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 survey1 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.

1 Morpace Inc. conducted the 2011 Delta Dental Children’s Oral Health Survey. Interviews were conducted by email nationally with 907 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin of error is ±3.25 percentage points at a 95 percent confidence level.


ACA’s Exchanges Offer Opportunity to Improve Dental Health

As the Affordable Care Act’s Exchanges begin to enroll people across the country, a seemingly minor provision in the law is bound to make a big difference in combating the most widespread disease children experience today: tooth decay.Federal legislators wanted to tackle this issue head-on, and saw fit to make children’s dental coverage one of the ten essential health benefits for people getting coverage on the Exchanges.

There are many options for new customers purchasing dental benefits for their kids on the Exchanges. Consumers will now be able to choose from stand-alone dental plans, which is the way dental benefits have traditionally been provided, and from health plans with dental coverage wrapped up inside.

In fact, besides health plans covering major medical benefits, stand-alone dental plans are the only other type of coverage that can be sold on the Affordable Care Act’s Exchanges. Our goal is to help parents get access to great coverage so they can get their kids to the dentist for the care they need. Delta Dental member companies are offering children’s plans in most of states across the country in 2014, with more offering coverage in their states in 2015.

Parents will be able to shop for dental coverage not only for their children, but also for themselves. Family plans can be sold on most Exchanges as long as the pediatric coverage is also included in the plan. Recent studies show that parents with dental plans go to the dentist.2 And when they do, they are likely to bring their children. Ultimately, we hope that Delta Dental and other carriers can do their part to reduce dental disease across the country.

1 Oral Health in America; A Report of the Surgeon General (Executive Summary). National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/datastatistics/surgeongeneral/report/executivesummary.htm 

2007 NADP Consumer Survey. National Association of Dental Plans. http://www.ineeddentalbenefits.com/wp-content/uploads/2008/07/nadpemployerwhitepaper.pdf

Don’t Let Meds Desert Older Adults

Novelist C. S. Lewis once wrote, “How incessant and great are the ills with which a prolonged old age is replete.” Indeed, the Centers for Disease Control and Prevention (CDC) reports that about four out of every five older adults suffer from a chronic condition, and half have at least two.1

Often, those chronic conditions are treated with a variety of prescription medications. During National Healthy Aging Month, Delta Dental, the nation’s largest dental benefits provider, cautions older adults to guard against a dangerous side effect of more than 400 prescribed and over-the-counter medications – dry mouth.2

As it is medically defined, dry mouth is the result of a reduction of salivary output or quality. But dry mouth is more than just irritating and mildly uncomfortable; it can also increase the risk of tooth decay, gum disease and other oral infections. Many medications that treat chronic illnesses – such as hay fever, heart disease, Parkinson’s disease, high blood pressure (hypertension) and depression – are known to have dry mouth as a side effect.3

The New York Times recently attributed the dry mouth that results from many prescription medications as a major contributor to the rapidly deteriorating oral health of nursing home residents.4 The American Dental Association (ADA) has even advocated for warning-label information on these types of “xerogenic” medications to promote awareness of the potential oral health complications associated with drug-induced dry mouth.3 According to the ADA, chronic dry mouth is a common adverse effect for each of the following medication groups:3

  • Cardiovascular medications (such as diuretics or calcium channel blockers)
  • Anticholinergic agents for treatment of urinary incontinence (e.g., oxybutynin and tolterodine)
  • Tricyclic antidepressants (e.g., amitriptyline)
  • Anti-psychotic agents (e.g., chlorpromazine)
  • Anti-Parkinson’s medications (e.g., benzatropine)
  • Anti-allergy medications (e.g., antihistamines)

If your mouth becomes dry after taking a medication, you may want to mention it to your physician. Sometimes, an equally effective substitute medication can be prescribed that does not have the same side effect. To help you maintain good oral health and stimulate saliva, your dentist might suggest sipping water or sucking on ice chips frequently, avoiding alcohol, caffeine and tobacco products, chewing sugar-free gum or sucking on sugar-free candies.

1 Centers for Disease Control and Prevention. Healthy Aging at a Glance (2011). Centers for Disease Control and Prevention.  http://www.cdc.gov/chronicdisease/resources/publications/AAG/aging.htm

 2 U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.

3 Warning Label Information on Medications Associated with Xerostomia (Dry Mouth). American Dental Association. http://www.ada.org/sections/newsAndEvents/pdfs/ltr_dry_mouth_110427.pdf

4 Nursing Homes’ Dental Problems. New York Times. http://www.nytimes.com/video/2013/08/05/health/100000002374631/nursing-homes-dental-problems.html?smid=tw-share

“Dry Mouth.” National Institute on Aging, National Institute of Dental and Craniofacial Research, National Institutes of Health, March 20, 2010. http://www.nidcr.nih.gov/OralHealth/Topics/DryMouth 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.

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

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 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.

Ozone in Dentistry

imgres

One simmering controversy in dentistry has to do with ozone, but nothing to do with the layer that surrounds our planet. Rather, it’s a new and controversial alternative form of dental treatment. Some dentists are convinced that delivering ozone gas, a powerful naturally-occurring oxidant, into a decaying tooth can halt or even reverse the process altogether.

Dental caries, otherwise known as cavities, are bacterial infections that erode and destroy tooth structure due to the acid that is produced every time food is consumed. Ozone is toxic to certain bacteria, so the theory goes that injecting ozone into a carious lesion might reduce the number of cariogenic bacteria.

Ozone (O3) is formed from oxygen (O2) splitting into two oxygen molecules (O1) under various conditions, including an electrical discharge like a lightning strike. Then these single molecules collide with O2 oxygen to form ozone. If you have ever noticed a different scent in the air after a lightning storm, it is likely that you are smelling the higher concentration of ozone. In fact, the word ozone is derived from the Greek word “ozein,” which means “to smell.”

Ozone can exist in gas, liquid or solid form, and has long been used in industrial and medical applications. The extra oxygen molecule on ozone is loosely bound, excited and readily available to jump off, attach to, and oxidize other molecules. This oxidation process can destroy a variety of microorganisms. Ozone-based sterilizers are often used for some instrument and equipment sterilizing applications in hospitals. Ozone is also used by some municipal water systems to kill bacteria in the water.

Proponents argue that dentists can use ozone to start a process that removes bacterial waste products, halts dental cavities and begins a process of repair through accelerated remineralization of damaged teeth. According to them, bacteria, viruses and fungi lack antioxidant enzymes in their cell membranes, so those harmful antibodies are destroyed when ozone ruptures their cell membrane. Healthy cells, on the other hand, are unaffected by therapeutic levels of ozone because they have antioxidant enzymes in their cell membranes.1 Those in the dental community in favor of ozone therapy say dentists are utilizing it for periodontal therapy, root canal treatment, tooth sensitivity, canker sores, cold sores and bone infections, among other things.1

It’s an interesting idea and a pretty straightforward concept. Any treatment that not only saves or protects a tooth from decay but avoid the use of needles and anesthetic would be a welcome addition to a dentist’s treatment options. Unfortunately, despite some promising evidence of effectiveness against decay-causing bacteria in laboratory studies, the current evidence base for ozone therapy in dentistry is insufficient to conclude that it is an effective or cost-effective addition to the management and treatment of caries. At this time, the U.S. Food and Drug Administration (FDA), which assesses new drugs and medical devices for safety and efficacy and regulates their use and marketing in the U.S., has not cleared any ozone-generating devices for use in dentistry.

Ultimately, not enough is known as this time and some high quality clinical trials research is necessary. Biased research and inconsistent outcome measures have made researchers unable to confidently conclude that the application of ozone gas to the surface of decayed teeth halts or reverses the decay process. Therefore, at this time, ozone therapy for treatment the prevention and control of tooth decay is not considered a viable alternative to current treatment methods in the world of evidence-based dentistry.2

1 American College of Integrated Medicine and Dentistry. http://www.ozonefordentistry.com/DentalO.html Accessed July 10.

2 National Center for Biotechnology Information. Ozone Therapy for the Treatment of Dental Caries. http://www.ncbi.nlm.nih.gov/pubmed/15266519 Accessed July 10.

3 Rickard GD, Richardson RJ, Johnson TM, McColl DC, Hooper L . Ozone therapy for the treatment of dental caries.  Cochrane review.   2008 http://summaries.cochrane.org/CD004153/ozone-therapy-for-the-treatment-of-dental-caries#sthash.qfFibqsE.dpuf

Image courtesy of webelements.com

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.

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

Don’t Pass on Your Dentophobia

Parents who are afraid to visit the dentist may pass the same fear on to their children, possibly keeping them from getting routine dental check-ups that are important to promote healthy teeth and a lifetime of good oral health habits.

That’s one of the key findings from a survey of children’s oral health1 conducted on behalf of Delta Dental, the nation’s leading dental benefits provider. On average, the survey found that nearly 30 percent of children are afraid to visit the dentist. But when their parents also fear the dentist, that number jumped to almost 40 percent. Conversely, just 24 percent of children whose parents are unafraid of the dentist were still fearful of dental visits themselves.

The top reason parents say their children are afraid to visit the dentist is due to painful or sensitive teeth (17 percent). Other explanations include the noise and smell (11 percent), drills and dental equipment (10 percent), and shots and needles (9 percent).

During National Mental Health Month, Delta Dental offers parents and caregivers three simple tips to help children feel more comfortable in the dentist’s chair:

  • Start young: It’s recommended that children visit the dentist within six months of getting their first tooth – and no later than their first birthday. Starting at a young age allows children and parents to establish trust with a dentist and begin a routine of regular dental visits.
  • Keep it simple and positive: If children ask questions before a visit to the dentist, avoid using words that could make them scared, such as drill, shot or filling, or counseling them that it won’t hurt, since they often aren’t aware it could hurt in the first place. Instead, explain that the dentist is simply going to check their smile and count their teeth. Try not to discuss any negative experience that you might have had so your child can form their own opinion through personal experience.
  • Call ahead: Tell the dentist ahead of time that your child may be anxious about the visit. Most pediatric dental offices will have toys or music that children can focus on instead of the appointment itself, helping them relax and making a trip to the dentist a fun and enjoyable experience.

Parents need to help children understand why visiting the dentist is so important and help make their visits as comfortable as possible. Kids who have negative experiences at the dentist may be less inclined to make regular visits as teenagers and grown adults.

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.

Going Green with Delta Dental

DD_Logo_pms360_RGB_3inWhen you think of green and Delta Dental, you might think of the green that has long been a featured part of the logo. But on Earth Day, it’s worth pointing out that Delta Dental companies have taken steps to ensure their business initiatives are green as well.

Delta Dental companies are moving their network provider offices from paper claims to electronic submissions, which helps save paper and reimburses their dentists faster. They also encourage their subscribers to go paperless by signing up for electronic dental benefits statements. A few even provide incentives – such as guaranteeing patient eligibility – for the subscribers who choose to perish paper.

Member companies use blog posts and pins on social media sites like Pinterest to share ideas with their environmentally-conscious consumers about reusing old toothbrushes for garden stakes or as cleaning tools, or turning empty tubes of toothpaste into a pencil holder.

Of course, corporations ought to practice what they preach. One Delta Dental company saved almost $60,000 by eliminating disposable paper cups and retrofitting light fixtures at its headquarters as part of its “green program initiative.”1

Like a lot of corporations in the 21st century, Delta Dental is always searching for ways to improve business efficiency and sustainability. We feel that corporate social responsibility these days must include going green.

1  Environmental & Energy Management News. Delta Dental Racks Up Savings with Varied Environmental Efforts. http://www.environmentalleader.com/2009/11/12/delta-dental-racks-up-savings-with-varied-environmental-efforts/