[sak9645]

Dental problems are extremely common in internationally adopted children, as a result of:

a) Poor birthmother nutrition, especially (but not only) a lack of calcium-rich foods. Remember that many foreign birthmothers are poor and also lack access to medical care that might include prenatal vitamins and so on.

b) Poor birth family/orphanage/foster home nutrition, once the child is born. Poor children may not get adequate supplies of calcium and other nutrients.

c) Poor birth family/orphanage/foster home attention to dental hygiene -- toothbrushing, flossing, etc.

d) Limited access to dental care, or extremely primitive care that addresses problems mainly by pulling teeth.

e) Use of medications -- rarely used in American children -- that can permanently stain teeth, such as tetracycline.


Children often come home with problems that can include:

a) Weak enamel -- very common -- that predisposes teeth to development of cavities. The weak enamel may affect only the "baby" teeth, or it may persist (despite improved nutrition) in the permanent teeth. (My daughter's weak enamel has persisted, and she has already had cavities in permanent teeth, even though they came in long after she arrived home.

b) Stained teeth, often from tetracycline, but also from lack of brushing. May affect baby or permanent teeth.

c) Extensive tooth decay in baby or permanent teeth. Bottles of formula left in cribs at night are a major cause.

d) Gum problems.

e) Malpositioned teeth.

f) Broken or damaged teeth.

When you adopt internationally, it is a good idea to have your new child see a dentist almost as quickly as he/she sees a pediatrician. The dentist can collect some baseline data, see if there are any problems that require immediate attention, and recommend a course of action for longer term care.

In the U.S., many general or family dentists will not see a child until he/she is age 2 or 2.5, or until he/she has all of his/her baby teeth. Nonetheless, a younger child adopted internationally SHOULD be seen by a dentist. A visit to a pediatric dentist may be in order, if your family dentist will not see the child, if the child clearly has some serious problems, or if the child is terrified of the dentist. A children's hospital is often a good place to find a pediatric dental clinic, but many pediatric dentists do have private practices.

Be aware that, in some countries, dentistry is fairly primitive, and a child may have been held down while rather serious work was done without anesthesia. A child who has been through such treatment may be terrified of going to the dentist, and considerable time may have to be spent by both the parent and the dentist, reassuring him/her.

It is important to identify a dentist who is familiar with adoption issues, whether or not your child has fears because of past experiences. You certainly don't need a dentist who lays a guilt trip on you, because your child has cavities, when the fact is that you do a great job of brushing/supervising brushing; it's just that your child's birthmother had a bad diet because of extreme poverty.

Also, while many dentists insist that parents leave the room during treatment, since children often "put on a show" -- cry and carry on -- only when their parents are present, and since some parents convey their own anxieties about dentall treatment to their children. However, a child with attachment disorder or sensory integration problems, related to early life experiences, may need the presence of a parent.


Sharon