Ignorance Not Blissful for Your Children’s Oral Health

“What you don’t know won’t hurt you” is a popular idiom that couldn’t be further from the truth when it comes to personal health. In fact, parents’ lack of knowledge about certain common at-home habits could jeopardize their children’s oral health.

For instance, nearly half of American children under age 3 have never seen the dentist, according to the 2013 Delta Dental Children’s Oral Health Survey.1 What many parents don’t realize is the American Academy of Pediatric Dentistry recommends that a child go to the dentist by age 1 or within six months after their first tooth erupts.2

Parents should take children to the dentist by age 1 to establish a trusting relationship with the dentist and receive critical oral health care advice. Studies show that early preventive dental care can save in future dental treatment costs.

Fill bottles with water, not juice or milk
Nearly 50 percent of caregivers with a child 4 years old or younger report that the child sometimes takes a nap or goes to bed with a bottle or sippy cup containing milk or juice. This bad habit can lead to early childhood (baby bottle) tooth decay.

Ideally, children should finish a bottle before they are put down to sleep. But if they must have something to comfort them while they go to sleep, fill a bottle with water. Don’t get in the habit of providing sweet drinks because you think it will please your child. Of course, most children do like sweets, but babies and toddlers want the soothing, repetitive action of sucking on a bottle more than sweetened drinks.

Avoid sharing food and utensils with children
Did you know that caregivers can actually pass harmful bacteria from their mouth to a child’s mouth, which can put the child at an increased risk for cavities? Bacteria are passed when items contaminated with saliva go into a child’s mouth. Typically, this takes place through natural, parental behaviors, such as sharing eating utensils or cleaning off your baby’s pacifier with your mouth. Parents with a history of poor oral health are particularly likely to pass germs along.

However, three out of every four caregivers say they share utensils such as a spoon, fork or glass with a child. Caregivers of children ages 2 to 3 are most likely to share utensils with their children.

For additional tips to help keep children’s teeth healthy during National Smile Month and all year long, visit www.oralhealth.deltadental.com.

1 Morpace Inc. conducted the 2013 Delta Dental Children’s Oral Health Survey. Interviews were conducted nationally via the Internet with 926 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin of error is ±3.2 percentage points at a 95 percent confidence level.

2 American Academy of Pediatric Dentistry – Policy on the Dental Home. http://www.aapd.org/media/Policies_Guidelines/P_DentalHome.pdf

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Are Sports Drinks as Harmful to Kids’ Teeth as Soda?

While kids play sports in the summer heat, they will be tempted to gulp down large sugary sports and energy drinks to stay cool. Swigging too many of these beverages, however, can harm a child’s teeth. Delta Dental advises parents to monitor and limit the number of these beverages their children are consuming to help prevent cavities.

Young athletes do need to replace fluids, carbohydrates, protein and electrolytes after hard exercise. But the high sugar and highly acidic content of sports drinks can increase a child’s susceptibility to tooth decay and enamel erosion if too much is consumed.

Like soda, energy and sports drinks contain high levels of acidity and high concentrations of sugar. A study from the Harvard School of Public Health found that 12 ounces of a leading brand of cola and a leading brand of energy drink each contained 42 grams of sugar, while a leading sports drink contained 21 grams of sugar.1 According to a University of Iowa study, a leading sports drink had the greatest erosion potential on both enamel and roots of teeth when compared to leading brands of energy drinks, soda and apple juice.2

Sugar itself doesn’t rot teeth, but rather, the acid that is produced when sugar mixes with certain bacteria in the mouth. Decay forms around the parts of the tooth where the plaque accumulates. The high acid from the drinks themselves can also have an erosive effect on the whole surface of the tooth. Sugary, acidic drinks are particularly damaging when they are sipped frequently throughout the day because they spend a prolonged amount of time washed over the teeth.

Instead of buying the 32 or 64 ounce bottles of sports drink, limit kids to a single 12 to16 ounce bottle. Encourage kids to consume as much water as they do sports drink. Drinking water will help them stay hydrated during outdoor activities and make sure any residual sports drink doesn’t linger on their teeth. Another option is to dilute the sports drink with water to lower the concentration of acidity and sugar. If your kids find water boring, consider adding slices of orange, lemon or cucumber to make it more appealing. Interestingly enough, recent studies suggest that low-fat chocolate milk may be as good as a sports drink at promoting recovery between workouts.3

1 Harvard School of Public Health. How Sweet Is It? Accessed June 2012.http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/how-sweet-is-it/index.html

2 University of Iowa College of Dentistry. Acidic Beverages Increase the Risk of In Vitro Tooth Erosion. Accessed June 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516950/

3 Spaccarotella KJ, Andzel WD. Building a beverage for recovery from endurance activity: a review. J Strength Cond Res. 2011 Nov;25(11):3198-204.

How to Handle Tooth Trauma

As children head back to school, it is important to remember that dental emergencies can happen any time, any place. According to the 2013 Delta Dental Children’s Oral Health Survey,1 one out of 10 children ages 10 or 11 have had a tooth emergency such as a knocked-out tooth, chipped tooth or a loosened permanent tooth at home or at school.

A knocked-out permanent tooth is a true dental emergency, and there’s a good chance it can be saved if you know what to do and act quickly. The primary concern should be getting the child in to see a dentist. Time is crucial if you want the dentist to be able to reinsert and salvage the natural tooth. Ideally, a child needs to be seen within 30 minutes of the accident.1

Whether a tooth is knocked out at school or home, here are several steps to ensure it is saved – or at least in optimal condition – by the time the child can see the dentist.

First, check to make sure the child doesn’t have a serious head, neck or other orofacial injury (i.e., a concussion, broken jaw, etc.).
Don’t worry about replacing a displaced baby tooth. Trying to reinsert it could damage the permanent pearly white coming in behind it.
To avoid infection, the tooth should be held by the crown, not the root. The crown is the part of the tooth visible to the naked eye. You want to leave the root intact, and touching it with bare hands could pass bacteria.2
Rinse any debris off of the tooth under room temperature water. Don’t scrub the root! Once the tooth is free of loose dirt and debris, try to reinsert it, asking the child to hold it in place using a piece of gauze if necessary. 3
If the tooth cannot be successfully reinserted, it needs to stay moist until the child can visit a dentist. Store the tooth in a clean container and cover it with milk or room temperature water to prevent it from drying out. 4 These liquids aren’t ideal but are often the only ones readily available. If you are a school nurse or your child frequently plays contact sports, purchase an emergency bag handy with a save-a-tooth kit in it (available at most drugstores.) These contain a solution that is better at preserving any live cells on the tooth root until the dentist can put the tooth back into the socket.
In most cases, tooth injuries are not life threatening. But they can have long-lasting effects on the child’s appearance and self-confidence, so it is important to act quickly in the event of a dental emergency.

1Morpace Inc. conducted the 2013 Delta Dental Children’s Oral Health Survey. Interviews were conducted nationally via the Internet with 926 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin error is ±3.2 percentage points at a 95 percent confidence level.

2“Saving a Knocked-Out Tooth.” American Association of Endodontists. http://www.aae.org/patients/patientinfo/references/avulsed.htm. Accessed 2010.

3 “Medical Encyclopedia: Broken or Knocked Out Tooth.” U.S. National Library of Medicine and the National Institutes of Health, February 22, 2010. www.nlm.nih.gov/medlineplus/ency/article/000058.htm. Accessed 2010.

4“Dental Emergencies.” American Dental Association. http://www.ada.org/370.aspx Accessed 2010.

Are Two Annual Dental Visits One Too Many – or Not Enough?

For decades, conventional wisdom held that certain dental procedures were best practices and were right for all people. You brushed your teeth after every meal (or at least morning and night) flossed daily, and visited the dentist twice a year. At each visit, you got an exam, X-rays and a cleaning. If you were a child, you could add on a fluoride treatment and perhaps sealants on your molar teeth.

However, thanks to advances in molecular medicine, genetics and other areas of research, health care in general (including oral health care) is being transformed from a system of treating disease in a one-size-fits-all manner to one that provides predictive, proactive, preventive and personalized care. Oral health care advances also allows for a more customized and tailored approach to each person’s individual situation.

Sure, basic prevention activities like brushing with fluoride toothpaste, flossing and drinking fluoridated water regularly is important for all. Based on risk factors, however, some people are considered at higher risk and some at lower risk for developing oral diseases like tooth decay, periodontal (gum) disease or oral cancer. Your risk for disease may help you determine what level of more costly professional services may be most beneficial. People with a history of good oral health, good dietary and oral hygiene habits, and no genetic red flags may need to only visit the dentist once a year or less. Conversely, those with a history of disease and other risk factors may need two or more routine visits each year.

A recent study published in the Journal of Dental Research looked at individual’s risk for periodontal disease and concluded that for low-risk individuals, “the association between preventive dental visits (dental cleaning) and tooth loss was not significantly different whether the frequency was once or twice annually.”1 It went on to recommend evaluating genetic tendencies for gum disease with conventional risk factors (smoking and diabetes) when assessing how often a patient needs to visit the dentist.1 While this study looked specifically at gum disease risk, risk factors are also established for other oral problems such as tooth decay and oral cancer.

In response to the JDR study, the American Dental Association released a statement to “remind consumers that the frequency of their regular dental visits should be tailored by their dentists to accommodate for their current oral health status and health history.” 2

For those who are unaware of their personal risk factors, Delta Dental provides an online tool (myDentalScore) that can help you self-assess your level of risk for gum disease, tooth decay and oral cancer. This self-assessment will provide you with valuable information to help you have a good discussion with your dentist about the best mix of self-care and professional care for you as an individual.

Ultimately, Delta Dental encourages consumers to honestly evaluate themselves and seek the kind of dental care that will be most beneficial to their oral health.

1 Patient Stratification for Preventive Care in Dentistry. http://jdr.sagepub.com/content/early/2013/06/05/0022034513492336.abstract

2 American Dental Association. American Dental Association Statement on Dental Visits. http://www.ada.org/8700.aspx

Kids Need to Brush Longer and More Often

Poor and infrequent brushing may be major obstacles keeping children from having excellent oral health and are the areas that cause caregivers the greatest concern.

A survey of American children’s oral health found that while nearly two out of five Americans (37 percent) report that their child’s overall oral health is excellent, more than a third of the survey respondents (35 percent) admit their child brushes his or her teeth less than twice a day. Parents and caregivers recognize the frequency as “not enough,” despite the fact that nearly all of those surveyed (96 percent) with children up to age 6 say they supervise or assist with brushing.

Among those who rate their child’s oral health as less than excellent, only 56 percent say their child brushes his or her teeth for at least two minutes, which is the amount of time dentists typically recommend spending on each brushing.

Getting children to brush regularly, and correctly, can be a real challenge. Here are some easy ideas to encourage brushing:

Trade places: Tired of prying your way in whenever it’s time to brush those little teeth? Why not reverse roles and let the child brush your teeth? It’s fun for them and shows them the right way to brush. Just remember, do not share a toothbrush. According to the American Dental Association, sharing a toothbrush may result in an exchange of microorganisms and an increased risk of infections.
Take turns: Set a timer and have the child brush his or her teeth for 30 seconds. Then you brush their teeth for 30 seconds. Repeat this at least twice.
Call in reinforcements: If children stubbornly neglect to brush or floss, maybe it’s time to change the messenger. Call the dental office before the next checkup and let them know what’s going on. The same motivational message might be heeded if it comes from a third party, especially the dentist.

The Silent Signs of Gum Disease

Diabetes is a pervasive problem in America, a cultural epidemic with wide-ranging and potentially severe consequences. According to the 2011 National Diabetes Factsheet, 25.8 million people or 8.3 percent of the U.S. population has diabetes at an estimated annual total cost of about $245 billion.

People with diabetes tend to develop periodontal (gum) disease earlier in life, and more severely. Though it is often painless, Delta Dental cautions people suffering from diabetes to be mindful of its warning signs. These can include bad breath, bleeding gums after brushing or flossing, red, swollen or tender gums, or changes in the way your teeth fit when you bite. Unfortunately, many people ignore those periodontal red flags until it’s too late.3

Individuals often ignore the warning signs of periodontal disease because there is usually no pain involved. So they will brush a little better to get rid of the bleeding or use mouthwash to hide their bad breath. The best idea is to schedule regular visits to your dentist to make sure that you are not developing periodontal disease.

Maintaining regular dental visits is particularly critical for patients suffering from diabetes.Oral diseases such as tooth decay and gum disease are often reversible if they are diagnosed and treated early. Dentists can also check for other common mouth conditions that afflict people with diabetes such as dry mouth, ulcers and infections. Periodontal disease and other mouth conditions may also be a sign that other medical conditions exist elsewhere in the body. Depending on their findings, the dentist might advise patients to seek a medical consultation.

Certain Kids Could Benefit From More Fluoride

Fluoride is a mineral that helps teeth become more resistant to decay (cavities). You can help prevent your child from getting cavities by making sure they drink fluoridated water and brush at least twice daily with fluoride toothpaste. For many children, this daily fluoride exposure is enough to protect them for a lifetime.

But, has your child had a cavity in the past three years? If you answered yes, he or she is likely at higher-risk for tooth decay in the future. If your child is at higher risk for future tooth decay, you should also talk to your dentist about prescription-strength fluoride that can be applied in their office two or more times per year. Unfortunately, many higher-risk children are not receiving this protective treatment.

Five Holiday Treats that May Lead to Ho-Ho-Holes in Your Teeth

Here are five common treats to limit during the holidays:

1. Candy Canes: The problem with candy canes is the prolonged amount of time that they linger as you slowly dissolve them in your mouth. Not to mention, the temptation to chomp them, which can lead to cracks or chips in your teeth. Consume them quickly and carefully to limit their negative oral health impact.

2. Christmas Cookies: It’s tempting to overindulge when there’s an abundance of baked goods – like Christmas cookies – laying around. But cookies are laden with sugar and can do significant damage to your pearly whites. Of course, we know suggesting skipping cookies entirely is impractical. Just enjoy them in moderation.

3. Holiday Drinks (such as eggnog, apple cider and hot chocolate): Festive beverages offer more than warm, holiday cheer – eggnog boasts over 20 grams of sugar per cup,1 while hot cider can pack over 65 grams of sugar when dolled up with caramel sauce and whipped cream.2 Stick to one small serving of your favorite drink and wash away some of the sticky sugar residue with a glass of water.

4. Caramels: Chewy, sticky treats such as grandma’s famous homemade caramels are particularly damaging because they are not only high in sugar, but they spend a prolonged amount of time stuck to teeth and are more difficult for saliva to break down. The same rule applies to all those sparkly gumdrops on your gingerbread house.

5. Fruitcake: Even though it’s the butt of many holiday jokes, some people actually eat the fruitcake that gets passed around at the holidays. Oral health reasons to avoid it include the sugary cake base and the chewy, candied fruit that stud it throughout.

Cookies, candy and sweet holiday beverages all have at least one main ingredient in common: sugar, whose negative effect on teeth has been well-documented. Why is sugar so bad for your teeth? It mixes with bacteria in the sticky plaque that constantly forms on teeth to produce acid that attacks tooth enamel. The stickiness of that plaque keeps those harmful acids against the teeth, which contributes to tooth decay.

Sealants Critical to Children’s Oral Health

Sealants are plastic coatings that protect those difficult to reach pits and grooves on the chewing surfaces of the teeth from the bacteria that cause tooth decay. A quick and painless procedure done in your dentist’s office, sealants are applied to the chewing surfaces of permanent molars as soon as possible after they fully erupt in the mouth, usually between the ages of six to eight for first molars and 10 to 12 for second molars. While sealants are not necessary for all children, they are particularly beneficial to children who are at higher risk for tooth decay. But, how do you know if your child is at higher risk?Although overall oral health risk is a combination of genetics, personal habits and diet, history of decay is a good predictor for future risk of decay. Your child is considered to be at higher risk if he or she has had a cavity filled in the past three years. The good news is you may be able to help prevent future cavities by making sure your child receives preventive care, including having sealants applied to first and second molars.

Although approximately 60 to 70 percent of cavities can be prevented by placing
sealants on children’s teeth, a recent study by Delta Dental shows that 60 percent of
children age 6 to 9 who are at higher risk of tooth decay did not receive sealants on
their first molars, and 80 percent of children age 11 to 15 did not receive sealants on
their second molars.1

These figures are particularly striking when you realize that many dental plans cover preventive care, like sealants, at as much at 100 percent of the cost. As a parent, you want your child to be as healthy as possible, and that includes protecting their teeth.