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Hot Topics: Meet baby-bottle tooth decay

Bill Johnson • Dec 10, 2013 at 12:55 PM

The Orange County Register


The minute you are finished talking with her you want to get on the telephone and apologize to your children.

It is not at all what I had planned to write about Geraldine Ruiz, but I cannot help it. She just knows too much about children’s teeth, of things I, and probably you, too, had never once considered.

She is 29 years old, and a newly minted pediatric dentist. There is a whole story behind that, which I will get to in a minute. But did you know you should never, ever allow a child to fall asleep with a bottle in his mouth?

The candy and soda stuff I knew all about. But fruit juice? The good doctor, and I am paraphrasing liberally here, said I pretty much should give them heroin while I’m at it.

She is an extremely sweet woman, and goes about telling me such things in an equally sweet way, but getting grown-ups to understand what they are and aren’t doing for their kids and their oral health is her passion. It is why she is what she is today.

It all goes back nearly 20 years. Ruiz was born in El Salvador, and arrived in Orange County, Calif., with her father, a machine shop operator, and her mother, a homemaker, when she was a year old.

Yes, she said, they were poor, and lived with her uncle and his wife in Westminster from early childhood until she left for college.

A toothache when she was 14 changed everything for her. She remembers walking the hallways at her high school for weeks, the pain in a rear molar nearly beyond comprehension.

“I told my mom,” she said. “She told me, ‘Oh, it will go away. It will be fine.’ It never was.”

In her family, she said, the idea of going to a dentist simply did not exist. Certainly her parents never had dental insurance. Government assistance for the poor?

“No. To my parents, it was you go to work, and afford what you can afford.”

Three weeks passed.

“I was eating one day, and it hit sudden, like an electric shock. Food had gotten stuck in my cavity. I was in tears and crying. Finally, Mom said, ‘OK.’”

Yet where to go?

Her mother had seen a sign for a nearby dentist. She took Ruiz over. They performed the necessary exams, and told Ruiz she would need a root canal. It would cost $1,500.”

“My mom took me to another dentist,” she said. “I think it was both that she wanted a second opinion and a cheaper cost. The second dentist told her the same thing as the first, and the cost was exactly the same. They gave Mom credit to pay it off over a year.”

Once the procedure was done, it was like night and day. The pain was gone. No one, she told herself, should ever have to experience that simply because they did not know how to prevent a cavity.

Still in high school, she began volunteering at the nonprofit Healthy Smiles for Kids of Orange County, teaching mostly poor families about prevention and the right things to eat.

She would spend hours talking to parents and teachers about brushing and flossing, about avoiding sweets and sodas.

“I wanted to get them to make changes early on,” Ruiz said. “When you’re older, it’s so much harder to make those changes, to get adults into good habits.”

Yes, she would become a dentist.

After graduating with a biology degree from Cal State Long Beach, she enrolled at the UCLA School of Dentistry. Upon graduation, she enrolled at the USC Pediatric Dental Residency Program, which she completed in July.

A full-fledged pediatric dentist now, she returned to Healthy Smiles in Garden Grove, Calif., and also hung a shingle at a pediatric dentist’s office in Anaheim, Calif.

“A lot of families don’t know about their children’s teeth,” she said. “My family certainly didn’t. We were on our own.”

She works now almost exclusively with poor children in families that have no other dental offices to go.

“That experience in high school,” Ruiz said, “made me want to become who I am today.”

A series of simple questions made Ruiz retreat to a back room of her home to fetch her laptop. She flipped it open, hit a few keys and made color photographs of her patients’ open mouths appear.

Oh, goodness.

They were children 4, 5 and 6 years old. Their teeth looked as though they belonged to a 100-year-old tobacco chewer. The teeth were blackened, some broken in half, deep, deep cavities eroding the rest.

OK, no candy or soda pop I get, I tell her. When I remember and tell her what I did with the grandkids the last time they were out, thinking I had done a good thing, she gives me a look.

“No fruit juice,” she said flatly. “It is loaded with sugar. When parents ask me what their kids should drink, I tell them only water and milk.”

We go around and around on this. She calls up more photographs. Kids, she says, should have their first dentist visit at age 1 or when the first tooth appears. Yes, I will apologize to my kids.

“The first adult tooth comes in at age 6,” Ruiz said, “a back molar. That’s the one in which I had to get the root canal. Parents simply aren’t informed.”

It was only after working at Healthy Smiles did she come to understand that her family and her situation were not unique.

“People all the time say, ‘Well, they are just baby teeth, are going to fall out anyway, so why bother?’ she said before opening more photographs.

Almost every day she has to pull teeth from children as young as 4 and 5. Her personal record, Ruiz said, was removing 16 teeth from the mouth of a child who had only 20.

“It’s bad tooth decay,” she said. “Sixteen is rare, but it can happen.”

Extraction of the two front teeth and the two beside them are much more common. Baby bottle tooth decay, she calls it, caused from parents allowing infants and young children to go to sleep with a bottle in their mouths. Don’t do it, she cautioned.

“It’s very hard to get people to change their family’s habits,” Geraldine Ruiz said. “Yes, kids will cry to get the candy, juice or the soda. And parents will give in. I’m working as hard as I can to change that.”

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