The first week of April is often a time of startling notices. I don’t mean Budget speeches which we know mean little, since governments do what they want in the Caribbean without parliamentary oversight or civil society representation. For example, in April 1957, the BBC broadcast a film on the news show Panorama, showing Swiss farmers picking freshly grown spaghetti, calling it the Swiss Spaghetti Harvest and fooling thousands of English women into calling in for requests for the plant. Since 1986, press releases for the New York city “April Fools” Day Parade have been issued. It does not exist but still manages to fool many into asking for directions to the “parade.”
Last week icebergs were said to have appeared, floating in the middle of the Demerara river off Georgetown. This caused some consternation among my climate believer friends, only too ready to believe the worst about hurricanes, earthquakes, icebergs and polar bears.
So it seemed appropriate at this time for last week’s New York Times to look at some misconceptions in paediatrics and what better place to start than with the teeth since undoubtedly “teething,” together with “gas” and “reflux,” form part of the deadly trio of the most commonly discussed children’s ailments in T&T, almost on a par with adult notions of motor car sickness, the extent to which vomit lingers in a car or whether a Mercedes Benz or a Tiida is better for sore bottoms and backs. Even what we going to call the T20 woman’s cricket team before they become Mommys and start demanding houses for winning games.
Misconception # 1: “Baby teeth do not matter because they are going to fall out anyway.” As the Times article says, nothing could be farther from the truth (unless you believe that the price of oil going back up to $100 a barrel in 2018 so “jess hold strain for a couple of years an we go be good,” which, with the singular exception of the hardworking Minister of Health, seems to be a strong component of this government’s economic policy).
Baby teeth matter because they set up a child’s permanent teeth. Preschoolers with cavities in their baby teeth are three times as likely as other preschoolers to have cavities in their permanent teeth. Bad teeth at five, before the baby teeth fall out, also predicts bad teeth at 25. Caries is partly due to bacteria and if left untreated can develop into an abscess and abscess can spread to the brain and other parts of the body and occasionally kill children.
Caries is set up by a multiple of things including the genes the baby inherits, the type of bacteria in the mother’s mouth and unsupervised bottle-feeding. Western society places much emphasis on brushing the teeth with toothpaste containing fluoride but preventing the child from drinking excessive amounts of milk and fruit juice, especially the ones in those nasty but convenient little cartons, sugar water masquerading as fruit, is more important. Children are quite unable to brush their teeth properly until they are dexterous enough to tie their shoe laces. That used to happen by the time children started primary school but the popularity of Velcro now means that many are learning this skill a couple years later.
Like competent parents, baby teeth serve as guides to the permanent teeth. When they are not around the permanent teeth may become blocked from growing into their proper place or wander off somewhere else. This invariably leads to the orthodontist office and the expenditure of large sums of money but not usually Forex! Still, who knows?
Misconception # 2: Exercise builds strong bones. It does not. Nor does taking expensive drugs for osteoporosis, one of the latest fashionable women’s diseases. Neither the latest nutritional fad, Vitamin D nor Fosfamox make any difference to building bone mass or strength. There is also no evidence that walking around the Savannah or running a marathon or lifting weights makes any difference to bone development.
This idea may have risen because of the observation that people who are bedridden lose bone mass. So do astronauts living in weightless conditions. People inferred that the pull of gravity, whether in space or on earth, was necessary for bone to strengthen. That is true but does not mean however that more gravity (from exercise) will make bones stronger.
In fact, exercise does build strong bones but not in adults, in children. By the time you are 18 or so and passed through puberty, your bones are built and fixed and there is almost nothing you can do to change them. Another reason to let children roam and run and climb and bicycle. That, and not milk, makes strong bones.
What you can change is your muscle mass and strength and most people confuse this with bone mass and bone strength. Older people who do weight bearing exercise can decrease their risk of fractures. But this seems to be more likely explained by the fact that exercise leads to stronger muscles that in turn makes falling less likely.
It’s difficult to understand why people believe certain things. I once asked the father of a patient of mine who I had been driving behind on the way to the office why he had slowed down so much going up Flagstaff Hill and then went faster going down?
“But the car always slows down going up hill,” he explained.
