule, so he knows when they’re coming. When it comes time to brush,

Three tips for preventing and controlling tooth decay

Brush two times each day with fluoride toothpaste, and find a way to make brushing enjoyable.
Talk with your child’s dentist about fluoride supplementation.
Cut the sugary drinks and snacks.

Matthew sits in his chair with one parent holding his hands and the other brushing his teeth from behind. Although he still doesn’t enjoy the feeling of the toothbrush, Matthew’s parents say he has gotten used to the process, and watching his favorite video after it’s over eases his anxiety.

These may seem like minor changes, but they’ve made a big difference in Matthew’s teeth, which are in the best shape of his life. “What we’re seeing with Matthew is that we can reverse the cavity process just by making these little changes,” says Ng.

Adds Janet, “I made a commitment to this. There are nights when you don’t want to necessarily do it, but you have to do it. He’s got one set of teeth, and we’ve seen the positive results. That’s the motivation.”dental_health_Carco_3

Learn more about the Boston Children’s Department of Dentistry.