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.


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

Ozone in Dentistry

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One simmering controversy in dentistry has to do with ozone, but nothing to do with the layer that surrounds our planet. Rather, it’s a new and controversial alternative form of dental treatment. Some dentists are convinced that delivering ozone gas, a powerful naturally-occurring oxidant, into a decaying tooth can halt or even reverse the process altogether.

Dental caries, otherwise known as cavities, are bacterial infections that erode and destroy tooth structure due to the acid that is produced every time food is consumed. Ozone is toxic to certain bacteria, so the theory goes that injecting ozone into a carious lesion might reduce the number of cariogenic bacteria.

Ozone (O3) is formed from oxygen (O2) splitting into two oxygen molecules (O1) under various conditions, including an electrical discharge like a lightning strike. Then these single molecules collide with O2 oxygen to form ozone. If you have ever noticed a different scent in the air after a lightning storm, it is likely that you are smelling the higher concentration of ozone. In fact, the word ozone is derived from the Greek word “ozein,” which means “to smell.”

Ozone can exist in gas, liquid or solid form, and has long been used in industrial and medical applications. The extra oxygen molecule on ozone is loosely bound, excited and readily available to jump off, attach to, and oxidize other molecules. This oxidation process can destroy a variety of microorganisms. Ozone-based sterilizers are often used for some instrument and equipment sterilizing applications in hospitals. Ozone is also used by some municipal water systems to kill bacteria in the water.

Proponents argue that dentists can use ozone to start a process that removes bacterial waste products, halts dental cavities and begins a process of repair through accelerated remineralization of damaged teeth. According to them, bacteria, viruses and fungi lack antioxidant enzymes in their cell membranes, so those harmful antibodies are destroyed when ozone ruptures their cell membrane. Healthy cells, on the other hand, are unaffected by therapeutic levels of ozone because they have antioxidant enzymes in their cell membranes.1 Those in the dental community in favor of ozone therapy say dentists are utilizing it for periodontal therapy, root canal treatment, tooth sensitivity, canker sores, cold sores and bone infections, among other things.1

It’s an interesting idea and a pretty straightforward concept. Any treatment that not only saves or protects a tooth from decay but avoid the use of needles and anesthetic would be a welcome addition to a dentist’s treatment options. Unfortunately, despite some promising evidence of effectiveness against decay-causing bacteria in laboratory studies, the current evidence base for ozone therapy in dentistry is insufficient to conclude that it is an effective or cost-effective addition to the management and treatment of caries. At this time, the U.S. Food and Drug Administration (FDA), which assesses new drugs and medical devices for safety and efficacy and regulates their use and marketing in the U.S., has not cleared any ozone-generating devices for use in dentistry.

Ultimately, not enough is known as this time and some high quality clinical trials research is necessary. Biased research and inconsistent outcome measures have made researchers unable to confidently conclude that the application of ozone gas to the surface of decayed teeth halts or reverses the decay process. Therefore, at this time, ozone therapy for treatment the prevention and control of tooth decay is not considered a viable alternative to current treatment methods in the world of evidence-based dentistry.2

1 American College of Integrated Medicine and Dentistry. http://www.ozonefordentistry.com/DentalO.html Accessed July 10.

2 National Center for Biotechnology Information. Ozone Therapy for the Treatment of Dental Caries. http://www.ncbi.nlm.nih.gov/pubmed/15266519 Accessed July 10.

3 Rickard GD, Richardson RJ, Johnson TM, McColl DC, Hooper L . Ozone therapy for the treatment of dental caries.  Cochrane review.   2008 http://summaries.cochrane.org/CD004153/ozone-therapy-for-the-treatment-of-dental-caries#sthash.qfFibqsE.dpuf

Image courtesy of webelements.com

Ignorance Not Blissful for Your Children’s Oral Health

“What you don’t know won’t hurt you” is a popular idiom that couldn’t be further from the truth when it comes to personal health. In fact, parents’ lack of knowledge about certain common at-home habits could jeopardize their children’s oral health.

For instance, nearly half of American children under age 3 have never seen the dentist, according to the 2013 Delta Dental Children’s Oral Health Survey.1 What many parents don’t realize is the American Academy of Pediatric Dentistry recommends that a child go to the dentist by age 1 or within six months after their first tooth erupts.2

Parents should take children to the dentist by age 1 to establish a trusting relationship with the dentist and receive critical oral health care advice. Studies show that early preventive dental care can save in future dental treatment costs.

Fill bottles with water, not juice or milk
Nearly 50 percent of caregivers with a child 4 years old or younger report that the child sometimes takes a nap or goes to bed with a bottle or sippy cup containing milk or juice. This bad habit can lead to early childhood (baby bottle) tooth decay.

Ideally, children should finish a bottle before they are put down to sleep. But if they must have something to comfort them while they go to sleep, fill a bottle with water. Don’t get in the habit of providing sweet drinks because you think it will please your child.  Of course, most children do like sweets, but babies and toddlers want the soothing, repetitive action of sucking on a bottle more than sweetened drinks.

Avoid sharing food and utensils with children
Did you know that caregivers can actually pass harmful bacteria from their mouth to a child’s mouth, which can put the child at an increased risk for cavities? Bacteria are passed when items contaminated with saliva go into a child’s mouth. Typically, this takes place through natural, parental behaviors, such as sharing eating utensils or cleaning off your baby’s pacifier with your mouth. Parents with a history of poor oral health are particularly likely to pass germs along.

However, three out of every four caregivers say they share utensils such as a spoon, fork or glass with a child. Caregivers of children ages 2 to 3 are most likely to share utensils with their children.

For additional tips to help keep children’s teeth healthy during National Smile Month and all year long, visit www.oralhealth.deltadental.com.

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.

2 American Academy of Pediatric Dentistry – Policy on the Dental Home. http://www.aapd.org/media/Policies_Guidelines/P_DentalHome.pdf