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).

Delta Dental Offers Alternative Approach to Resolutions

Failure to keep New Year’s resolutions is so commonplace these days that it has become an easy punch line for many derisive jokes. Studies have found only eight percent of people actually keep their resolutions annually. Conversely, one out of four people have never successfully kept a New Year’s resolution.

Maybe the problem is how you think of these resolutions, and simply changing your mindset might help. In 2014, take a cue from the 2007 movie The Bucket List, and put together a list of things that you must do before the year ends.

We at Delta Dental suggest you consider including some oral health-related items in your bucket list. Dr. Bill Kohn, DDS, DDPA’s vice president of dental science and policy, has a few time-honored suggestions:

  • Brush/floss regularly: Commit to brushing your teeth twice a day for two minutes at a time. Simple tools like egg timers or mobile apps can help you keep track of the time. If you never, ever floss, pledge to do so more frequently (starting with once a week and increasing to once a day).
  • Easy on the sweets: Limit your consumption of sugary snacks because the more times teeth are exposed to sugar, the longer acids have time to attack tooth enamel – and expedite tooth decay!
  • Kick butts: Cigarette smoking is the primary cause of severe gum disease in the U.S., so do yourself a favor and quit using tobacco products. Your teeth, gums and lungs will thank you.

Fill your bucket list with things that will make you happy and healthy, provide some adventure, and encourage personal growth. The length of your list doesn’t matter, but you should write it down and refer to it regularly throughout the year. Keep it simple and try to do at least one thing on your list each month.

An appointment with your dentist should be at the top of any healthy checklist. Like most things that we value and want to keep working properly, a regular dental check-up and some preventive maintenance goes a long way towards maintaining long-term, disease-free oral health.

Delta Dental sends you our best wishes for a happy, healthy and prosperous 2014!

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

The old adage “too much of a good thing” is never more true than during the holiday season. There tends to be an overabundance of everything – especially sweet treats. While it’s impractical to suggest complete avoidance of holiday goodies, Delta Dental encourages moderation to make sure you receive the gift of great oral health!

Here are five common treats to limit during the holidays:

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

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

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

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

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

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

“No one wants to be the Grinch about enjoying all the special experiences of the holidays, particularly the tasty treats that are usually around,” said Dr. Bill Kohn, DDS, Delta Dental Plans Association’s vice president for dental science and policy. “Try to enjoy in moderation, and if you find yourself overindulging, perhaps spend some extra time flossing and brushing at least twice a day with a fluoride toothpaste.”

When you do indulge your holiday sweet tooth, it’s best to enjoy goodies as part of, or immediately following a meal, rather than snacking on treats throughout the day. Another good tip to is to stick to one small serving of your favorite drink or snack and to follow up by swishing around some water, chew sugar-free gum, or brush soon after finishing to wash away some of the sticky sugar residue.

1USDA. Basic Food Report: Eggnog. http://nutritiondata.self.com/facts/dairy-and-egg-products/55/2

2MyFitnessPal. http://www.myfitnesspal.com/food/calories/starbucks-grande-caramel-apple-spice-cider-with-whip-61966862

The Silent Signs of Gum Disease

Diabetes is a pervasive problem in America, a cultural epidemic with wide-ranging and potentially severe consequences. According to the 2011 National Diabetes Factsheet, 25.8 million people or 8.3 percent of the U.S. population has diabetes at an estimated annual total cost of about $245 billion. 1

November is National Diabetes Month and Delta Dental wants to remind people of the well-documented connection between diabetes and oral health. 2 People with diabetes tend to develop periodontal (gum) disease earlier in life, and more severely. Though it is often painless, Delta Dental cautions people suffering from diabetes to be mindful of its warning signs. These can include bad breath, bleeding gums after brushing or flossing, red, swollen or tender gums, or changes in the way your teeth fit when you bite. Unfortunately, many people ignore those periodontal red flags until it’s too late.3

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

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

Even before visiting the dentist, patients can use an online risk assessment tool (such as Delta Dental’s myDentalScore) to answer a series of questions that can gauge their risk levels for gum disease, oral cancer and other serious oral health problems. Additional lifestyle best practices for people with diabetes include controlling blood sugar, brushing and flossing daily, and quitting smoking.

1 Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

2 National Institute of Dental and Craniofacial Research. Diabetes and Oral Health. http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes/default.htm

3American Diabetes Association. 2013  Diabetes Facts.   http://www.diabetes.org/diabetes-basics/diabetes-statistics/

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.