The Best and Worst Halloween Treats for Teeth

Little ghosts and goblins will trick-or-treat to collect as much candy as they can this Halloween, but it’s not just kids who will enjoy the treats. Nearly 80 percent of parents admit they eat their children’s Halloween candy, according to the Delta Dental Children’s Oral Health Survey.1 But some candies have the potential to do more damage to teeth than others.

The best way to protect teeth from decay is to have candy in small portions at limited times, such as after a meal, as dessert or at regular snack times. Nearly 90 percent of parents say their kids consume Halloween candy this way.Choose candy that melts and disappears quickly. The longer teeth are exposed to sugar, the longer bacteria can feed on it, which could produce cavity-causing acid.

While no sweets are good for teeth, some are less harmful than others. We rated the best and worst treats for teeth on a scale of 1 to 5, with 1 being least harmful.

  1. Sugar-free candy and gum with xylitol                                                                   Sugar-free foods don’t contain sugar that can feed on the bacteria in the mouth and produce decay-causing acids. Gum and candy with xylitol may actually protect teeth by reducing the acids produced by bacteria and increasing saliva to rinse away excess sugars and acids.
  • Our survey says 44 percent of kids eat sugar-free candy at Halloween.1
  1. Powdery candy (such as sugar straws)                                                                     Sure, powdery candy is packed with pure sugar. But powdery candy dissolves quickly and doesn’t stick to the teeth.
  1. Chocolate (such as candy bars)                                                                             Chocolate dissolves quickly in the mouth and can be eaten easily, which decreases the amount of time sugar stays in contact with teeth. And calcium could help protect tooth enamel. However, chocolate with fillings, such as caramel and nuts, is a lot more harmful for teeth than the plain variety.
  • Our survey says 86 percent of kids eat chocolate at Halloween. 1
  1. Hard candy (such as lollipops or mints)                                                                     Hard candy is tough on teeth because it tends to be sucked on at a leisurely pace for an extended period of time. Plus, chomping down on hard candy can chip or break teeth.
  • Our survey says 50 percent of kids eat hard candy at Halloween. 1
  1. Chewy candy (such as caramels or gummies)                                                         Chewy, sticky treats are particularly damaging because they are high in sugar, spend a prolonged amount of time stuck to teeth and are more difficult for saliva to break down.
  • Our survey says 57 percent of kids eat chewy candy at Halloween. 1

Another way to protect teeth is to give kids something other than candy.  Nearly 25 percent of parents hand out non-candy items to trick-or-treaters, such as toys, money or fruit.1

For additional tips on how to help keep children’s teeth healthy during Halloween and all year long, visit the Tooth Fairy’s Halloween website at www.toothfairytrickytreats.com.

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.

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.

Are Two Annual Dental Visits One Too Many – or Not Enough?

For decades, conventional wisdom held that certain dental procedures were best practices and were right for all people. You brushed your teeth after every meal (or at least morning and night) flossed daily, and visited the dentist twice a year. At each visit, you got an exam, X-rays and a cleaning. If you were a child, you could add on a fluoride treatment and perhaps sealants on your molar teeth.

However, thanks to advances in molecular medicine, genetics and other areas of research, health care in general (including oral health care) is being transformed from a system of treating disease in a one-size-fits-all manner to one that provides predictive, proactive, preventive and personalized care. Oral health care advances also allows for a more customized and tailored approach to each person’s individual situation.

Sure, basic prevention activities like brushing with fluoride toothpaste, flossing and drinking fluoridated water regularly is important for all. Based on risk factors, however, some people are considered at higher risk and some at lower risk for developing oral diseases like tooth decay, periodontal (gum) disease or oral cancer. Your risk for disease may help you determine what level of more costly professional services may be most beneficial. People with a history of good oral health, good dietary and oral hygiene habits, and no genetic red flags may need to only visit the dentist once a year or less. Conversely, those with a history of disease and other risk factors may need two or more routine visits each year.

A recent study published in the Journal of Dental Research looked at individual’s risk for periodontal disease and concluded that for low-risk individuals, “the association between preventive dental visits (dental cleaning) and tooth loss was not significantly different whether the frequency was once or twice annually.”1 It went on to recommend evaluating genetic tendencies for gum disease with conventional risk factors (smoking and diabetes) when assessing how often a patient needs to visit the dentist.1 While this study looked specifically at gum disease risk, risk factors are also established for other oral problems such as tooth decay and oral cancer.

In response to the JDR study, the American Dental Association released a statement to “remind consumers that the frequency of their regular dental visits should be tailored by their dentists to accommodate for their current oral health status and health history.” 2

For those who are unaware of their personal risk factors, Delta Dental provides an online tool (myDentalScore) that can help you self-assess your level of risk for gum disease, tooth decay and oral cancer. This self-assessment will provide you with valuable information to help you have a good discussion with your dentist about the best mix of self-care and professional care for you as an individual.

Ultimately, Delta Dental encourages consumers to honestly evaluate themselves and seek the kind of dental care that will be most beneficial to their oral health.

Patient Stratification for Preventive Care in Dentistry.  http://jdr.sagepub.com/content/early/2013/06/05/0022034513492336.abstract

2 American Dental Association. American Dental Association Statement on Dental Visits.  http://www.ada.org/8700.aspx

How to Handle Tooth Trauma

As children head back to school, it is important to remember that dental emergencies can happen any time, any place. According to the 2013 Delta Dental Children’s Oral Health Survey,1 one out of 10 children ages 10 or 11 have had a tooth emergency such as a knocked-out tooth, chipped tooth or a loosened permanent tooth at home or at school.

A knocked-out permanent tooth is a true dental emergency, and there’s a good chance it can be saved if you know what to do and act quickly. The primary concern should be getting the child in to see a dentist. Time is crucial if you want the dentist to be able to reinsert and salvage the natural tooth. Ideally, a child needs to be seen within 30 minutes of the accident.1

Whether a tooth is knocked out at school or home, here are several steps to ensure it is saved – or at least in optimal condition – by the time the child can see the dentist.

  • First, check to make sure the child doesn’t have a serious head, neck or other orofacial injury (i.e., a concussion, broken jaw, etc.).
  • Don’t worry about replacing a displaced baby tooth. Trying to reinsert it could damage the permanent pearly white coming in behind it.
  • To avoid infection, the tooth should be held by the crown, not the root. The crown is the part of the tooth visible to the naked eye. You want to leave the root intact, and touching it with bare hands could pass bacteria.2
  • Rinse any debris off of the tooth under room temperature water. Don’t scrub the root! Once the tooth is free of loose dirt and debris, try to reinsert it, asking the child to hold it in place using a piece of gauze if necessary. 3
  • If the tooth cannot be successfully reinserted, it needs to stay moist until the child can visit a dentist. Store the tooth in a clean container and cover it with milk or room temperature water to prevent it from drying out. 4 These liquids aren’t ideal but are often the only ones readily available. If you are a school nurse or your child frequently plays contact sports, purchase an emergency bag  handy with a save-a-tooth kit in it (available at most drugstores.) These contain a solution that is better at preserving any live cells on the tooth root until the dentist can put the tooth back into the socket.

In most cases, tooth injuries are not life threatening. But they can have long-lasting effects on the child’s appearance and self-confidence, so it is important to act quickly in the event of a dental emergency.

1Morpace 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 error is ±3.2 percentage points at a 95 percent confidence level.

2“Saving a Knocked-Out Tooth.” American Association of Endodontists. http://www.aae.org/patients/patientinfo/references/avulsed.htm. Accessed 2010.

3 “Medical Encyclopedia: Broken or Knocked Out Tooth.” U.S. National Library of Medicine and the National Institutes of Health, February 22, 2010. www.nlm.nih.gov/medlineplus/ency/article/000058.htm. Accessed 2010.

4“Dental Emergencies.” American Dental Association. http://www.ada.org/370.aspx Accessed 2010.

Are Sports Drinks as Harmful to Kids’ Teeth as Soda?

While kids play sports in the summer heat, they will be tempted to gulp down large sugary sports and energy drinks to stay cool. Swigging too many of these beverages, however, can harm a child’s teeth. Delta Dental advises parents to monitor and limit the number of these beverages their children are consuming to help prevent cavities.

Young athletes do need to replace fluids, carbohydrates, protein and electrolytes after hard exercise. But the high sugar and highly acidic content of sports drinks can increase a child’s susceptibility to tooth decay and enamel erosion if too much is consumed.

Like soda, energy and sports drinks contain high levels of acidity and high concentrations of sugar. A study from the Harvard School of Public Health found that 12 ounces of a leading brand of cola and a leading brand of energy drink each contained 42 grams of sugar, while a leading sports drink contained 21 grams of sugar.1 According to a University of Iowa study, a leading sports drink had the greatest erosion potential on both enamel and roots of teeth when compared to leading brands of energy drinks, soda and apple juice.2

Sugar itself doesn’t rot teeth, but rather, the acid that is produced when sugar mixes with certain bacteria in the mouth. Decay forms around the parts of the tooth where the plaque accumulates. The high acid from the drinks themselves can also have an erosive effect on the whole surface of the tooth. Sugary, acidic drinks are particularly damaging when they are sipped frequently throughout the day because they spend a prolonged amount of time washed over the teeth.

Instead of buying the 32 or 64 ounce bottles of sports drink, limit kids to a single 12 to16 ounce bottle. Encourage kids to consume as much water as they do sports drink. Drinking water will help them stay hydrated during outdoor activities and make sure any residual sports drink doesn’t linger on their teeth. Another option is to dilute the sports drink with water to lower the concentration of acidity and sugar. If your kids find water boring, consider adding slices of orange, lemon or cucumber to make it more appealing. Interestingly enough, recent studies suggest that low-fat chocolate milk may be as good as a sports drink at promoting recovery between workouts.3

1 Harvard School of Public Health. How Sweet Is It? Accessed June 2012.http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/how-sweet-is-it/index.html

2 University of Iowa College of Dentistry. Acidic Beverages Increase the Risk of In Vitro Tooth Erosion. Accessed June 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516950/

3 Spaccarotella KJ, Andzel WD.  Building a beverage for recovery from endurance activity: a review. J Strength Cond Res. 2011 Nov;25(11):3198-204.