1ICAN: Infant, Child, & Adolescent Nutritionvol. x • no. x Do You Need to Worry About Tooth Decay in Patients Who Aren’t Eating?

Abstract: Although it may seem counterintuitive, patients who are not being fed by mouth are still vulnerable to tooth decay, and the health problems that have required alternative forms of feeding make them more vulnerable to the complications of decay—pain, abscess, and septicemia. Even without oral intake, bacteria that live in the mouth stick to the tooth surface and can potentially threaten oral health. The bacteria’s metabolism produces acids that erode the tooth structure. If unchecked, this erosion can reach the tooth’s pulp causing an abscess and potentially resulting in septicemia and even death. Unfortunately, it is not always recognized that patients not taking food by mouth are still vulner-able to tooth decay. Additionally, the ways in which fluoride prevents decay are also misunderstood, which may contribute to decay rather than prevent it. To most effectively prevent decay, caregivers can apply fluoride directly to the teeth. It is commonly understood that fluoridated water protects teeth from tooth decay; however, it is the direct contact of the fluoride to the tooth surface that is protective, rather than ingestion of the fluoridate water. Therefore, by applying fluoride-containing pastes, gels, and/or var-nishes directly onto demineralized tooth surfaces tooth decay can be arrested in its earliest and most repairable stage. Fluoride applied topically remineralizes demineralized tooth structure, forming a surface even more resistant to the acid attack and stopping tooth decay