Gabriel Sanchez is screaming at the top of his tiny lungs.
But hes not hurt. At 13 months old, hes just objecting to the strangers hands in his mouth. Hes having his nine baby teeth brushed, during his first visit to the dentist.
Even though dental hygienist Valerie Haustein is trying to make Gabriel laugh by wearing a Groucho Marx-like mask and using a Tigger toothbrush, the toddler is not falling for it.
The nation is in the midst of a resurgence in childhood tooth decay. So the top U.S. dental associations now recommend a first visit when a child has just one tooth. That can be as young as 6 months.
I always tell moms that if their kids are fighting and fussing with you when youre brushing their teeth, this is a fight you have to win, said Haustein, who was recently treating Gabriel at the dental clinic in Childrens Hospital of Colorado. She finds some white spots on some of the toddlers teeth, and warns his mom they could be an early sign of decay. Were seeing a lot more cavities in children, even Gabriels age.
Gabriels mother, Lisa Casaus, tells Haustein she is careful not to load her son up with too much sugar, and she scores extra points with the hygienist because she gives him tap water. Its better than bottled water because it contains cavity-fighting fluoride.
Gabriels visit is part of a statewide University of Colorado-coordinated initiative called Cavity Free at Three, which works with parents and health-care providers to eliminate all tooth decay in Colorado children younger than age 3.
Dental disease is the No. 1 chronic health problem for American children more common than hay fever and asthma, according to the U.S. Centers for Disease Control and Prevention.
Colorado mirrors the nation. The states latest health report card, compiled by The Colorado Health Foundation, indicates that parents in Colorado are often slacking when it comes to caring for their childrens teeth. Some 23 percent of Colorado kids didnt go to the dentist for a preventative visit last year, ranking the state 38th in the nation.
Among uninsured families, only a third of 2- to 4-year-olds went to the dentist, the report card found.
By age 17, nearly 80 percent of Colorado kids have had at least one cavity. Nearly 10 percent have lost a tooth because it rotted out.
This is not surprising, says pediatric dentist Mark Koch. He has seen an alarming increase in the number of cavities in young children. His worst case: a 4-year-old who lost all 20 of his teeth to decay. They were so far gone, we couldnt repair them.
Koch adds that oral surgery is a serious proposition for preschoolers, because they almost always have to go under anesthesia. Childrens Hospital reports nearly 3,000 pediatric dental surgical cases last year, at a cost of $8,000 to $10,000 per child.
Poverty is a major reason for the increase in cavities among children. Studies show that poor kids have 12 times more restricted-activity days such as missing school than higher income children, because of dental problems.
But many American families take the easy way out when it comes to feeding their children.
Fast foods, which can have more sugars, have become a part of our diets, over fresh fruits and vegetables, Haustein says.
Koch says too many parents also want to be their kids best friends, but they need to be stricter. Parents arent making them brush their teeth, and they dont recognize what decay looks like until its too late.
When a serious toothache does happen, parents are relying more and more on the emergency room. Thats a mistake, says Koch.
Most ERs arent equipped to respond to dental needs other than Are they in pain? Do they have an infection? Koch said. After charging a hefty emergency fee, What theyll probably do is provide medication and ... tell you to see a dentist!
Dentist Ulrich Klein, also of Childrens, notes that many parents also dont think baby teeth are important. They figure theyll fall out eventually, so why bother? They are setting their kids up for a lifetime of cavities.
Klein advises that if a baby cant stand toothbrushes, parents can wipe their teeth with a cloth.
Further, Klein tells parents not to share spoons with a baby, or put an infants pacifier in their own mouths before handing it over to their child. This can introduce bacteria that cause decay.
Back in the exam room, by the time Haustein puts the finishing touches on a brand new tooth with vitamin fluoride, Gabriel Sanchez is hopping mad. Wowie zowie! Lets hurry up! she says to him, and she folds him back into his moms lap for a big hug. All is well for little Gabriel, whose mom promises shell bring him regularly.
But next time, things will be different. Next checkup, hell actually have a mouthful of teeth.
Colorado Public News, a nonprofit news organization, reports on issues of statewide interest. It partners with Colorado Public Television 12, Denvers independent PBS station.