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Many parents don’t realize how early oral care needs to start.

Many parents don’t realize how early oral care needs to start.

By Melinda Wenner Moyer

160726_KIDS_oral-health

If you hear blood-curdling screams coming from my house at 7 a.m. or 7 p.m., don’t fret: I’m just brushing my 2-year-old’s teeth. It’s a traumatic endeavor for us both, and I admit that I’ve sometimes wondered: Is this really worth it? Baby teeth are just, like, temporary teeth, right?

Then I saw some statistics on cavities in young kids and spoke with a couple of pediatric dentists, and was surprised to discover that caring for your wee one’s teeth isn’t optional—it’s essential. So is taking kids to the dentist at a very young age. Don’t worry; you can learn from my mistakes, because I’ve been doing pretty much everything wrong.

Let’s start with the stats: Numbers of cavities among kids have been going down in general, but cavities in baby teeth have become more common over the past 20 years. Today, a whopping 60 percent of 5-year-olds have had at least one cavity; many have had five or even 10. Dental decay in kids isn’t just a nuisance—it can cause a lot of pain, and decayed teeth often have to be repaired or pulled using general anesthesia, which, as I’ve previously reported, isn’t risk-free. And when baby teeth are pulled, they can no longer do the important job of holding space for the budding permanent teeth—some of which don’t come in until age 12—so the American Academy of Pediatric Dentistry recommends that dentists fit “space maintainers” in their stead when baby teeth are lost early. Cavities in baby teeth can also harm the permanent teeth directly, if the tissue in the central portion of the baby tooth gets infected.

There is good news, though: “Dental decay is preventable,” says AAPD president Jade Miller. When dentists see a cavity forming, they can actually reverse the process—which is in part why the organization recommends that parents bring their children to the dentist when they get their first tooth or by the time they turn 1, at the latest. (If these recommendations don’t mesh with what you’ve heard, that’s probably because the American Academy of Pediatrics used to recommend the first dental visit by age 3. But since 2003, the AAP and the AAPD have both recommended this timeline.)

To understand how dentists work their magic, you first need to know how cavities are formed. Bacteria in the mouth feed on the sugar and carbohydrates your kids eat, releasing acid in response. This acid breaks down tooth enamel and leads to tooth decay, explaining why dentists aren’t fond of kids consuming candy and juice; sugary foods provide feasts for mouth bacteria and lead to a buildup of cavity-causing acid. (Whole fruit, though, is fine: Chewing it stimulates saliva production, which helps to keep teeth clean, and its fibrous texture stimulates the gums.)

One way pediatric dentists can reverse burgeoning cavities is by applying a fluoride varnish to kids’ teeth, which causes fluoride to be released when the pH of the tooth drops as a result of the acid. The fluoride then helps rebuild the tooth enamel. When I finally brought my daughter to a pediatric dentist last week—those statistics on cavities really rattled me!—he didn’t even try to clean her teeth, because (surprise!) she was so uncooperative. But he did apply a quick fluoride varnish. Fluoride from drinking water and toothpaste can also get incorporated into the tooth enamel itself as it grows, thereby protecting it from future decay.

Of course, pediatric dentists do more than just deal with cavities in young toddlers; they can determine whether kids are doing things that might put them at risk for future cavities. For instance, if you’re letting little Jaden take a bottle of milk or juice into the crib with him at night, that’s a red flag for future cavities, and a dentist would likely tell you to stop. (This is so common it has its own name: baby bottle tooth decay.)  The dentist can also check kids for signs of bigger dental or jaw problems. I got a talking-to about my daughter’s pacifier use, which is causing her to develop a gap between her upper and lower teeth. He advised me to nip her pacifier and periodically trim it more, to make it less damaging and appealing and hopefully prompt her to stop reaching for it.

Infant visits also give dentists the chance to educate parents on what to expect during teething and how best to care for kids’ teeth. If I had taken my daughter in when she got her first tooth, I might not be suffering through daily tooth-brushing battles, because I would have been told to wipe her teeth with a washcloth each day as an infant (which I didn’t do) and to start brushing with a toothbrush at age 1 (didn’t do that either). These are habits that establish oral care as a routine early on, making kids more compliant when they hit the terrible twos. Other important advice you might not have heard: brush your kid’s teeth for them at least once a day until they turn 8 or 9—oops, my 5-year-old son has been brushing solo for at least a year!—because the fine motor skills that make for good brushing “don’t really develop until about the age when a child can begin to tie shoes or write in cursive,” Miller explains; and start flossing when your child’s teeth no longer have space between them, because then the toothbrush isn’t able to reach plaque and debris between the teeth. (Yup, cavities can form between teeth, too.)

OK, but what if you, like me, have a kid who just won’t let you near her pearly whites? Jessica Lee, a pediatric dentist at the University of North Carolina at Chapel Hill School of Dentistry, suggests experimenting with different types of toothbrushes—maybe little Anna would prefer an electronic toothbrush to a manual one, or vice versa. IPad apps like Brusheez, a brushing timer with characters and music, may also make the task more fun. Or, try letting your kid brush your teeth while you’re brushing hers. If you still can’t get in there for more than a few seconds, Lee suggests that you put a rice grain–size amount of fluoride toothpaste on the brush or your finger and at least just get a little bit of fluoride on her teeth. (Generally, a child shouldn’t use fluoride toothpaste until she knows not to swallow it, but it’s OK, Lee says, to use a tiny amount in this way.)

This article originally appeared on 7/29/16, http://slate.me/2av9Yc9

To schedule an appointment or for more information, please visit, www.visitworldofsmiles.com. We have two Portland area locations to serve you.

Snacking and Cavities

Snacking and Cavities

Snacking can increase your child’s cavity risk!

Picture1Dental professionals recommend that eating smaller, scheduled meals throughout the day can help prevent childhood obesity, but also tooth decay! Researchers now know that frequent snacking – or “grazing” – is becoming a major source of tooth decay, especially in children.

Teeth go through a healing process between meals as our saliva naturally remineralizes our teeth from the acidic attacks caused from normal eating. When kids snack on sticky foods such as crackers or fruit chews, the result is a constant attack on the teeth that breaks down the enamel and can quickly turn into cavities.

Here are some more things about snacking that might surprise you.

  • How often kids snack – not just what they eat – can be harmful to their teeth. Teeth need breaks between meals and snacks to prevent cavities.  Your mouth needs time to remineralize.
  • Carbs cause cavities? Starchy foods like snack crackers and bagels quickly turn to sugar and easily get stuck on kids’ teeth. The longer they sit there, the higher the risk.
  • Fruit rolls, fruit chews, fruit juice: not really fruit. While there is a dash of fruit juice concentrate and dried fruit in these snacks, the main ingredient is sugar. Even if the product is “all-natural” or “organic.” What’s more, it gets stuck on teeth and eats through the enamel. Result: cavities.

You may be thinking, “They’re just baby teeth.” But think again. Baby teeth are important! Baby teeth serve several important functions. They help children chew food and speak clearly. They also shape the face and guide permanent teeth into place. Here are some tips for keeping your kids’ baby teeth healthy and strong:

  • Choose healthy snacks like cheese, yogurt, cucumbers and fresh fruit. Limit cavity causers like cookies, candy, crackers, juice, energy/sport drinks and soda.
  • Eat and drink in one sitting instead of sipping and snacking all day long. If you choose to have  sweets or juice, do so with your meal, and wash them down with water.
  • Cavities are completely preventable. Make sure to brush kids’ teeth twice a day, two minutes at a time, with a small amount of fluoride toothpaste—the size of a grain of rice until age 2, the size of a pea after that. Floss once a day as soon as teeth touch.
  • Get your kids’ teeth checked by a dentist by their first birthday, and then twice a year after the initial visit to ensure changes or concerns are caught early!

How Cavities Start

Cavities in children generally begin three ways: Bacteria, Sugar, and Hygiene.

From the time your children are toddlers, many families have found it helpful to keep crackers or other pre-packaged snack foods in the diaper bag, purse, or car for those longer-than-expected car rides or to help with hungry tummies in between meals. Unfortunately, the amount of sugar in most packaged snack items, combined with natural bacteria found in the mouth is a major cause of cavities in children. Gummy vitamins or sticky snacks (fruit leather, dried fruit, fruit snacks) tend to remain in the grooves of the teeth even after brushing which leads to cavities on your child’s molars (chewing teeth in the back).

Natural bacteria found in the mouth can pass from person to person. If mom or dad has an active cavity and they share food or utensils with their child, they can pass the decay back and forth. Bacteria that cause cavities is contagious (like sharing a cold) until treated.

Next time you come into World of Smiles, Pediatric Dentistry feel free to ask the dental staff about additional ways to prevent cavities, and to pick up information about the new SoniCare for Kids electric toothbrush. Education and prevention leads to a healthy smile and happy kids!

Link Between dental issues and poverty

Late last year, The Columbus Dispatch put out an excellent article discussing a recent research study done by Case Western Reserve University. By way of the study, the article assesses the link between obesity and cavities among children living in poverty, and makes a host of valid points. The article is reprinted below. Follow this LINK for the original source material.

Dental issues have big effects in poor kids
by Denise Trowbridge of The Columbus Dispatch

A recent study by Case Western Reserve University researchers shows a link between obesity and cavities among children living in poverty. The study found that as those children age, the risk of obesity increases, as do the number of cavities. The two are related, but not the way one might guess.

“It’s not the obesity causing the cavities or the cavities causing obesity,” said Peg DiMarco, an associate professor of nursing and the author of the study, which examined health data of homeless children in Akron.“Poverty is the underlying cause of both.”

It boils down to lack of access to fresh, healthful foods and to basic dental care.In Columbus, as in other cities, the areas where many people live in poverty “don’t have large grocery stores. They have quick stops,” said Dr. Dennis McTigue, professor of pediatric dentistry at Ohio State University and spokesman for the American Academy of Pediatric Dentistry.“Those places tend to sell processed, high-fat and high-carbohydrate food. When accessing healthy food is difficult, families end up eating the high-carb foods that cause obesity and cavities.”

Although many of the health problems associated with obesity are well-known, such as increased risk for diabetes and cardiovascular problems, those linked with cavities don’t receive as much attention. “Cavities are a silent epidemic, and they’re the No. 1 chronic infectious disease in children,” DiMarco said.

Cavities are five times more common than asthma and seven times more common than hay fever, according to the U.S. surgeon general. They’re caused by an oral bacterial infection and are contagious.The bacteria that cause tooth decay can be passed from person to person via shared spoons, kissing and saliva, DiMarco said. “If a child’s siblings or parent have bad teeth, they can spread that via everyday contact.”

About 37 percent of poor children 2 to 9 years old have one or more untreated decayed baby teeth, compared with 17.3 percent of higher-income children, according to a report released by the U.S. surgeon general.Low-income children are less likely to receive regular dental care, and the cavities are more likely to go unfilled.“They’re more likely to have the more-severe forms of the disease,” said Dr. Susan Fisher-Owens, a pediatrician and children’s health researcher at the University of California-San Francisco.

Overall, about “80 percent of decay occurs in those living in the lowest socio-economic status,” McTigue said. “The neediest financially also have the overwhelming percentage of the decay. “These kids are in pain and can’t eat. Their faces are swollen, they’re not sleeping, not learning in school and not eating well.”

Most people consider tooth decay an inconvenience, said Dr. Paul Casamassimo, a pediatric dentist at Nationwide Children’s Hospital specializing in dental care for children living in poverty.“But in poor children, it’s like a ‘silent spring.’ These kids’ cavities turn into infections and abscesses. The decay causes failure to thrive. They have poorer behavior compared to peers and live in chronic pain. “This can go on for months before they get care.”

Low-income children lose about 51 million school hours each year to dental-related illness, according to the surgeon general. Low-income children also have 12 times more restricted-activity days — meaning days of missed school, play or enrichment time — as a result of dental problems than higher-income children do. Dental pain and suffering also can lead to eating, speaking and socialization problems.

And complications from untreated cavities can lead to hospitalization and death, Fisher-Owens said. Many in the dental community use the example of a 12-year-old Maryland boy who died in 2007 after an infection from an unfilled cavity spread to his brain.

The issue in his case, as well as many low-income children’s, was access to dental care.

Many low-income children rely on Medicaid for dental coverage, but reimbursement rates to dentists are so low that many dentists don’t accept it or limit the number of low-income patients they see.

“As much as we try to dance around that issue, the low reimbursement rate means dentists won’t take Medicaid patients, which undermines the concept of a dental safety net,” Casamassimo said.

According to a recent Pew Charitable Trust study, 38.1 percent of Medicaid-enrolled children ages 1 to 18 received any dental care in 2007, the most recent data available. That compares with the approximately 58 percent of children with private insurance who received care that year.

“Children with severe oral-health problems, once adults, have more heart and lung disease, higher instance of stroke, and if they become diabetic, their condition will be worse,” Fisher-Owens said. “It sets them up for a host of problems.”DiMarco added: “Sometimes, dental problems can initiate a disease that might not have been there otherwise.”

It’s an issue that affects everyone, not just those in low-income families. Society as a whole pays the costs, both social and financial, when cavities progress into severe infection, via lost present and future productivity, and preventable emergency-room visits and hospital bills, Fisher-Owens said.

“The solution is simple and difficult all at the same time,” she said. “People need help living a healthy life. Solving the (dental-care) and underlying diet issues would impact both obesity and oral health.”

How Diabetes Swept The Nation

Obviously, here at World Of Smiles, we are especially concerned with the amount sugar in kids’ diets as it relates to cavities and oral health.  However, the big picture cannot be ignored and this NPR story with accompanying interactive chart illustrate the rapid rise of a very serious health condition.

Click on the image to go to the interactive version at NPR.

NPR Story

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