Delta Dental’s Top 5 Oral Health Resolutions for 2013

With a new calendar year on the horizon, many people are engaging in that time-honored American tradition of making resolutions, vowing to improve certain aspects of their lives.

For individuals who aspire to better their oral health in 2013, Delta Dental offers the following suggestions to help make these resolutions work.

• Brush/floss regularly: The uncomplicated daily one-two punch of brushing twice a day with fluoride toothpaste and flossing once is still the foundation for maintaining healthy teeth and gums. The sooner you can brush following a meal, the better. The longer food stays stuck to your teeth, the more acid is produced that erodes tooth enamel.

• Visit a dentist in 2013: Don’t delay making an appointment for a check-up. Dentists do more than just check and clean teeth. They can also check for signs of serious oral health problems like oral cancer and gum disease, answer questions and provide advice for adults and children and alert patients to signs of potential medical conditions.

• Avoid tobacco products: 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 non-smokers.1 Consuming products like cigarettes, cigars and smokeless tobacco is arguably the single most destructive oral health habit.

• Eat sweets in moderation: It was ancient Greek philosopher Aristotle who advised, “Moderation in all things” and that axiom rings especially true for sweet snacks. Tooth decay occurs when candy, cookies, sodas and other sweets, or simple carbohydrates like those in chips or crackers mix with bacteria in the sticky plaque that constantly forms on teeth to produce acid, which can destroy tooth enamel. Whenever possible, stick to having sweets with dinner and brush afterward if possible. Limit sugary snacks because the more times during the day that your teeth are exposed, the longer the acids attack.

• Wear a mouthguard during contact sports: It’s not just kids who play contact sports these days. Millions of adults participate in competitive sports leagues in which there can be significant risk of contact. Though there is insufficient evidence to suggest mouthguards prevent concussions, they do absorb and distribute the forces that impact the mouth, teeth, face and jaw when an athlete takes a shot to the face. Wearing a mouthguard can prevent chipped, fractured, displaced or dislodged teeth, fractured or displaced jaws, TMJ trauma, and lacerations to the lips and mouth that result from the edges of the teeth.

1 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.

Don’t Beware the Dentist’s Chair

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 26 million Americans suffer from diabetes. Even more troubling, another 57 million – about a fourth of U.S. adults – have pre-diabetes, which means their blood sugar levels are higher than normal, but not yet high enough to be classified as diabetes. Delta Dental is reminding Americans during “National Diabetes Month” that regular dental visits are crucial for people with diabetes.

According to the American Diabetes Association, controlling blood sugar levels is a key to preventing many serious complications of diabetes such as heart disease, kidney disease and stroke. Research also suggests a two-way relationship between serious periodontal (gum) disease and diabetes. Not only are people with diabetes more susceptible to severe gum disease, but it may have the potential to affect blood glucose control and contribute to the progression of diabetes.1 People with diabetes tend to develop periodontal disease earlier in life, and more severely. Instead of losing their teeth from gum disease in their 60s, they might begin losing teeth in their mid-40s. Smokers with diabetes are especially at-risk for gum disease and tooth loss.

Unfortunately, studies have found that people with diabetes see their dentist less often than those without the disease.2 Dentist visits are crucial because oral diseases such as tooth decay and gum disease are often reversible if they are diagnosed early and preventive treatments are delivered. Dentists will also check for other common mouth conditions that afflict people with diabetes such as dry mouth, ulcers and infections. 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 medical attention.

Daily brushing and flossing, regular dental check-ups and good blood glucose control are the best defenses against periodontal disease. In addition, quitting smoking may be the most important thing that people can do to protect their oral and overall health. The good news is that with proper dental hygiene at home and regular visits to the dentist (at least twice annually), there’s no reason people with diabetes should have worse oral health than people without.

1 American Diabetes Association. News and Research. http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/oral-health-faqs.html Accessed October 2012.

2 Macek MD, Tomar SL. Dental care visits among dentate adults with diabetes and periodontitis. J Public Health Dent. 2009 Fall;69(4):284-9.

Vote for Good Oral Hygiene

My fellow citizens: If you are like most Americans, a toothbrush, a tube of toothpaste and a spool of dental floss are long-standing incumbents in your bathroom cabinet.

During Dental Hygiene Month, another candidate, mouthrinse (also known as mouthwash), is vying for a spot beside the aforementioned daily use products. Should you welcome it to this exclusive club?

For its part, mouthrinse has long campaigned on a cosmetic platform of simply reducing or eliminating bad breath and making your mouth feel fresh. The cosmetic mouthrinse caucus has a large and loyal following. People who use it like that it eliminates bad breath, morning mouth and pesky food particles when used after meals, and that it promises to meld easily into your morning or evening routine. These are noble ideals.

More recently, a new ideology, therapeutic mouthrinse, has tried to distance itself from the cosmetic party line. Therapeutic mouthrinse has on its slate active ingredients like fluoride to fight cavities, and anti-microbial agents (such as hydrogen peroxide) to combat plaque, gingivitis and other gum diseases.

Every candidate has its critics, however, and mouthrinse is no different. Some point out that cosmetic mouthwash has too limited an agenda, that it just masks bad breath but doesn’t reduce cavities, gingivitis or plaque. Others have questioned the harmful effects of some mouthrinse products’ high concentration of alcohol content (ranging anywhere from 6.6 percent to 26.9 percent). A small but vocal contingent believes that factor could be a risk for oral cancer, but so far the overall evidence does not support that conclusion.

These criticisms have led mouthwash to position itself as a dental hygiene populist product that can appeal to all people, introducing non-alcoholic varieties to please even the harshest critics. It has also rolled out exciting new flavors (like cinnamon, bubblegum and orange) to appeal to a block of voters who want fresh breath but desire more than just the taste of mint.

“Mouthrinses are not a substitute for brushing or flossing but they might be a useful addition to your daily oral hygiene routine,” said Dr. Bill Kohn, DDS, a mouthrinse campaign expert and Delta Dental’s vice president for dental science and policy. “At a minimum, most mouthrinses will at least provide temporary relief from bad breath. Check with your dentist if you have persistent bad breath or to see if you would benefit from a mouthrinse that has fluoride or anti-bacterial agents to protect against cavities or periodontal diseases.”

Top 10 Fright Night Facts

Did you know Americans consumed 24.7 pounds of candy per capita in 2010?1 That’s a lot of sugar to potentially cause cavities if left on the teeth of boys and ghouls too long. After eating candy, Delta Dental recommends a thorough brushing of teeth (or at least a big drink of water).

Since Halloween is a favorite holiday of many Americans, Delta Dental has compiled a list of the 10 best terrifically terrifying truths:

1. Americans purchase nearly 600 million pounds of candy for Halloween each year.2

2. Major pumpkin-producing states like California, Illinois, New York and Ohio helped America grow 1.1 billion pounds of pumpkins in 2010.3

3. Sixty percent of dentists polled for Delta Dental’s Tricky Treats survey said they give out candy on Halloween. Of the dentists who dispense candy, 79 percent choose chocolate, while just 13 percent hand out varieties like hard candy or lollipops. This confectionary choice is no accident. Chocolate dissolves quickly in the mouth and can be eaten easily, which decreases the amount of time sugar stays in contact with teeth.4

4. Americans spent nearly $6.9 billion on Halloween costumes, decorations and “entertainment”.2

5. About 50 percent of Americans decorated their homes or yards, 44 percent dressed in a costume, 34 percent attended a Halloween party and 23 percent visited a haunted house in 2011.2

6. In 2011, the three most popular costumes worn by children were Harry Potter, princess and Green Lantern. Classic characters like Winnie the Pooh, Elmo and the Smurfs were also among the top 10 favorites. Captain America, Green Lantern and Where’s Waldo were popular costume choices for adults.5

7. Nearly one out of four dentists said they do not hand out anything on Halloween, while five percent attack the holiday head on by handing out toothbrushes.4

8. Not everyone gives out candy on Halloween. Ideas include toothbrushes, pretzels, fruit (such as raisins), modeling clay and books.4

9. An estimated 41 million children between the ages of five and 14 went trick-or-treating across the U. S. in 2010.1

10. Candy corn, a popular treat commonly associated with Halloween, was created in the 1880s and popularized by farmers who appreciated its resemblance to kernels of corn. 6

To learn more about what dentists give out at Halloween and get their best advice for keeping kids’ teeth healthy, please visit http://www.trickytreats.org.

1 United State Census Bureau, 2010 Census. http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed August 2012.

2 National Retail Federation. Consumers Eager to Have a Frightfully Good Time This Halloween, According to NRF. http://www.nrf.com/modules.php?name=News&op=viewlive&sp_id=1197. Accessed August 2012.

3 USDA National Agricultural Statistics Service.
http://usda.mannlib.cornell.edu/usda/current/VegeSumm/VegeSumm-01-27-2011.pdf. Accessed August 2012.

4 Delta Dental conducted the 2011 Tricky Treats Halloween survey. Delta Dental network dentists were invited via e-mail to participate in the web-based survey. For results based on the total sample of 253, the margin of error is ±6.15 percentage points at a 95 percent confidence level.

5 Sortprice.com. Hollywood Blockbusters & Traditional Favorites Dominate SortPrice.com’s Annual Top 10 Halloween Costume Lists for 2011. http://www.sortprice.com/docs/Halloween-Popular-Costumes-for-2011. Accessed August 2012.

6 National Confectioners Association. Candy Corn. http://www.candyusa.com/FunStuff/CandyType.cfm?ItemNumber=1582. Accessed August 2012.

Top 4 Tips for Antibiotics Use

The Centers for Disease Control and Prevention (CDC) says that antibiotic resistance is one of the world’s most pressing public health problems. According to the CDC, an estimated 50 percent of antibiotic prescription use in hospitals is inappropriate or unnecessary.(1)

Other studies have found that dentists also may prescribe antibiotics unnecessarily.(2-3) During “Talk About Prescriptions Month,” Delta Dental advises people to be responsible about how they use antibiotics.

Antibiotics are powerful medicines that fight bacterial infections. They work by killing bacteria or preventing them from reproducing until the body’s immune system can fight off the rest of the infection. When prescribed and taken correctly, their value in helping cure or prevent the spread of disease is significant. Contrary to popular belief, antibiotics do not fight infections caused by viruses such as the common cold, flu and bronchitis.

Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. These resistant germs can then be spread to others and over time, an antibiotic resistant strain of bacteria can become a community problem. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.

Dentists mainly prescribe antibiotics for the management of infections in and around the mouth, which are usually caused by bacteria. They are sometimes used after oral surgery as a preventive measure or to treat a toothache. Most common dental infections take the form of a toothache and require some type of treatment, like a filling, root canal therapy, or tooth extraction. Antibiotics cannot cure a toothache and are not always necessary after routine oral surgery.

Individuals who are taking antibiotics should keep a few things in mind:

Take the entire prescription: Even if your condition is improving and you feel cured, finish the prescription. If you stop too soon, some bacteria can survive and reinfect.

Only take antibiotics to treat a bacterial infection: People instinctively want to take medication to make them feel better, even if they just have the flu or common cold. Antibiotics only work on bacteria, however, and the common cold is usually a virus.

Don’t save the bottle for future reuse: Antibiotics degrade when they are stored for months at a time, rendering them ineffective. Check with your pharmacy for appropriate disposal of expired medications.

Don’t share your antibiotics with others: Antibiotics are prescribed for specific purposes. Your doctor will typically check for potential adverse interactions or drug allergies before prescribing.

1 “Antibiotics: Will they work when you really need them?” Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/campaign-materials/week/downloads/factsheet-Monday-GetSmart-week.pdf. Accessed September 2012.

2 Zadik Y and Levn L. Clinical Decision Making in Restorative Dentistry, Endodontics, and Antibiotic Prescription. Journal of Dental Education January 1, 2008 vol. 72 no. 1 81-86

3 Dar-Odeh NS, Abu-Hammad OA, et.al. Antibiotic prescribing practices by dentists: a review. Ther Clin Risk Manag. 2010; 6: 301–306.

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.

Top Five Best Oral Health Practices at School

It may seem like a mindless matter, but packing an apple instead of a sugary snack in a child’s lunch this fall can help improve oral health and educational performance. After all, children eat more than 20 percent of their meals at school during the academic year. So Delta Dental, the nation’s largest dental benefits provider, reminds parents to make good decisions when packing a child’s school lunch.

Overconsumption of sugar harms a child’s oral and overall health. Snacks like cookies, candy and chewy fruit snacks mix with bacteria in the sticky plaque that constantly forms on teeth to generate acid, which can wear away enamel and cause tooth decay. While sweets may provide a temporary jolt for kids, that sugar rush soon turns into a crash and kids are left feeling lethargic. That is not the kind of mental state kids need to prepare for an afternoon of classes.

Instead, Delta Dental recommends these top five oral health best practices:

• After breakfast, before leaving for school, make sure your child brushes well with a fluoridated toothpaste. Brushing immediately following a meal helps clean teeth and eliminates halitosis (bad breath).

• Fill a child’s lunch box with healthy lunch food and snacks such as lean meats, whole grain breads, low-fat yogurt or cheeses, apples, bite-size carrots and baked chips or whole-grain crackers. Besides being packed with nutrients, certain fruits and veggies can even help clean the teeth and gums. Make treats a treat. Serve sugary sticky snacks like cookies, cake and brownies and candy only in moderation. Room parents should discuss bringing in healthy snacks along with sugary treats for birthdays and other classroom parties.

• If a child chews gum and the school allows it, chewing sugar-free gum for a few minutes in between lunch and afternoon classes can help stimulate saliva to buffer the acid and help dislodge food particles from the mouth. Gum containing the natural sweetener, Xylitol, is a particularly good option since studies have shown that consistent exposure to Xylitol can reduce cavity-causing bacteria in the mouth.

• Children with braces should try to brush or rinse well with water after lunch. Children who wear removable retainers should clean them well after each meal and rinse out their mouths.

• Before the school year starts, schedule a dental visit to make sure there are no problems to distract a child during the school year. Ask the dentist about sealants as a way to protect children’s teeth from cavities. Sealants – a thin coating of bonding material applied over the chewing surface of molar teeth – act as a barrier to cavity-causing bacteria.

Make Dentist Visits the Rule for Back-to-School

Along with an annual physical, clothes and backpacks, Delta Dental suggests adding a visit to the dentist to your child’s back-to-school list this fall. Dental professionals recommend biannual visits for most children, and the end of summer is an ideal time because it follows a season in which kids have indulged in treats like soda, ice cream and cotton candy.

A dental visit is important because a dentist can diagnose potential oral health problems such as tooth decay or gum disease and apply preventive measures as needed, including teeth cleaning, fluoride treatment, dental sealants, and instruction on good dental hygiene habits. Making sure children get a clean bill of oral health before the school year allows them to return to class flashing a happy and healthy smile. Conversely, untreated dental problems can be painful and embarrassing, and can harm a child’s educational and social development. In 2007, for example, the State of California estimated that seven percent of their more than seven million schoolchildren (504,000) missed at least one day of school because of a dental problem. 1

Unfortunately, access to sufficient dental care is not nearly what it needs to be for children from poor and uninsured families. A study from the Pew Center on the States found that two-thirds of states in the U.S. do not have adequate policies in place to ensure access to proper preventive dentistry, particularly for those children that lack appropriate access to care. 2 Instead, programs like mobile dental units that visit schools and school-based dental sealant programs are playing a critical part in improving the oral health and quality of life of low-income, American children.

Ultimately, good oral health for children starts at home with proper dental hygiene and diet. The daily one-two punch of brushing twice a day with a fluoride toothpaste and flossing once is still the foundation for maintaining healthy teeth and gums. Very young children (ages one to five) are particularly prone to tooth decay and parents should supervise (or actually brush) to make sure they do a good job. A diet light on sugary snacks and drinks and rich in fruits and vegetables goes a long way toward maintaining good oral and overall health.

1(Source: 2007 California Health Interview Survey) UCLA Health Policy Research Brief – Unaffordable Dental Care Is Linked to Frequent School Absences, 2009 Pourat N and Nicholson G. http://www.healthpolicy.ucla.edu/pubs/files/Unaffordable_Dental_Care_PB_1109.pdf

2The Cost of Delay: State Dental Policies Fail One in Five Children. Pew Center on the States. http://www.pewtrusts.org/uploadedFiles/Cost_of_Delay_web.pdf.

Five Ways to Help Your Children Brush Better

Poor and infrequent brushing may be some of the biggest obstacles preventing children in the United States from having good oral health. That’s one of the key findings from a recent survey1 of American children’s oral health, conducted on behalf of Delta Dental Plans Association, the nation’s leading dental benefits provider.

While nearly two out of five Americans (37 percent) report that their child’s overall oral health is excellent, more than a third of survey respondents (35 percent) admit their child brushes his or her teeth less than twice a day.

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 2 minutes, which is the amount of time dentists typically recommend spending on each brushing.

While the American Association of Pediatric Dentistry recommends daily flossing, nearly half (48 percent) of the survey respondents whose children have teeth say they have never been flossed; only 22 percent report their child’s teeth are flossed daily.

Getting small children to brush properly can be a challenge, but here are some ideas that can help:

• 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 don’t 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.

• Fun Toothbrush Holder/Toothbrush: Another way to get children brushing is by utilizing oral health gifts like robot, tree or animal-shaped toothbrush holders that stick to walls. Kids like the characters and the holder provides a sanitary storage spot for their toothbrushes and toothpaste. Remember to apply just a small dab of toothpaste to the brush since the amount of fluoride in children’s toothpaste is still adult strength.

• Take turns: Set a timer and have the child brush his or her teeth for one minute. Then reset the timer and brush their teeth for the final minute.

• 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.