Yes, it’s that time of year again – Halloween – now second only to the Christmas holiday in the amount of money and attention we pay to it as a culture. Halloween – that time of year when children across the country dream of dressing up as their favorite character and scouring the neighborhood for as much candy as they can carry. And for parents – it’s a time for enjoying the festivities but in the back of their minds – the worry of “sugared up” hyperactive kids bouncing off the walls and the inevitable tooth decay and dental bills from all of that sugar.
But if you think that it all begins with that first candy bar you couldn’t be more mistaken. The truth is that your child’s teeth are at risk long before their first exposure to sugar. Tooth decay is actually the result of a bacterial infection, specifically lactobacillus. Infants are born without these cavity-producing germs but typically are infected by their mothers before the age of two through sharing utensils and toothbrushes.
Once infected, children will be prone to decay for the rest of their lives! Sugars and other starchy carbohydrates contribute to the problem because they are the bacteria’s favorite food. Bacteria easily turn these foods into acids that eat away at the structure of the teeth by depleting calcium. Once the decay process destroys enough of the integrity of the tooth structure, it collapses, causing a cavity or hole in the tooth.
Bacteria do the most damage when they “colonize” on the surface of the tooth and form a transparent sticky film known as “plaque”. Plaque is actually a bio-film and concentrates the acids produced by the bacteria on the tooth surface. The CDC (Centers for Disease Control) estimates that bio-films cause 80% of all human illnesses! It may also surprise you to know that at least 4 million preschoolers (about 40% of all 2-5 year olds) suffer from tooth decay making it the most common disease in children, affecting even more kids than asthma and diabetes!
In recent years tooth decay has been on the rise in part for the following reasons:
- Some communities have opted to discontinue fluoridating their community water supplies. (Fluoride makes teeth more resistant to the acids produced by decay causing bacteria.) This is particularly surprising in light of the fact that the CDC has stated that community water fluoridation is one of the top ten public health advances in the last 100 years!
- There has been an increase in the use of bottled water, which typically does not contain fluoride.
- The prevalence of high fructose corn (HFC) syrup used as a sweetener in most of our processed foods including juices and sodas. HFC syrup can actually be more damaging to our teeth than other sugars! Sodas are particularly harmful because they are acidic to begin with and lower the pH of the saliva, making it even more acidic.
- Many of us get our drinking water from wells that may not be naturally fluoridated.
- Access to care in underserved areas of the country, and in some underserved populations, continues to be an issue in this country as well as a throughout the world.
So here is a list of my top 10 things you can do to improve the dental health of your children:
- Make sure your child has a dental check-up by the age of one as recommended by the American Academy of Pediatric Dentistry (AAPD) and has regular visits thereafter.
- Use fluoride supplements if your local water is not fluoridated. Your dentist or pediatrician can supply you with appropriate prescriptions.
- Limit exposure to sugar and starchy carbohydrates, especially around the holidays. And remember, it’s not the total amount of sweets consumed, but the number of exposures to sweets throughout the day that matters most. I recall the mother of a childhood friend who took control of the Halloween stash and periodically doled it out to my friend over the next several months following the holiday!
- Set a good example. Take care of your own smile by practicing good oral hygiene, brushing and flossing regularly.
- Make sure your child brushes twice a day (after breakfast and before bed) for two minutes each time. Choose a child size toothbrush with soft bristles and replace it every 3-4 months.
- Consider using Xylitol products. Xylitol is an all-natural sugar substitute. It comes from beech trees and other natural plant sources and is “non-nutritive” to the bacteria that cause decay. It is also completely safe. (Studies have even shown that expectant mothers that chew Xylitol gum give birth to children who have healthier mouths!)
- Never allow infants to sleep or toddlers to walk around with milk or juice drinks. This produces what dentists call “baby bottle tooth decay”.
- Avoid toothpastes containing fluoride for children under the age of two; they tend to swallow it. Use water or a non-fluoridated toothpaste.
- For children ages 2-6 years old, use a pea-sized amount of a fluoride toothpaste, and make sure they spit it out after brushing. Any more than that is wasted.
- And remember – when in doubt, ask your dentist. With proper guidance, most children should be able to graduate high school today with no cavities!
There are many helpful references to this important topic, some of which have been used to develop this article. These include the ADA’s brochure: “Happiness is a Healthy Smile: A Message for Parents”, available through your local dentist, and Rebecca Feisenthal’s article in Parents Magazine: “The Surprising Truth About Cavities”, published in the October 2006 issue and available online at: http://www.parents.com/baby/health/baby-teeth/cavities/.
Other helpful websites where you can read more about this important topic include:
http://www.MouthHealthy.org (the ADA’s consumer site with a complete section on babies and kids)
www.choosemyplate.gov (for more information on healthy foods and drinks for your children)
Feel free to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA with any questionsor concerns on this important topic, or to schedule your next visit so we can talk more about this. In the meantime, have a safe and happy Halloween!