[hylo]

We recently adopted a sibling group of three in Poland, ages 3-6. I knew that problems with teeth are the most common problems that adoptive parents mentioned, but was wondering if anyone knows why?

I have a 6 year old with 8 cavities. A 5 year old with 7 cavities and even the 3 year old has a cavity!

They told me that they brushed their teeth once a day when in Poland (they lived with a foster family for two years).

I am frustrated and almost angry at the family for not taking the kids to the dentist to get fillings done. Instead, these poor kids have been complaining about pains in their teeth from the day we met them.

While I can understand that they had other more important priorities in raising these children, it angers me that they caused them to suffer unnecessary pain in the long run.

How does dental health work in Poland? Does the State not pay for the children to get dental care while in orphanages or foster care? How much does it cost for foster families to take a child to see a dentist and get a filling?

What is common in Poland when it comes to brushing teeth? Once a day?

Does Poland add Flouride to their water?

It really saddens me that my kids have to suffer so much at such a young age, when this is something totally preventable!!!

[momraine]

My son's teeth were fine, but he was in an orphanage not a foster home, I don't know if that made a difference. I doubt they put flouride in thier water, as that is actually only a fairly recent thing, our parents did not have that and Poland is behind us in many ways. Also I know my Russian daughter was given lots of sugary tea in her orphanage and the bottles propped, and that lead to lots of tooth problems for kids from there, I don't know if it's the same in Poland. Also if your kids lived for two years with thier bio families, they probably did not brush teeth there, after all, they were removed from that home, so it was probably not the most watchful home. The good thing is they are home now and getting the care they need. I also don't know how expensive dental care is there. The family I stayed with in Russia did not get dental cleanings or anything because it was very expensive.

[lastpaige]

My husband is a native Pole, and every dentist he sees here takes one look in his mouth and says, "Where, in eastern Europe, did you grow up?"

When we met our sons, it was the same thing, one complaining of aches in his mouth. We took one look at the brown pits in his teeth and about fell over - annoyed with the same thought process that you had. One of the ladies who worked at the orphanage said that they do nothing until there is pain because it’s so expensive, and even then it takes a long time to get an appointment. We bought some Oragel (sp?) at the pharmacy and I kept it in my purse. (It wasn’t ideal, but it held us over until we got home.)

Two days later, once the boys were with us 24/7, we got to see their washing up routines. At night it consisted of using the toilet. No washing of hands or face, no care of teeth. In the morning it consisted of using the toilet, putting a barely visible amount of toothpaste on the brush, then shoving the brush once to the left of the mouth, and once to the right. We immediately began shoring up this lacking area.

Later, when talking with some family there, they told us that they wait for almost a year to get into the dentist, and that we could buy our way into an appointment if we had to, especially since we had US dollars (which were still worth something then). We talked to our driver about it and he said to try to hold off until we got back to the states, as children are not always properly anesthetized for dental work. Nice!

Once home, our first stop was the dentist. One of the boys had 5 teeth pulled and one cavity filled, and the other had one tooth pulled and 5 cavities filled. Both are now master teeth brushers. Having seen the brown decaying yick that came out of their mouths, they’re motivated to not experience that again!

Is it right? No. But nor can we change it. We can only warn others to be ready, and have dental appointments waiting for them upon arrival home.

[LisArno]

The initial report on our children indicated "has cavities". We asked if they had been filled. The answer was no, due to it costing too much.

One of my three children (4 years old at the time) had really rotten teeth - many down to her gums - and other teeth with only a "shell" left. Once here, she had a few pulled, others capped, and more filled. She was absolutely thrilled with her "shiny new teeth" (the silver caps). Since she's now almost 7, the horrible front baby teeth have fallen out. My other daughter - then 10 - had a few fillings and one tooth pulled. She continues to have poor brushing habits and I've had to monitor/watch her brush even at 12 years old. My then almost 3 year old son was blessed with needing only one minor filling.

A year or longer after being home, my two girls were playing house/dolls. The oldest showed the youngest how to get a bottle ready - put in some milk, add some sugar, add some water. Since she was the one responsible for caring for her two younger siblings, that probably explains the bad teeth.

Just this week, a co-worker noted that a non-American friend told her "We can tell who the Americans are because of their teeth. They look so much better than Europeans." Having lived in Germany for 16 years and traveled to other countries, I would definitely agree with that!

[sak9645]

First off, please understand that dental problems are EXTREMELY common in internationally adopted children.

The main reason is poor birthmother nutrition and medical care. Most children become available for adoption because their birth families are poor. The birthmothers may eat a terrible diet during pregnancy out of sheer necessity, and may have no access to -- or awareness of the need for -- prenatal vitamins/calcium. Poor prenatal nutrition generally translates into poor quality baby teeth, and the problem sometimes persists even in the permanent teeth. My daughter, who is from China, has weak enamel and pitted enamel on her permanent teeth, just as she had on her baby teeth. Despite my attention to her teeth, she got a cavity in a permanent tooth soon after it emerged.

In addition, children who spend some time with their biological parents after birth will continue to experience the effects of poverty. In the early years, when it is very important for children to have adequate calcium and other nutrients, they simply may not get it. Instead of high quality breast milk or formula, for example, they may get powdered milk that is watered down and sugared. This is also a cause of poor tooth and bone development. A lot of kids come home from overseas with rickets, a nutritionally related bone condition, as well as bad teeth.

Birth families may or may not know about the need for toothbrushing and the risks of "nursing bottle mouth". This term refers to the practice of letting a baby have a bottle of formula or milk in his/her crib at night. As the baby sucks on it, the sugars pool in the mouth, without being washed away with drinks of water or tooth brushing. The milk sugars increase the growth of decay-causing bacteria.

Once in an orphanage or foster family, some of the same conditions may apply. Many orphanages around the world are woefully underfunded. The children's diets may be poor, and strategies that get babies fed quickly, such as sugaring bottles to make the babies drink faster, are common. The staff may leave bottles in cribs because there aren't enough employees to hold the children, feed them, and clean their teeth. Babies and toddlers need supervision and assistance, or they will not brush their teeth properly, and without adequate staff, they simply won't get much brushing done. Doctor and dentist visits are few and far between, and usually reserved for serious problems.

Foster families, just as in the U.S., may not go into being foster parents with the best of motives. Money given to the foster parents for care of the children may go for other purposes. But even truly caring foster parents may not be well educated, and may not know how important calcium-rich foods are, how risky it is to prop bottles in cribs at night, or that supervision of toothbrushing is a must. Their stipend may not cover much medical or dental care, and if they don't live in a big city, there may be no dentist around. In many countries, people just pull teeth when they decay.

All in all, it doesn't surprise me that kids come home from overseas with bad teeth. In fact, I'm always surprised that this topic doesn't arise more often in adoption forums.

And one other thing should be noted. It may actually be a blessing in disguise if your older children have had limited dental care overseas. In some countries, particularly in Eastern Europe, it is common practice for children, and especially orphans, to be subjected to some fairly serious dental work without any form of pain control. They may be tied or held down, and may be berated or hit if they scream.

Unfortunately, this sort of treatment is absolutely traumatic for the children, and can leave them with a total fear of dentists. Such a fear can make it difficult for their adoptive parents to get treatment for them, even when they need it badly. It can take months or years for a dentist to win their trust.

As far as fluoridation of water, that is not common in the countries from which Americans adopt. And you aren't going to find many dentists in those countries who use fluoride treatments or sealants. In fact, there is very little preventive dental care, just as there is very little preventive medicine, in many countries. You get treatment when you have a big problem.

The good news is that American dentists can do a great deal to correct dental problems in internationally adopted children, and can do it with good pain control. Many of the dentists also receive special training in how to deal with the concerns and fears of children.

The care that is required won't be cheap, of course. In fact, some children may need to have work done in a hospital setting, under general anesthesia, because the problems are so severe. And the need for orthodontia seems to be almost universal. It wouldn't be a bad idea for a person contemplating international adoption to get dental insurance, if it is available through his/her workplace and he/she doesn't already have it.

Sharon

[MN_Mom]

Timely. We just went to the dentist for the first time this morning. We knew Chris' (age 9) mouth was in bad shape just from looking in it ourselves. He actually does a pretty good job brushing his teeth, but his teeth were horrible!

About a month ago he lost a tooth. He was so excited to hide it for the Tooth Fairy! Then the next day, he lost some more of the same tooth. Umm, yuck. All in all, it took three tries before the whole tooth came out. There was a whole lot of rot in there.

Long story short, he needs to have at least 6 teeth pulled -thankfully all baby teeth, but still. All of his adult teeth are in good shape, so that is the good news.

We had an interpreter with us for this appointment because we expected it to be a doozy. The interpreter was helpful, and even got Chris to talk a little about the dentists he had seen in Poland - a lot of drilling seems to have been involved there.

Needless to say, we will be seeing a lot of the dentist in the next few months.


~sarah
based on a true story...

[jola_nyc]

Here is how it works. Poland has socialize health care but most dentist prefer to have private practice and don't accept general patients. There is not enough public dentists. If you want to make appointment with public dentist you have to wait 6 months or longer. Also many little towns don't have a dentist who would accept a public health care plan so if you adopted a child who was living in a small town the care givers had to go to a bigger town to see a dentist for free (6 months after they made appointment). Many schools in Poland have a visiting dentist who takes care of all students but he or she might have a dozen or so schools in care and each school has hundreds of children. As for water most small towns in Poland don't have water or septic system. In Warsaw they use Chloride instead of Fluoride to sanitize water and almost all Warsaw residents don't cook and drink water from faucet but they only use bottled water or water from public deep-drilled well that serves water from Oligocene period for consumption. I would not drink water from tap in Poland.

[CherieW]

We were informed by our interpreter when we got to Warsaw not to drink the water. We were there in the summer and it was very HOT! We went through TONS of bottled water jugs and bought TONS more for making ice cubes, cooking and cleaning our sons bottles etc. Our son had very few teeth at the time but we were told he rarely had water, only a strawberry drink of some sort. Sugar, sugar, sugar.

[mama08]

Great....Cherie I believe we had the same interpreter and we weren't told to not drink the water!!! We're all fine, but still, we drank lots, made lots of tea & soups!

Our son was 2 and had all of his baby teeth, We've been to the dentist here twice so far (he's 3 now), and the only issue will be in another year or so if he can't/won't stop sucking on his fingers in his sleep:-) I guess we got lucky with this issue. My husband did say that he could visibly see a difference in the color of our son's teeth after he'd been with us for a week.

[PolishMom]

I think you've gotten a great number of excellent responses. My experience with my 3 are exactly the same. Their physical health is better than any child I have met in the US (I'm thinking immunity built up in the orphanages) but their dental health was atrocious!

Just a funny side...my youngest daughter actually came to us with one cavity already filled. The filling was pink!! Let's just say it was very visible in her mouth! Our dentist says he has never seen a color like that before for a filling...

Heather

[LisArno]

Does anyone know about temporary "fillings"? Our then 10 year old told us that she was given something to roll into a ball, stick it in the hole in her tooth, and then bite down on it to get it to stay.

[Mom2_4]

My two older adoptees had nearly all of these same dental issues. We will be home 5 years next Wednesday and the change in their dental health and teeth appearance is amazing!

[mschaefer]

Our twin girls were from the same orphanage as mama08 and also 2 y.o. when adopted. They have been to the dentist three times and teeth look great; however we do have the same problem with both girls still sucking their fingers so their bites are very off.