Dental decay is the most powerful disease of mankind, but ninety percent of it is controllable and preventable regardless of fluorides or brushing. Not long ago half of the two-year-old children in Seattle and the average three-year-old were reported to have one or more cavities. Two or three years ago it was reported that 29% of people under thirty-five were in dentures. This year dental authorities reported that approximately half of those aged fifty-five in the United States were in dentures. This is a catastrophic disease, and yet is can be prevented.

Dental decay is a disease caused by bacteria, an infection of the mouth. Bacteria require a specific environment and specific nutrition; in the mouth the bacteria that cause decay have a perfect environment: it is warm, dark, moist and lacks air. Because everyone harbors bacteria, is it almost impossible to eradicate the bacteria that produce the acid that eats away a tooth. Bacteria differ greatly from human beings in that a human being can eat almost anything but bacteria are very specific in the nutrition they require to survive. Bacteria in the mouth require one substance: sugar. When it occurs frequently, the bacteria form colonies that produce acid as a by-product. The acid eats into the tooth like hot water over an ice cube. Although most people avoid feeding sugar to their household pets, they give it to their children frequently! The average child consumes about 154 pounds of sugar a year and receives it two and a half to three times a day. It is thus understandable why dental decay has reached the proportions it has in this country.

The amount of sugar is not important, the frequency is. Therefore at Christmas, Easter, Halloween, a birthday party, or once a week at one specific time (but not all day), a parent is wise to give his children all the sweets they want; instead of one cookie, a bag full of cookies and whatever other treat they would like. In other words, if you're going to use it, use a lot of it and get it over with.

Perhaps we could compare sweets to alcohol; while the odd drink now and then seems to be perfectly all right in most people's minds, continuous consumption during the day results in alcoholism. Because of eating habits established by their parents, many children become sugarholics.

Two things can be noted about children's eating habits: one is that the child will not starve without sweets. The other is the child will eat what is in his environment. If only nutritious food is in the environment the child will eat the nutritious food. If the nutritious food plus foods containing sugar are around, the child will usually eat the foods that contain sugar.

One other observation: what a child likes or dislikes is not important. What is important is what is good for the child; and the child should not be expected to understand this difference. Perhaps this is why God gave children parents. Mark Twain's remark is so true: "My father didn't know anything when I was fourteen but it was amazing what the old man had learned by the time I was twenty-one."

A recommended solution to the problem of dental decay is not rigid control of sugar, but rather pointing out to the child that there is a time for sweets as there is for anything. On the special occasion, perhaps once a week, and at one time, load the child with sugar if you wish.

Following is a list of so-called "treats" that should not be frequently used. Everyone understands that gum and candy contain sugar, and will readily agree that these cause cavities. However, parents serve many other foods containing sugar without thinking of them as candy. For examples, pastries, jam jelly, s weet rolls, doughnuts, cakes, pies, cookies, graham crackers, and honey are the same as candy - but parents call them by a different name. A parent allowing a child to have a cookie containing three to four teaspoons of sugar, but not a piece of candy, which contains the same, is similar to telling an alcoholic that he may drink as much Scotch as he wants but not Bourbon.

Other items that contain sugar are: soda pop, cokes, kool-aids, chocolate milk, cocoa, hot chocolate, Ovaltine, malted milks, milk shakes, and sweetened fruit juices. The latter contain on the average of three to four teaspoons of sugar per serving. Ice cream is candy; it contains three to four teaspoons full of sugar. Sherbet is sweeter than ice cream, and Popsicles are not only sweet but are very acid. Canned fruits are packed in sugar; the average serving of canned peaches or canned pears contains three to four teaspoons full of sugar. So, if one is going to give a child some canned peaches or canned pears, he may as well give him a candy bar, too; there is no difference.

Dried fruits such as raisins, dates, figs, prunes, etc., contain a high concentration of fermentable sugars. For example, one-quarter cup of raisins contains four to six teaspoons of sugar. It goes without saying that frozen fruits packed in sugar should be avoided, and flavored jellos as a rule contain three to four teaspoons of sugar per half cup. One may substitute ordinary Knox gelatin, a protein, mixed with fresh fruits.

The last item in the list of decay-causing substances is one that shocks most people. It is my feeling that all cereals, cooked or dried, should be completely eliminated from children's diets for two reasons. First, cereal is either sugar coated, sugar impregnated, or the child puts sugar over it. One could safely say that the average child in Seattle has candy for breakfast; only parents call it cereal. Second, cereal is a highly refined carbohydrate and burns much like gasoline, so the average child in Seattle usually runs out of gas by 9:30 or 10:00 in the morning. Proteins and fat burn more like coal in the body and will last for the morning. We might picture a child coming to breakfast in the morning empty, like the bowl that is placed in front of him for his cereal. At this time you could put anything into him. If you fill him three quarters full with cereal then tell him to eat eggs, you are asking the impossible.

The following breakfast is excellent: fresh fruit or toast and butter or peanut butter, bacon and eggs, ham and eggs, or sausage and eggs. Because a growing child is building bone, muscle, blood tissue and other tissues very rapidly, and because he is completely restoring ninety-five percent of his body every 120 days, he needs strength. Therefore, hamburger, hot dogs, soup, spaghetti and meatballs or even pizza are good for breakfast! Why not give your child his dinner in the morning when he needs it, rather than in the evening when he does not have as much demand on his body.

Substitutes for the so-called foods, or sugar substances, are nuts, peanut butter, popcorn, and fresh fruits and vegetables. Fresh fruits and vegetables could be termed in dentistry detergent foods; as they pass over the teeth and gums they clean and scrub.

Cold wieners are good for between meal snacks. All hors d'oeuvres such as beef jerky, pepperoni, twiglets, corn curls, potato chips, cheese dips, ad infinitum are okay. Children are taught tot like sweets just as they could be taught to drink or smoke. There are many, many things that can be used in place of sugar substances.

If one mixes the so-called treats or sugar substances and the recommended foods as a habit pattern, cavities are inevitable. However, if a recommended daily food intake is followed and if sugar is consumed infrequently, one can control most of the cavities that might develop.

There can be a dramatic reduction in decay without the use of drugs, shots, pills or other devices. The most painless dentistry can be practiced in the kitchen with the parent as the painless dentist. Most people write their own dental bills through their eating habits. The eating habit pattern is inherited more than so-called "bad teeth".

Tooth brushing is important for cleanliness more than for cavity prevention. Most cavities occur between the teeth where it is impossible to brush. A child should be taught to brush his teeth when they are dirty, and his teeth are dirty after he eats, just like the dishes.

There are four rules for the control of dental cavities:

1. A child should see the dentist every six months. If a child sees the dentist that often, a possible financial burden can be eliminated as nothing gets out of hand. Moreover, if the child goes every six months, psychologically he becomes a good patient, because he undergoes no traumatic treatment. And a high "dental IQ" is built into the mind of the child; as he matures he begins to take of his own teeth without parental supervision.
   
2. Ninety-nine percent if the control of cavities is in the home, through proper eating habits. One percent is the dentist's responsibility.
   
3. A child should keep his mouth clean as he keeps his body clean, just a part of hygiene. If a reduction in decay occurs, it's that much better.
   
4. Fluorides should be used both in drinking water and topically; fluorides do help.
   

One could safely say that if children follow these four points, they have done practically all that the profession knows today to prevent holes in their heads.