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

Don’t Pass on Your Dentophobia

Parents who are afraid to visit the dentist may pass the same fear on to their children, possibly keeping them from getting routine dental check-ups that are important to promote healthy teeth and a lifetime of good oral health habits.

That’s one of the key findings from a survey of children’s oral health1 conducted on behalf of Delta Dental, the nation’s leading dental benefits provider. On average, the survey found that nearly 30 percent of children are afraid to visit the dentist. But when their parents also fear the dentist, that number jumped to almost 40 percent. Conversely, just 24 percent of children whose parents are unafraid of the dentist were still fearful of dental visits themselves.

The top reason parents say their children are afraid to visit the dentist is due to painful or sensitive teeth (17 percent). Other explanations include the noise and smell (11 percent), drills and dental equipment (10 percent), and shots and needles (9 percent).

During National Mental Health Month, Delta Dental offers parents and caregivers three simple tips to help children feel more comfortable in the dentist’s chair:

  • Start young: It’s recommended that children visit the dentist within six months of getting their first tooth – and no later than their first birthday. Starting at a young age allows children and parents to establish trust with a dentist and begin a routine of regular dental visits.
  • Keep it simple and positive: If children ask questions before a visit to the dentist, avoid using words that could make them scared, such as drill, shot or filling, or counseling them that it won’t hurt, since they often aren’t aware it could hurt in the first place. Instead, explain that the dentist is simply going to check their smile and count their teeth. Try not to discuss any negative experience that you might have had so your child can form their own opinion through personal experience.
  • Call ahead: Tell the dentist ahead of time that your child may be anxious about the visit. Most pediatric dental offices will have toys or music that children can focus on instead of the appointment itself, helping them relax and making a trip to the dentist a fun and enjoyable experience.

Parents need to help children understand why visiting the dentist is so important and help make their visits as comfortable as possible. Kids who have negative experiences at the dentist may be less inclined to make regular visits as teenagers and grown adults.

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.

Don’t Bottle Up the Oral Health Benefits of Fluoridated Water

Nearly 60 percent  of caregivers say they are more likely to give children bottled water than tap water, potentially depriving kids of fluoride that is critical to good oral health. In addition, according to the 2013 Delta Dental Children’s Oral Health Survey,1 more than twice as many caregivers say bottled water is better for children’s oral health than tap water – an opinion at odds with evidence-based dentistry and more than six decades of public health experience.

Fluoride actually helps to repair (remineralize) tooth surfaces that are damaged by the acid produced by certain bacteria in the mouth, which prevents cavities from continuing to form.2 Since U.S. cities began adding fluoride to water supplies more than 65 years ago, tooth decay has decreased dramatically.3 This result led the Centers for Disease Control and Prevention (CDC) to name water fluoridation “one of the 10 great public health achievements of the 20th century.”4

Unfortunately, only 17 percent of parents believe that tap water is better for their children’s oral health than bottled water.1 Some bottled waters do contain fluoride but usually not in the optimal amount.5  Fluoride in the water provides decay-preventive benefits for the teeth of both children and adults, which makes it the most cost-effective way for communities to improve overall oral health.

The key to fluoride’s protective benefit is by having a little fluoride on your teeth throughout the day. Brushing teeth with a fluoride toothpaste at least twice a day, drinking fluoridated water and limiting frequent between-meal snacking on sugary or starchy foods will help keep most children and adults tooth decay-free.

If children don’t drink fluoridated water, Delta Dental offers these ways to get more fluoride into their diet:

  • Fluoridated toothpastes, mouth rinses and/or professionally-applied gels or varnishes. These products can help strengthen teeth by hardening the outer enamel surface. With toothpaste and rinses children tend to swallow much of what they put in their mouth. So fluoride toothpaste use should start about age 2 and fluoride rinses probably not until about ages 6 or 7.
  • Dietary fluoride supplements, such as tablets, drops or lozenges, which are typically available only by prescription and are intended for children typically older than 6 months living in areas without fluoridated water in their community.
  • Bottled water that states on the label that it contains the right amount of fluoride.

As with other vitamins and minerals, it’s important to get enough, but not too much. When young children whose teeth are still developing under their gums (up to about age 9) get too much fluoride, their teeth may erupt with faint white lines or patches called dental fluorosis. The CDC has reported an increase in dental fluorosis over the past couple of decades. Inappropriate swallowing of toothpaste and children living in fluoridated areas that also receive fluoride supplements are believed to play a major role in this increase.

For advice on the proper amount of fluoride specifically recommended for your child, consult with your dentist. The recommendation will depend on your child’s age, how much fluoride naturally occurs in your local water and your child’s risk for tooth decay.

The Tooth Fairy Loosened Her Purse Strings in 2012

How much are kids getting for lost baby teeth these days? The average gift from the Tooth Fairy was $2.42 last year, up 32 cents from $2.10 in 2011, according to The Original Tooth Fairy Poll® sponsored by Delta Dental.1 The most common amount left under the pillow was $1 (51 percent).

According to the poll, the Tooth Fairy was even more generous with kids who lost their first tooth, leaving more money for the first tooth in 46 percent of homes. On average, the amount given for the first tooth was $3.49.

Leaving gifts from the Tooth Fairy is a great way to help make losing teeth less scary and enjoyable for kids. Delta Dental encourages parents to use the Tooth Fairy as an opportunity to talk about good oral health even before a child loses the first tooth. Caring for baby teeth is important, as they help children chew and speak properly and hold space for permanent teeth.

In 2012, the Tooth Fairy visited nearly 90 percent of U.S. homes with children who lost a tooth. Delta Dental suggests the following ways parents can use the Tooth Fairy as a teachable moment:

• Introduce the Tooth Fairy early on. Kids will start losing baby teeth around age 6. Before this age, parents can teach kids about the Tooth Fairy and let them know that good oral health habits and healthy teeth make her happy. Use this as an opportunity to brush up on a child’s everyday dental routine. Kids not wanting to brush and floss? Remind them the Tooth Fairy is more generous for healthy baby teeth, not teeth with cavities. This will help get kids excited about taking care of their teeth.

• Leave a note reinforcing good habits. A personalized note from the Tooth Fairy could be nearly as exciting for kids as the gift itself. Parents should include tips for important oral health habits that the Tooth Fairy wants kids to practice, such as brushing twice a day, flossing once a day and visiting the dentist twice a year. And, of course, parents should give the Tooth Fairy a special name. After all, Flossie or Twinkle is a bit more exciting than just Tooth Fairy!

• Give oral health gifts. Although the Tooth Fairy left cash for kids in 98 percent of homes she visited, two percent of children received toys, candy, gum or other gifts. Consider forgoing cash and providing oral health gifts instead, like a new toothbrush or fun-flavored toothpaste. For readers, there are numerous children’s books about Tooth Fairy adventures in bookstores or online. The days of jamming a tiny tooth underneath a huge pillow and making the Tooth Fairy blindly grope around under a heavy sleeping head are gone. Special pillows with tiny, tooth-sized pockets attached are now available online, with themes ranging from princesses to ninjas and beyond. Some of the pillows can even be customized with your little gap-toothed child’s name. Or if a parent, er, ahem, the Tooth Fairy, is feeling generous, kids could receive both cash and a new toothbrush.

For more information, visit http://www.theoriginaltoothfairypoll.com. To get a sense of the taste and style choices of the Tooth Fairy and for some fun ideas, parents can follow her on Pinterest at http://www.pinterest.com/origtoothfairy.

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.

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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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.

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.