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 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.

The Toothbrush: From Horsehair to Heroes

Even our ancient ancestors – primitive though they were – recognized the need for good dental hygiene. At least that’s what archeologists believe the chewed frayed ends of aromatic twigs from early times indicate.1

The first bristled toothbrushes didn’t appear until around the year 1,000 in China, when people fashioned together a crude tool using an ivory handle with tufts of horsehair. Five hundred years later, the Chinese introduced a bone or bamboo-handle with bristles from the back of a boar’s neck. 2 The “modern” toothbrush debuted in 1938, when a Frenchman named Dupont de Nemours introduced a nylon bristle called Doctor West’s Miracle Toothbrush. 2 The National Museum of Dentistry in Baltimore has amassed quite a collection of such old-school devices and other dental memorabilia.

Of course, dental hygiene’s main tool has come a long way since the Ming Dynasty. These days, toothbrushes have smooth, polished, soft-ended and flexible nylon bristles in various configurations designed to get under the gums and between the teeth. Some offer streamlined plastic handles with rubberized gripping surfaces, action character handles for kids, timers to help you brush an appropriate length of time, LCD screens with smiley faces to encourage optimal brushing, and even tiny speakers to play music. Battery-powered toothbrushes have also evolved and may offer ultrasonic and ionic abilities, as well as oscillating and rotating brushes to mimic the best brushing technique.

Replace your toothbrush every three to six months or even earlier if the bristles start to look bent and splayed apart. Children or adults who scrub too aggressively or chew on the bristles will need to replace their brush more often. The more expensive powered models usually have replacement heads for purchase whereas the cheaper models may not.  Clean your toothbrush thoroughly under running tap water after each use, and store upright and away from other brushes so it dries out between uses.

Golfers often say “it is more the golfer than the club” that determines how good the score is. It’s the same in toothbrushing – it’s more the brusher than the brush itself that determines how well the job is done and if disease is prevented. Even the most basic manual toothbrush will work well if it is picked up and used properly.

Whether you are using a manual or battery-powered toothbrush, the most important thing is that people brush their teeth twice daily (morning and night), taking proper time (about two minutes) to cover the entire surface of every tooth. Brush gently but thoroughly and make sure to reach below the gumline and between the teeth. Take your time. Brushing harder or more aggressively for a shorter period of time doesn’t help and may actually damage the gums or tooth surface.1  Finally, always remember that for most people brushing alone isn’t adequate to prevent tooth decay caused by the sticky, bacteria-laden, acid-producing plaque that is constantly forming on the teeth. Fluoride is currently our best tool for preventing tooth decay, so always use a fluoride containing toothpaste.

Whether manual or battery-powered, the toothbrush is the best vehicle to both remove plaque and deliver fluoride to the teeth at least twice a day. So pick up that toothbrush! One of the keys to good oral health is in your hands.

1 Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Copyright © by Harvard University. All rights reserved.

2 Mandel ID The Plaque Fighters: Choosing a Weapon. Journal of the American Dental Association 1993; April 124(4); pages 71-74

3 Library of Congress http://www.loc.gov/rr/scitech/mysteries/tooth.html. Accessed Feb. 2012.