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.

Sip Sparingly for Your Oral Health

Binge drinking may be frequently celebrated in pop culture and joked about on social media, but during Alcohol Awareness Month, Delta Dental warns consumers that alcohol abuse can be extremely harmful to oral health.

April is also Oral Cancer Awareness Month, and heavy alcohol consumption is one of the major risk factors for oral cancer. It is estimated that in 2013 there will be more than 36,000 new cases of oral and oropharyngeal cancer diagnosed in the United States, and about 17 people will die from this disease every day.1 In addition, certain popular adult beverages – such as Long Island Ice Teas, piña coladas and energy drink-and-vodka concoctions – contain large amounts of sugar, which causes tooth decay, while others (like red wine) can stain teeth. The Centers for Disease Control and Prevention (CDC) has found that other short-term risks of binge drinking include car crashes, violence (including child abuse), risk of HIV and other sexually transmitted diseases, and unintended pregnancy. Long-term risks include liver disease, cancer, stroke, heart disease, and other chronic diseases.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), binge drinking means drinking to the point that one’s blood alcohol concentration (BAC) levels reach 0.08g/dL.2 For women, this usually occurs after about four drinks in two hours, and for men, after about five. By the CDC’s definition (four or more adult beverages in one sitting), more than one in eight women binge drink and twice as many men binge drink as women do.3

Not surprisingly, the age group with the most binge drinkers is 18-34 adults. However, this cultural problem extends beyond college kids and twentysomethings. According to the CDC, nearly a quarter of all adults in the U.S. (more than 38 million) binge drink about four times per month. Drinking to excess causes 80,000 deaths in the U.S. annually.3

Drinking, like most other things, is best done in moderation for both your oral and overall health. For example, drinking the occasional glass of red wine (which contain heart-healthy antioxidants like resveratrol) may be beneficial for lowering LDL cholesterol and helping prevent clogging of arteries.4

1 American Cancer Society. Oral Cavity and Oropharngeal Cancer.  Accessed March 2013. http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/oral-cavity-and-oropharyngeal-cancer-key-statistics

2 National Institute on Alcohol Abuse and Alcoholism (NIH). Moderate & Binge Drinking. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking. Accessed March 2013.

3 Centers for Disease Control and Prevention. Binge Drinking. http://www.cdc.gov/vitalsigns/bingedrinking/. Accessed March 2013.

4 Wu JM, Hsieh TC.  Resveratrol: a cardioprotective substance. Ann N Y Acad Sci. 2011 Jan;1215:16-21. 

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.

How Does Your Smile Score?

In the past, almost everyone developed tooth decay, and as people aged, tooth loss from decay and gum disease was routine. Today, thanks to scientific advances and preventive therapies like community water fluoridation, fluoride toothpaste and dental sealants, there has been dramatic and continuing improvement in the oral health of Americans. Many people still suffer from oral disease problems, however, and risk for oral disease varies among all people.

The good news is that if you know your specific risk factors for tooth decay, gum disease and oral cancer, you can take simple preventive action to avoid these problems. That’s why Delta Dental, the nation’s largest dental benefits company, is helping people assess their risk for diseases and take steps to prevent or treat them.

Through a partnership with a leading risk and disease analytic software designer, PreViser Corp., Delta Dental has launched myDentalScore, a risk assessment tool that provides leading edge technology to evaluate your oral health. By taking just a few minutes to answer some simple questions online, you will receive an easy to understand oral health scores report that estimates your risk of tooth decay, gum disease and oral cancer. Once you have your score in hand, you can use myDentalScore to get valuable oral health advice and print out your report to bring to your next dental examination.

myDentalScore

Click on the above photo to visit mydentalscore.com/deltadental and access our quick, user-friendly survey. The survey asks a series of questions about your personal habits, past history of dental disease and treatment, and current symptoms of oral disease to assess your risk level for tooth decay, gum disease and oral cancer. After taking the risk assessment survey, you’ll receive a risk score for each problem area. You can bring this report to your dentist to verify your risk levels and, if needed, develop strategies to lower your risk for oral disease and improve your oral health. No personal health information (PHI) is ever revealed, and the survey can be taken anonymously. You can also visit oralhealth.deltadental.com for more oral health information. Find out your smile scores today, and take steps to protect it for a lifetime!

Traits of Toothpaste

Toothpaste – it has been the foundation of the most basic of daily oral health routines dating back to ancient civilizations. But, how many people today actually know what makes up the concoction that we dab on our toothbrushes and scrub all over our teeth every morning and night? You’ll be happy to know that we’ve come a long way since the use of crushed bones and oyster shells, ashes, burnt eggshells and powder of ox hoof.

Toothpastes, also called dentifrices, are pastes, gels or powders that help remove plaque and strengthen tooth enamel. So, what are all of those substances listed on the side of the tube? The paste or gel itself takes its form from abrasives, water, humectants and binders. Other ingredients like detergents or surfactants; preservatives; flavor, color, and sweetening agents; fluoride; calcium phosphate; anti-bacterials; whiteners; and other agents may be added to provide certain properties to each specific toothpaste forumulation. All of these ingredients can be important for not only helping to prevent dental disease but also for giving the toothpaste the taste, appearance and feel in the mouth that makes a person want to brush with it.

Let’s take a closer look at some of the most common ingredients you will find in your toothpaste and why they are there.

Fluoride is the key active ingredient in toothpaste that has been demonstrated in numerous clinical trials to prevent tooth decay. Fluoride affects the bacteria that cause tooth decay, but its primary action is to incorporate into the tooth structure (enamel and dentin) making the tooth more resistant to acid attack by decay-causing bacteria. It actually repairs (remineralizes) the tooth enamel that gets damaged by the acid producing bacteria present in almost everyone’s mouth. Without fluoride in the toothpaste, the cavity-preventing benefit from brushing your teeth is severely limited. Very few people brush thoroughly enough to prevent cavities by brushing alone. Over-the-counter (OTC) toothpaste in the U.S. contains fluoride at approximately 1,100 parts-per-million (ppm). There are several different fluoride formulations and all are effective in helping to prevent tooth decay. Other remineralizing agents such as amorphous calcium phosphate have demonstrated some decay prevention ability and are now being added to some toothpastes.

Mild abrasives remove food debris and stains, as well as the sticky plaque that is always forming on the teeth. The goal is to make them abrasive enough for efficient cleaning, but not so abrasive as to damage the tooth enamel or the softer dentin or cementum that makes up the tooth root surface. Common abrasives you may see on your tube include calcium carbonate, sodium bicarbonate (baking soda), dehydrated silica gels, hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates.1

Humectants are organic compounds that hold water and help the toothpaste maintain its moisture even when exposed to air. Examples include glycerol, propylene, glycol and sorbitol.1

Binders or thickeners help keep the whole mix together in a nice paste or gel and stabilize this form. They provide the texture and flow to get the toothpaste onto the brush and keep it there. These include natural xanthum gums, seaweed colloids (carrageenan) and synthetic cellulose.1

Flavor, color and sweetening agents make brushing enjoyable by providing visual appeal, pleasing taste and fresher breath. Specific ingredients vary, but common flavorings include spearmint and peppermint, though nowadays there seems to be toothpaste available in flavors for every taste including strawberry, bubblegum, vanilla, green tea, fennel and bacon – even scotch and bourbon. For a sweet taste, artificial sweeteners like saccharin or natural sweeteners like xylitol are added since they do not promote tooth decay.

Antibacterial agents are added to reduce plaque growth, the sticky bacterial-laden film that forms constantly on the teeth and can eventually cause tooth decay and/or gingivitis and more serious gum diseases if not brushed away regularly. Some anti-plaque agents include triclosan and cetylpyridinum chloride.

Detergents in toothpaste create foaming action that helps the toothpaste coat the teeth. The foam helps reduce surface tension on the tooth, and makes cleaning easier and food particles or debris less likely to reattach to the tooth before it can be spit out. They include sodium lauryl (dodecyl) sulfate (SLS) and sodium N-Lauryl sarcosinate. 1 Some toothpaste users have been reported to develop canker sores as a result of an allergic reaction to SLS, but SLS-free toothpastes are available.

Preservatives prevent the growth of microbes in the toothpaste. Methyl paraben and sodium benzoate are also commonly found in food and beverage products.

Whiteners, desensitizers and tartar preventers Other agents appear in toothpastes that make specific claims for whitening (carbamide peroxide or hydrogen peroxide); desensitizing sensitive root surfaces (potassium nitrate, arginine bicarbonate/calcium carbonate complex); and preventing tartar/calculus buildup (tetrapotassium pyrophosphate/tetra and disodium pyrophosphates, sodium hexametaphosphate). Even though some whitening toothpastes contain similar chemicals to those used in dental office bleaching, these toothpaste products work primarily by removing surface stains and don’t typically change the basic tooth shade like bleaching strips or bleaching treatments at a dental office.

For best tooth decay prevention, we recommend brushing with fluoride toothpaste at least twice a day. So, when is the best time to become one with your favorite toothpaste? Preferably right before bed and in the morning, but soon after meals is also very effective.

1 American Dental Association. Toothpaste. http://www.ada.org/1322.aspx Accessed January 2013.

Wearing the Wires: Kids and Braces

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Once upon a time, kids who wore braces were teased by their peers with mean-spirited nicknames such as brace face, tinsel teeth, zipper lips and metal mouth. These days, however, braces have become seemingly as ubiquitous as eyeglasses, almost a rite of passage for American youth in their formative years. Studies have estimated anywhere from 50-70 percent of American children will wear braces between the ages of 6-18.

Children from ages 6-18 (and even some adults) typically get braces to correct malocclusions (i.e., bad bites). These jaw or tooth alignment problems are usually genetic, but can result from an injury, early or late tooth loss or thumb-sucking.1 Historically, most children started wearing braces in their early- and into mid-adolescent years, after all of their permanent teeth had erupted (ages 11-15), but in more recent years there has been a trend towards earlier intervention to take advantage of high rates of growth and to correct certain conditions that might otherwise adversely affect growth and development. Crowded, poorly-positioned teeth not only affect a child’s appearance, but can negatively impact the way a child bites, chews and speaks, and can increase the long-term potential for developing periodontal disease or temporomandibular joint (TMJ) problems.1

Whether or not they have braces, kids should always eat a healthy diet. In general, however, kids with braces should avoid foods that are difficult to bite off or chew, that may damage the braces, or that are difficult to clean from around the wires and attachment brackets. Foods like popcorn, corn on the cob, whole apples, sunflower seeds and sticky candy fall into these categories. It is also not a good idea to chew on ice, pencils or any other oral habits that can bend the wires or otherwise damage the appliances that go into moving teeth into proper position.2 Eating too many sticky and sugary foods is particularly damaging to children with braces, since plaque tends to build-up around the appliances and can lead to decay where the brackets are attached to the teeth.

Standard oral health care best practices apply to all children – with or without braces. This includes brushing with fluoride toothpaste and flossing daily, wearing a properly fitting mouthguard during contact sports, and making regular dental visits. Obviously brushing and flossing presents some challenges while wearing braces but the child’s dental team will usually provide the proper guidance on facing the challenges to good oral hygiene that wearing braces can present. This may include things like using fluoride rinses, floss threaders, interproximal cleaners, powered brushes or irrigators, dental wax and other tips for keeping the braces and teeth clean and wearing them comfortably.

A child’s teeth are often sore for a day or two after the braces are first put on or after an adjustment appointment. In addition, other typical problems that children may have to deal with include food caught between the teeth and appliance, one or more of the little rubber bands break that hold the wires to the bracket, a wire breaks and pokes into the cheek, a sore develops on the cheek or gum where something is rubbing.

1.American Dental Association. “Braces” http://www.mouthhealthy.org/az-topics/b/braces.aspx
2.American Dental Association 2010 Survey of Dental Practice
3.American Association of Orthodontists. http://www.mylifemysmile.org/faq