How Many Dental X-Rays Do Your Kids Need?

Young Teen at DentistFebruary is National Children’s Dental Health Month, the perfect time to take your kids to the dentist for one of their regular visits. But before you do, Delta Dental encourages you to be well-informed about how often your child should have dental X-rays.

The purpose of X-rays is to allow dentists to see signs of disease or potential problems that are not visible to the naked eye. They are should be suggested after the dentist has done a clinical exam and considered any signs and symptoms, oral and medical history, diet, hygiene, fluoride use and other factors that might suggest a higher risk of hidden dental disease.

However, all X-rays use ionizing radiation that can potentially cause damage. Though it is spread out in tiny doses, the effect of radiation from years of X-rays is cumulative. The risks associated with this radiation are greater for children than for adults. So be sure that your dentist checks your child’s teeth, health history and risk factors before deciding an X-ray is necessary.

“X-rays are an important tool for dentists to diagnose dental diseases. However, they do not need to be part of every exam,” said Dr. Bill Kohn, DDS, Delta Dental Plans Association’s vice president of dental science and policy. “They should be ordered only after the dentist has examined the mouth and has determined that X-rays are needed to make a proper diagnosis. In general, children and adults at low risk for tooth decay and gum disease need X-rays less frequently.”

Ideally, your dentist should adhere to the guidelines established by the U.S. Food and Drug Administration and the American Dental Association. The following chart, adapted from those guidelines, gives a basic timeline for recommended frequency of X-rays by age group. Keep in mind that multiple factors such as the child’s current oral health, future risk for disease, and developmental stage determine need, and some children will require more X-rays, and some fewer.

Ages

First visit

Routine recall visit

Routine recall visit

Active tooth decay or   history of cavities (Increased Risk)

No active tooth decay   or history of cavities (Low Risk)

Young children(ages 1 – 5),   with no permanent teeth Personalized exam which may consist of bitewing X-rays of back teeth (if no gaps exist between teeth that allow the dentist to examine the sides of teeth) and select individual X-rays, usually of front teeth. Bitewing X-rays every six to 12 months Bitewing X-rays every 12 to 24 months
Older children (ages 6 – 12), with some or all permanent teeth Personalized exam consisting of bitewing X-rays of back teeth and select individual X-rays, usually of front teeth; or a panoramic X-ray. Bitewing X-rays every six to 18 months Bitewing X-rays every 12 to 36 months
Adolescent, with permanent teeth but no wisdom teeth Personalized exam consisting of   bitewing X-rays of back teeth and select individual X-rays; or a panoramic X-ray; or a full mouth survey of X-rays if evidence of widespread oral disease. Bitewing X-rays every six to 18 months Bitewing X-rays every 12 to 36 months

Many people believe that if their dental plan pays for a certain number of X-rays, they should take advantage of that benefit. For most patients, however, this yearly X-ray exposure is excessive and unnecessary. Don’t let your insurance coverage dictate your decision. If you have questions or concerns related to dental X-rays, discuss them with your dentist.

 

Source: http://www.fda.gov/downloads/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/ MedicalImaging/MedicalX-Rays/UCM329746.pdf  (Accessed February 11, 2014).

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

Sealants Graphic

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. Delta Dental is here to help. Our myDentalScore risk assessment tool helps you better assess your child’s risk for oral disease by providing an easy to understand oral health scores report that you can use to consult with your dentist to determine the best treatment patterns for your child’s oral health needs. We also encourage you to take a look at your dental plan and make sure you are using preventive treatments to their full advantage – most are simple, painless and inexpensive. They can save your child from future pain and discomfort that often accompany cavities, and save you from paying for expensive fillings, crowns, or root canals.

To learn more about keeping all of the mouths in your life healthy, and to access the myDentalScore risk assessment tool, visit Delta Dental’s Oral Health Library at oralhealth.deltadental.com.

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.

Although 2.5 million of the children Delta Dental covers are considered to be at higher-risk for cavities, 70 percent of them did not receive the recommended two or more fluoride treatments per year.1 The great news is that many of Delta Dental’s benefits plans cover preventive care, like two fluoride treatments per year, at 100 percent.

Take a look at your plan and make sure you are using preventive treatments to their full advantage – most are simple, painless and inexpensive. They can save your child from future pain and discomfort that often accompany tooth decay, and save you from paying for expensive fillings, crowns, or root canals. Delta Dental knows that you are doing your best to keep your family healthy, and that’s why we want to help you assess your child’s risk for oral disease and give you the information you need to help take steps to prevent or treat them. Delta

Dental’s myDentalScore risk assessment tool provides you with leading edge technology to evaluate your family’s oral health. By taking just three minutes to answer a few simple questions, you will receive an easy to understand oral health scores report that tells you exactly where your child stands for risk of oral diseases. Once you have the report, consult with your dentist to determine the best treatment patterns for your child’s oral health needs.

For answers to all of your oral health questions and to access the myDentalScore risk assessment tool, visit Delta Dental’s oral health education website at oralhealth.deltadental.com.1

1The Preventive Dental Care Study is a landmark claims study of Delta Dental’s more than 90 million dental claims that investigated whether higher-risk children and adults were receiving the preventive care they needed. For more information on the study, visit deltadental.com/pdcstudy.

The Best and Worst Halloween Treats for Teeth

Little ghosts and goblins will trick-or-treat to collect as much candy as they can this Halloween, but it’s not just kids who will enjoy the treats. Nearly 80 percent of parents admit they eat their children’s Halloween candy, according to the Delta Dental Children’s Oral Health Survey.1 But some candies have the potential to do more damage to teeth than others.

The best way to protect teeth from decay is to have candy in small portions at limited times, such as after a meal, as dessert or at regular snack times. Nearly 90 percent of parents say their kids consume Halloween candy this way.Choose candy that melts and disappears quickly. The longer teeth are exposed to sugar, the longer bacteria can feed on it, which could produce cavity-causing acid.

While no sweets are good for teeth, some are less harmful than others. We rated the best and worst treats for teeth on a scale of 1 to 5, with 1 being least harmful.

  1. Sugar-free candy and gum with xylitol                                                                   Sugar-free foods don’t contain sugar that can feed on the bacteria in the mouth and produce decay-causing acids. Gum and candy with xylitol may actually protect teeth by reducing the acids produced by bacteria and increasing saliva to rinse away excess sugars and acids.
  • Our survey says 44 percent of kids eat sugar-free candy at Halloween.1
  1. Powdery candy (such as sugar straws)                                                                     Sure, powdery candy is packed with pure sugar. But powdery candy dissolves quickly and doesn’t stick to the teeth.
  1. Chocolate (such as candy bars)                                                                             Chocolate dissolves quickly in the mouth and can be eaten easily, which decreases the amount of time sugar stays in contact with teeth. And calcium could help protect tooth enamel. However, chocolate with fillings, such as caramel and nuts, is a lot more harmful for teeth than the plain variety.
  • Our survey says 86 percent of kids eat chocolate at Halloween. 1
  1. Hard candy (such as lollipops or mints)                                                                     Hard candy is tough on teeth because it tends to be sucked on at a leisurely pace for an extended period of time. Plus, chomping down on hard candy can chip or break teeth.
  • Our survey says 50 percent of kids eat hard candy at Halloween. 1
  1. Chewy candy (such as caramels or gummies)                                                         Chewy, sticky treats are particularly damaging because they are high in sugar, spend a prolonged amount of time stuck to teeth and are more difficult for saliva to break down.
  • Our survey says 57 percent of kids eat chewy candy at Halloween. 1

Another way to protect teeth is to give kids something other than candy.  Nearly 25 percent of parents hand out non-candy items to trick-or-treaters, such as toys, money or fruit.1

For additional tips on how to help keep children’s teeth healthy during Halloween and all year long, visit the Tooth Fairy’s Halloween website at www.toothfairytrickytreats.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.

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

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.

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.

Don’t Bottle Up the Oral Health Benefits of Fluoridated Water

Nearly 60 percent  of caregivers say they are more likely to give children bottled water than tap water, potentially depriving kids of fluoride that is critical to good oral health. In addition, according to the 2013 Delta Dental Children’s Oral Health Survey,1 more than twice as many caregivers say bottled water is better for children’s oral health than tap water – an opinion at odds with evidence-based dentistry and more than six decades of public health experience.

Fluoride actually helps to repair (remineralize) tooth surfaces that are damaged by the acid produced by certain bacteria in the mouth, which prevents cavities from continuing to form.2 Since U.S. cities began adding fluoride to water supplies more than 65 years ago, tooth decay has decreased dramatically.3 This result led the Centers for Disease Control and Prevention (CDC) to name water fluoridation “one of the 10 great public health achievements of the 20th century.”4

Unfortunately, only 17 percent of parents believe that tap water is better for their children’s oral health than bottled water.1 Some bottled waters do contain fluoride but usually not in the optimal amount.5  Fluoride in the water provides decay-preventive benefits for the teeth of both children and adults, which makes it the most cost-effective way for communities to improve overall oral health.

The key to fluoride’s protective benefit is by having a little fluoride on your teeth throughout the day. Brushing teeth with a fluoride toothpaste at least twice a day, drinking fluoridated water and limiting frequent between-meal snacking on sugary or starchy foods will help keep most children and adults tooth decay-free.

If children don’t drink fluoridated water, Delta Dental offers these ways to get more fluoride into their diet:

  • Fluoridated toothpastes, mouth rinses and/or professionally-applied gels or varnishes. These products can help strengthen teeth by hardening the outer enamel surface. With toothpaste and rinses children tend to swallow much of what they put in their mouth. So fluoride toothpaste use should start about age 2 and fluoride rinses probably not until about ages 6 or 7.
  • Dietary fluoride supplements, such as tablets, drops or lozenges, which are typically available only by prescription and are intended for children typically older than 6 months living in areas without fluoridated water in their community.
  • Bottled water that states on the label that it contains the right amount of fluoride.

As with other vitamins and minerals, it’s important to get enough, but not too much. When young children whose teeth are still developing under their gums (up to about age 9) get too much fluoride, their teeth may erupt with faint white lines or patches called dental fluorosis. The CDC has reported an increase in dental fluorosis over the past couple of decades. Inappropriate swallowing of toothpaste and children living in fluoridated areas that also receive fluoride supplements are believed to play a major role in this increase.

For advice on the proper amount of fluoride specifically recommended for your child, consult with your dentist. The recommendation will depend on your child’s age, how much fluoride naturally occurs in your local water and your child’s risk for tooth decay.