Wearing the Wires: Kids and Braces

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Once upon a time, kids who wore braces were teased by their peers with mean-spirited nicknames such as brace face, tinsel teeth, zipper lips and metal mouth. These days, however, braces have become seemingly as ubiquitous as eyeglasses, almost a rite of passage for American youth in their formative years. Studies have estimated anywhere from 50-70 percent of American children will wear braces between the ages of 6-18.

Children from ages 6-18 (and even some adults) typically get braces to correct malocclusions (i.e., bad bites). These jaw or tooth alignment problems are usually genetic, but can result from an injury, early or late tooth loss or thumb-sucking.1 Historically, most children started wearing braces in their early- and into mid-adolescent years, after all of their permanent teeth had erupted (ages 11-15), but in more recent years there has been a trend towards earlier intervention to take advantage of high rates of growth and to correct certain conditions that might otherwise adversely affect growth and development. Crowded, poorly-positioned teeth not only affect a child’s appearance, but can negatively impact the way a child bites, chews and speaks, and can increase the long-term potential for developing periodontal disease or temporomandibular joint (TMJ) problems.1

Whether or not they have braces, kids should always eat a healthy diet. In general, however, kids with braces should avoid foods that are difficult to bite off or chew, that may damage the braces, or that are difficult to clean from around the wires and attachment brackets. Foods like popcorn, corn on the cob, whole apples, sunflower seeds and sticky candy fall into these categories. It is also not a good idea to chew on ice, pencils or any other oral habits that can bend the wires or otherwise damage the appliances that go into moving teeth into proper position.2 Eating too many sticky and sugary foods is particularly damaging to children with braces, since plaque tends to build-up around the appliances and can lead to decay where the brackets are attached to the teeth.

Standard oral health care best practices apply to all children – with or without braces. This includes brushing with fluoride toothpaste and flossing daily, wearing a properly fitting mouthguard during contact sports, and making regular dental visits. Obviously brushing and flossing presents some challenges while wearing braces but the child’s dental team will usually provide the proper guidance on facing the challenges to good oral hygiene that wearing braces can present. This may include things like using fluoride rinses, floss threaders, interproximal cleaners, powered brushes or irrigators, dental wax and other tips for keeping the braces and teeth clean and wearing them comfortably.

A child’s teeth are often sore for a day or two after the braces are first put on or after an adjustment appointment. In addition, other typical problems that children may have to deal with include food caught between the teeth and appliance, one or more of the little rubber bands break that hold the wires to the bracket, a wire breaks and pokes into the cheek, a sore develops on the cheek or gum where something is rubbing.

1.American Dental Association. “Braces” http://www.mouthhealthy.org/az-topics/b/braces.aspx
2.American Dental Association 2010 Survey of Dental Practice
3.American Association of Orthodontists. http://www.mylifemysmile.org/faq

New Survey: Kids Need Brushing up on Oral Health

Although cavities are nearly 100 percent preventable, more than one out of four American caregivers reported that their children had a cavity filled in the past year. This was among the findings of a new survey1 of nearly 1,000 caregivers released today by Delta Dental in conjunction with National Children’s Dental Health Month. Among children who had a cavity in the past year, 53 percent had two or more cavities.

The 2013 Delta Dental Children’s Oral Health Survey shows that not only are Americans unaware they can pass cavity-causing bacteria to children, but they also need to brush up on some critical children’s dental health habits, including basics such as brushing and flossing.

Parents and caregivers need to teach good oral health habits to children at a young age to help prevent cavities. Baby teeth are very important. They help children chew and speak properly and hold space for permanent teeth. If a child has healthy baby teeth, chances are he or she will have healthy adult teeth.

These are some of the oral health habits that fall short of what’s recommended by dental professionals:

• Survey shows: Seventy-five percent of caregivers say they share utensils such as a spoon, fork, or glass with a child.
• Delta Dental recommends: Parents and caregivers should eliminate saliva-transferring behaviors – such as sharing utensils and toothbrushes and cleaning a pacifier with their mouths – all activities which can pass harmful bacterial to a child.

• Survey shows: Forty-nine percent of Americans with a child four years or younger report that the child sometimes takes a nap or goes to bed with a bottle or sippy cup containing milk or juice.
• Delta Dental recommends: Parents and caregivers should not put a child to bed with a bottle of milk, juice, sweetened water or soft drinks, which can lead to baby bottle decay. Instead, caregivers should fill the bottle with water.

• Survey shows: For children who have visited the dentist, the average age at the first visit was 3 years old.
• Delta Dental recommends: Children should first visit the dentist within six months of getting the first tooth – and no later than the first birthday.

• Survey shows: Only 58 percent of children had their teeth brushed twice a day and 34 percent of children brush for less than two minutes.
• Delta Dental recommends: Children’s teeth should be brushed twice a day for at least two minutes each time. Parents should assist with this task until the kids are about 6 years old.

• Survey shows: Forty-three percent of parents or caregivers report that their children’s teeth are never flossed, and of children whose teeth are flossed, only 23 percent are flossed daily.
• Delta Dental recommends: Once any two teeth are touching, caregivers should floss, or help the child floss, once a day.

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.

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.

Dog Diffuses Dental Distress

According to the National Institutes of Health, more than 20 million Americans avoid going to the dentist out of fear.

Most dentists are well aware of their patients’ anxieties. They try to create a soothing environment where patients can feel calm and comfortable, beginning with an inviting waiting room and a caring, attentive staff. Some practices offer television, music, or even virtual reality glasses to entertain and distract nervous patients in the chair. Others employ pillows, blankets or aromatherapy to help their patients relax.

But one practitioner has found a unique solution to help his young patients conquer their dental phobia. The clinic of Dr. Paul Weiss, a pediatric dentist in Williamsville, N.Y., recently posted a photo on the popular website reddit that showed how he uses his golden retriever Brooke to act as a therapy dog to calm nervous young patients. According to MSN.com, Brooke is bathed before each visit and Weiss’s office is cleaned after she leaves to maintain proper sanitation.

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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.