BANGOR – It’s no news that breakfast is the most important meal of the day, but here’s another reason for Maine parents and caregivers to heed that ancient wisdom: Children who eat a healthful breakfast are much less likely to develop dental decay than those who don’t.

Bangor dentist Jonathan Shenkin, who in July took over the longtime pediatric practice of retired dentist Roger Nightingale, is one of half a dozen researchers who have studied the relationship between healthful eating behaviors – including eating breakfast and regularly consuming five or more servings of fruits and vegetables – and tooth decay in children from 2 to 5 years old. The results of the national study are published in the January issue of the Journal of the American Dental Association.

The study found that while tooth decay is most common in children from low-income families, the largely preventable problem crosses all social and economic boundaries. More than 4,000 children were included in the study, which was conducted using data gathered by the federal Centers for Disease Control and Prevention.

“We found that even middle-class children who don’t eat breakfast are four times more likely to develop tooth decay than kids who do,” Shenkin said in a recent interview.

The most obvious explanation is that youngsters who power up on healthful foods in the morning are less likely to crave snacks and juices later in the day. These quick-fix foods contain high concentrations of sugar, which encourages bacterial growth and leads to tooth decay.

Even 100 percent fruit juice, which Shenkin noted is a popular offering among health-conscious caregivers, is essentially a sugar bath for teeth, best followed with brushing or at least a swish of fresh water. “The American Academy of Pediatrics recommends that children between 1 and 6 years old drink no more than 4 to 6 ounces of juice a day,” Shenkin pointed out. “But the average intake is 12 ounces, and, in our office survey, parents often report their kids take in 24 or 30 ounces a day or more.”

Shenkin said the breakfast table is where youngsters are most likely to consume dairy products such as milk or yogurt, important sources of calcium and other nutrients that make for healthy teeth and bones.

But the most compelling explanation for a correlation between eating breakfast and having healthy teeth is the caring involvement of parents or other adults from an early age. Shenkin said parents or caregivers who set out a good breakfast at the beginning of the day and ensure a high intake of fruits and vegetables, are, in many cases, the same adults who will see that the children in their care brush regularly and observe other healthful behaviors, including routine dental visits.

Caregivers too often put off preventive cleanings and examinations, Shenkin said, and wait instead until a child complains of severe pain before scheduling a trip to the dentist. By that time, he said, decay can be widespread and a child’s pain and apprehension may become a barrier to treatment.

It’s not uncommon for him to see children 3 years old – or even younger – who have decay in all of their teeth. He schedules frequent time at Eastern Maine Medical Center where he can perform “full-mouth rehabs” on these youngsters under general anesthesia.

Older generations of Mainers, Shenkin said, “have just accepted the destiny of tooth loss. I’d like to change that attitude. It’s not written in stone anywhere that a child has to lose teeth to decay … the two biggest villains are poor nutrition and a lack of basic oral hygiene.”

Shenkin and his cheerful staff of assistants and hygienists practice in a sunny, colorful office near the Bangor Mall. The walls are covered with bright movie posters and cartoon character decals. Youngsters are issued big, goofy sunglasses to shield their eyes from the bright examination lamp, and they can play with handheld electronic game modules while they wait for their Novocain to kick in.

Parents sometimes may have to help calm a squirmy, upset child, Shenkin said, but in most cases a specially trained dentist and a staff that genuinely likes working with children can make the visit positively pleasant. “Most kids really do just fine,” he said.

This is the only specialty pediatric practice north of Falmouth, with a current client list of more than 2,000 young patients plus a growing roster of referrals from general dentistry practices throughout the northern half of the state.

“Most pediatric specialists work in high-income communities,” Shenkin said, but about half of the children he sees are enrolled in MaineCare, Maine’s Medicaid program.

A graduate of the Columbia University School of Dentistry, with a master’s degree in public health from Johns Hopkins University, Shenkin, 32, said the health of children’s deciduous or “baby” teeth is essential. Untreated decay can lead to serious pain, infection and disease, and teeth too decayed to be salvaged can cause long-term misalignments that may require expensive orthodontia to repair.

MaineCare pays for prevention and treatment of decay, and for spacers to hold the teeth in alignment,” Shenkin observed. “But it won’t pay for braces on your teeth.”

In addition to maintaining his busy Bangor practice, Shenkin is an associate professor at Boston University’s School of Dental Medicine. Through his position at BU, Shenkin conducts research and presents his findings to academic and professional groups.

He also serves on a special task force to study public health issues in Maine.