Sealing a Smile Packs a Preventive Punch

Why is 80 percent of tooth decay found in only 25 percent of children, disproportionately kids from low-income families?1 The answer is multifold and complex, but Delta Dental believes that school-based dental sealant programs are a large part of a workable solution.

Dental sealants are a critical but underutilized component of preventive dentistry. The one-two punch of sealants and fluoride (in toothpaste and water) along with a proper diet can almost totally prevent new tooth decay.

National surveys by the Centers for Disease Control and Prevention (CDC) indicate that only 38 percent of children and teenagers ages 12 to 19 have dental sealants. This number is much lower among children from low-income families and certain races/ethnicities with higher tooth decay rates who would benefit most from sealants.1

Dental sealants can save families time, money and the discomfort of dental fillings. Sealants are thin, plastic coatings applied to the pits and grooves of teeth to protect them from the bacteria and foods that lead to tooth decay. First and second permanent molars are the most likely to benefit from sealants, so it’s best if the sealant is applied soon after those teeth appear, before they have a chance to decay (usually ages 6 and 12).

A sealant is virtually 100 percent effective if fully retained on the tooth, and studies have shown they remain intact 92 to 96 percent of the time after one year and 67 to 82 percent after five years. Sealants should be checked at each regular dental appointment and can be reapplied if they are no longer in place. 2

Sealants delivered through school-based programs have been shown to decrease tooth decay by 60 to 65 percent.3 Using school-based sealant programs at lower-income schools has proven to be highly effective in improving the oral health of those schoolchildren. Studies of children in either Medicaid programs or with private dental insurance show that placement of sealants on first and second permanent molars reduced the need for future cavity fillings.

1 Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. MD: National Center for Health Statistics. Vital Health Stat. 2007 Apr. 11 (248):1-91. Available from: http://www.cdc.gov/nchs/data/series/sr_11/sr11_248.pdf

2 Griffin SO, Kolavic-Gray S, et al. Caries Risk in Formerly Sealed Teeth. Journal of the American Dental Association April 2009 vol. 140 no. 4 415-423.

3 Truman BI, Gooch BF, Sulemana I, et al. Reviews of evidence on Interventions to prevent dental caries, oral and pharyngeal cancers and sports-related craniofacial injuries. Am J Prev Med 2002; 23(1 suppl):21-54. http://www.thecommunityguide.org/oral/oral-ajpm-ev-rev.pdf. Accessed March 14, 2012.

Help Your Teeth Age Gracefully with You

Advances in medical technology, public health, personal health knowledge and greater access to health insurance are some of the key factors helping people in the U.S. today live longer and in better health than previous generations. The most recent data indicate that life expectancy from birth is at an all-time high of nearly 78 years, with women at 80.5 and men at 75.5 years.1

Improvements in oral health are also significant, and adults 65 and older are keeping more of their natural teeth for their entire lives than previous generations. During National Healthy Aging Month, Delta Dental is advising older adults that practicing good oral health habits is more important than ever.

The popular idiom “long in the tooth” references how gums wear away in the aging process, leaving the root of the tooth exposed. The tooth root is much softer and more prone to dental decay than the enamel that covers the tooth crown. Dental disease is cumulative over a lifetime, so almost all adults ages 65 and older have had dental caries in their permanent teeth.2 Older adults who take any one of several hundred medications that can cause a decrease in saliva should be especially careful because a lack of saliva brings a much higher risk for tooth decay.

Smart dental hygiene is important even for those seniors who have lost their regular teeth. Besides helping ensure dentures and other prosthetic replacements fit properly, dentists can catch life-threatening diseases like oral cancer early when they are at a more treatable stage.

Studies show that individuals with dental insurance are far less likely to have unmet dental needs than those with insurance, and are also more likely to get regular dental exams.3 However, once individuals retire they often neglect to purchase ongoing dental coverage. Medicare does not provide dental coverage but individual plans are available for purchase. Seniors can also check to see if membership in any national organizations or associations qualifies them to purchase dental benefits.

1 The 2012 Statistical Abstract.. The National Data Book. Data Source: U.S. National Center for Health Statistics, National Vital Statistics Reports (NVSR), Deaths: Preliminary Data for 2008, Vol. 59, No. 2, December 2010. Accessed August 27, 2012 at:http://www.census.gov/compendia/statab/2012/tables/12s0104.pdf

2 “Dental Caries (Tooth Decay) in Seniors (Age 65 and Over).” National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesSeniors65older. Accessed August, 2012.

3 Bloom B, Simile CM, Adams PF, Cohen RA. Oral health status and access to oral health care for U.S. adults aged 18–64: National Health Interview Survey, 2008. National Center for Health Statistics. Vital Health Stat 10(253). 2012.

Before Your Due Date, Schedule a Date With a Dentist’s Office

Most pregnant women recognize how important their own overall health is for their baby’s health, but may ignore a critical component – their oral health. In fact, a survey of American children’s oral health conducted on behalf of Delta Dental found that nearly 4 out of 10 American mothers neglect to visit a dentist during pregnancy, which is significant to helping prevent harmful oral and overall health problems for themselves and their babies. Dentists can identify and treat teeth and gum problems, lowering the risk for more serious, ongoing health problems for both a mother and her baby.

While having a healthy mouth is always important, pregnancy can intensify dental problems. Hormonal changes during pregnancy can exaggerate the way gum tissue reacts to plaque, increasing the risk for gingivitis, the first stage of periodontal (gum) disease. Some studies have suggested that pregnant women with moderate-to-severe gum disease may be more at risk to give birth to low-weight or pre-term babies, who are at risk for many serious diseases.

Dental hygiene habits are controllable, but some pregnancy side effects may wreak havoc on a woman’s oral health. For instance, nausea and vomiting affect 80 percent of all pregnant women.2 The stomach acid from vomiting can erode tooth enamel – making teeth sensitive and more vulnerable to decay. A woman may also feel less willing to follow her usual pattern of regular brushing and flossing.

Most moms-to-be also experience cravings. The additional snacking can lead to increased tooth decay. Giving into cravings for sugary foods can be worse for expectant mothers’ teeth, since sugar is a major cause of tooth decay.

Along with visiting the dentist, Delta Dental offers the following tips to help prevent oral health complications during pregnancy:

• Brush your teeth twice daily with fluoride toothpaste and floss once daily.
• Limit foods containing sugar to mealtime only. If you do indulge one of those cravings, drink a glass of water while snacking and brush your teeth once you’re done.
• Choose water or low-fat milk to drink and avoid carbonated beverages.
• Opt for fruit rather than fruit juice to meet the recommended daily fruit intake.
• If you suffer from “morning sickness,” rinse your mouth out with water and baking soda solution afterward. The combination will neutralize the acid. Also brush your teeth gently and if you chew gum, use the kind with xylitol as the main sweetener.

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.

2 American Academy of Family Physicians, Nausea and Vomiting of Pregnancy, 2003.

Delta Dental Encourages Major League Baseball to Quit the Spit (Tobacco)

While smokeless tobacco has not been completely banished from baseball, Delta Dental applauds Major League Baseball (MLB) and the Major League Baseball Players Association (MLBPA) during Oral, Head and Neck Cancer Awareness Week for making a positive step toward completely eliminating tobacco’s visibility from impressionable young fans. Under a recent agreement, MLB players, managers and coaches will no longer be able to carry a smokeless tobacco tin or package in their uniforms during games or when fans are in stadiums. Additionally, they will be prohibited from “chewing” during televised interviews, at autograph signings and other fan events.

Smokeless tobacco has been banned from Minor League Baseball since 1993 and from collegiate athletics since 1994. The surge of support for an outright ban on smokeless tobacco has a website, and players like Boston Red Sox outfielder Adrian Gonzalez and Chicago White Sox pitcher John Danks have recorded public service announcements speaking out against smokeless tobacco. Joe Garagiola, an 84-year-old former tobacco chewing-MLB catcher and current broadcaster, is the chairman of NSTEP, the National Spit Tobacco Education Program. NSTEP is a 17-year-old program operated by Oral Health America that educates baseball players of all ages about the dangers of chewing or “spit” tobacco.

The American Cancer Society estimated that more than 39,000 people were diagnosed with oral cancer and nearly 8,000 people died of the disease in 2011, and that men are twice as likely as women to be diagnosed.Tobacco use is considered a major risk factor for the development of oral cancers. Whether they like it or not, athletes serve as role models for impressionable children and teens. The Centers for Disease Control and Prevention (CDC)’s 2009 Behavioral Risk Factor Surveillance Study found that more than 11 percent of male high school students and four percent of male middle school students were current smokeless tobacco users.2 Though smokeless tobacco has been banned in all venues by the NCAA and MILB, a significant number of young players get hooked on the habit earlier in life.

Delta Dental puts its support and resources behind this message. Delta Dental of Tennessee, for instance, leveraged their sponsorship with the Memphis Redbirds (Triple-A affiliate of the St. Louis Cardinals) to present Oral Cancer Awareness Night at AutoZone Park. The event included oral cancer screenings performed by teachers from the University of Tennessee Health Science Center’s College of Dentistry.

Delta Dental wants the professional baseball community to be aware of the inherent risks and dangers of smokeless tobacco use, and the influence that the actions of professional baseball players have on their youthful fans. We ask that – for their own health and that of their young fans – players pause next time before throwing in a dip. We applaud the progress that MLB has made in limiting tobacco use in the sport but would support a complete ban on smokeless tobacco during games when so many young fans are watching attentively.

Below is a video in which Dr. Kohn explores the relationship between smokeless tobacco use and oral cancer.

1 American Cancer Society. Oral Cancer Fact Sheet. Accessed February 2012. http://www.cancer.org/acs/groups/content/@nho/documents/document/oralcancerpdf.pdf

2 Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2000–2009. Morbidity and Mortality Weekly Report 2010;59(33):1063–8

You Booze, You Lose: Excessive Drinking Harms Oral Health

People most often associate the health risks of excessive alcohol drinking with damage to the liver or stomach lining. But during Alcohol Awareness Month, Delta Dental warns that alcohol abuse can also prove harmful to oral health.

It is estimated that each year in the United States there will be more than 30,000 new cases of oral cancer diagnosed and about one person every hour will die from this disease.1  Heavy alcohol consumption is a risk factor for oral cancer.* According to the American Cancer Society, about 70 percent of oral cancer patients consume alcohol frequently.Tobacco smoking (i.e., cigarette, pipe or cigar smoking), particularly when combined with heavy alcohol consumption, has been identified as the primary risk factor for approximately 75 percent of oral cancers in the U.S. Using tobacco with alcohol poses a much greater risk than ingesting either substance alone. According to the National Institute on Alcohol Abuse and Alcoholism, there are approximately 17.6 million adults who are alcoholics or have alcohol problems.3 

People with alcohol problems also tend to neglect other healthy habits like eating properly or taking care of daily hygiene. A small 2003 study conducted at an alcohol rehabilitation center found that residents had a higher incidence of periodontal (gum) disease and cavities.4

Drinking, like most other things, is best done in moderation for both your oral and overall health and well-being. Some epidemiological studies suggest a heart protective association for low-to-moderate average alcohol consumption.5  Indeed, sipping alcoholic beverages like red wine (which contain heart-healthy antioxidants like resveratrol) may be beneficial for lowering LDL cholesterol and helping prevent clogging of arteries.6

*According to the Centers for Disease Control and Prevention (CDC), heavy drinking for men is typically defined as consuming an average of more than two drinks per day. For women, heavy drinking is typically defined as consuming an average of more than one drink per day.

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1 National Institutes of Health. NIH Fact Sheets. Oral Cancer – updated February 14, 2011. Accessed March 30, 2012. 

Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988;48:3282-7.

3 Medline Plus – Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html. Accessed March 30, 2012.

4 Araujo MW, Dermen K, Connors G, Ciancio S. Oral and dental health among inpatients in treatment for alcohol use disorders: a pilot study. J Int Acad Periodontol. 2004 Oct;6(4):125-30.

5 Di Minno MN, Franchini M, Russolillo A, Lupoli R, Iervolino S, Di Minno G. Alcohol dosing and the heart: updating clinical evidence. Semin Thromb Hemost. 2011 Nov;37(8):875-84. Epub 2011 Dec 23.

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

Take it to Heart: Oral Health is Important

Heart disease has been the leading cause of death in the U.S. since 1921, according to the Centers for Disease Control and Prevention (CDC), which estimated that nearly 1.24 million people – or 141 every hour  and 2.35 every minute – suffered a new or recurrent heart attack in 2010.1 Valentine’s Day – a holiday commonly associated with the heart – seems like the perfect time to point out the connection between oral health and heart health.

Researchers continue to find associations between periodontal (gum) disease and other chronic health conditions including heart disease. Persons with periodontal disease and heart disease share common risk factors such as smoking, older age, low-income status and obesity. Ongoing studies are attempting to determine questions such as if you treat the gum disease will you lower the likelihood of developing or worsening heart disease?

A mix of conditions, behaviors and genetics including high cholesterol and blood pressure, diabetes, smoking and a combination of poor diet and insufficient exercise leading to obesity have helped keep coronary ailments king. Genetics likely has some role in high blood pressure, high cholesterol and other heart disease factors. Odds are that an individual you know and love has dealt with some kind of heart ailment in their lifetime.

Studies show that people with periodontal (gum) disease may be at a higher risk for coronary artery disease (CAD), the most common type of heart disease, than those without it. Researchers are now trying to determine if bacteria and inflammation in the gum tissues as a result of periodontal disease contribute to the clogging of arteries and lead to CAD. 2 

So, for your heart’s sake practice sound dental hygiene habits like brushing and flossing teeth twice daily and eating healthfully. In particular, don’t smoke cigarettes or use other tobacco products. Finally, make time for regular dental check-ups. It is an oft-neglected, but vital aspect of maintaining good oral health. Like most diseases, periodontal disease is much easier to treat and control if discovered early.

Your dentist and hygienist play a major role in detecting and treating any gum problems. Based on what they see in your mouth, they may also suggest you see your physician to evaluate you for other important health problems including cardiovascular disease and diabetes.

1Centers for Disease Control and Prevention. Roger V, Go, A, Lloyd-Jones, D, et al. Heart disease and stroke statistics—2011 update. a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation 2011;123:e1-e192.

2“Gum Disease Links to Heart Disease and Stroke.”American Academy of Periodontology, May 8, 2008. www.perio.org/consumer/mbc.heart.htm Accessed 2010.

Resolve to Kick Butts in 2012

Of the nearly 8,000 deaths in the United States attributed to oral and pharyngeal cancer annually,1 about 75 percent are due to tobacco and heavy alcohol use.2   Resolving to quit smoking may be one of the most difficult challenges to undertake in 2012, but it also comes with some of the best life- and mouth-saving benefits.

A lifestyle factor that the Surgeon General calls “the single greatest avoidable cause of death,”3 smoking also drastically affects periodontal (gum) health.4-5 According to the Centers for Disease Control and Prevention (CDC), half of the cases of severe gum disease in U.S adults can be attributed to cigarette smoking and the prevalence of gum disease is three times higher among smokers than nonsmokers.6

Smoking is the leading cause of oral and pharyngeal cancer and using tobacco in any form – including dipping snuff 7 or chewing – increases the risk of developing an oral cancer.8 Even if you’ve smoked for decades, you can reap nearly immediate benefits by quitting.9-11 Within 20 minutes, your heart rate drops, and within 12 hours, the carbon monoxide level in your blood returns to normal. Within one year, your added risk for coronary heart disease will fall to half that of a smoker’s, and within 15 years, your risk is that of a nonsmoker’s.10 Quitting reduces many of the cosmetic effects of smoking and can even improve sensitivity to smell and taste.

There are many reasons why smoking is a health risk, but here are the top five ways that kicking butts can immediately improve your oral health:

  1. It significantly reduces your risk of developing oral and pharyngeal cancer
  2. It reduces your risk of developing periodontal disease
  3. It improves the color of your teeth
  4. It can help eliminate halitosis (bad breath)
  5. It can help reduce dental decay12

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1 National Cancer Institute, National Institutes of Health – Oral Cancer http://www.cancer.gov/cancertopics/types/oral

2 Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Research 1988; 48(11):3282–3287

3 U.S. Dept. of Health and Human Services. The health conse­quences of smoking: A report of the Surgeon General. U.S. Dept. of Health and Human Services, CDC, National Center of Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004. Available at: “http://www.surgeongeneral.gov/library/smokingconsequences/”. Accessed June 29, 2010.

4 Tomar SL, Asma S. Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. . J Periodontol. 2000 May;71(5):743-51

5 “Longitudinal Study of the Association Between Smoking as a Periodontitis Risk and Salivary Biomarkers Related to Periodontitis.” M. Kibayashi. Journal of Periodontology. 2007, vol. 78, no. 5, pages 859–867.

6 Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancer – 2011 At A Glance. http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm. Accessed 2012.

7 Oral Cancer.” National Institutes of Health. July 2007. http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=106&key=O#O

8 “Oral Health Topics A-Z: Smoking (Tobacco) Cessation.” American Dental Association. http://www.ada.org/public/topics/smoking_tobacco_faq.asp. Accessed 2009.

9 “Quitting Smoking: Why to Quit and How to Get Help.” National Cancer Institute, August 17, 2007. www.cancer.gov/cancertopics/factsheet/Tobacco/cessation Accessed 2010.

10 “Guide to Quitting Smoking.” American Cancer Society, August 7, 2008. www.cancer.org/docroot/PED/content/PED_10_13X_Guide_for_Quitting_Smoking.asp Accessed 2008.

11 “Women and Smoking: Questions and Answers. ” National Cancer Institute, February 27, 2008. www.cancer.gov/cancertopics/factsheet/Tobacco/women Accessed 2010.

12  Rooban T, Vidya K, Joshua E, et.al. Tooth decay in alcohol and tobacco abusers. J Oral Maxillofac Pathol. 2011 Jan;15(1):14-21.