Halloween and the Surprising Truth about Cavities


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:

  1. 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.
  2. Use fluoride supplements if your local water is not fluoridated. Your dentist or pediatrician can supply you with appropriate prescriptions.
  3. 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!
  4. Set a good example. Take care of your own smile by practicing good oral hygiene, brushing and flossing regularly.
  5. 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.
  6. 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!)
  7. Never allow infants to sleep or toddlers to walk around with milk or juice drinks. This produces what dentists call “baby bottle tooth decay”.
  8. Avoid toothpastes containing fluoride for children under the age of two; they tend to swallow it. Use water or a non-fluoridated toothpaste.
  9. 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.
  10. 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!

Candy and tooth decay – It’s raining candy; what’s a parent to do?


With Halloween upon us I would be remiss without making a few hopefully helpful suggestions on how best to weather the “ candy storm”! With almost $ 7 billion in sales, Halloween has somehow become the second most popular holiday in America, only outdone by the Christmas season. The Huffington Post reports about $2 billion of that in the sale of candy alone!

No, this doesn’t translate to an immediate need for my services starting the day after, but it does give pause for thought on the consequences of our behavior. The consumption of treats sweetened with high fructose corn syrup not only adds to the problems of obesity and diabetes, but promotes tooth decay as well. Every parent is tasked with the responsibility of how to handle this challenge, so here are a few suggestions to minimize the destruction. I hope this helps.

  1. Take control of the candy supply and dole out sweets periodically throughout the holidays.
  2. Make sure your kids swish with water after indulging to dilute the acids created by  decay causing bacteria. (Don’t brush immediately after eating candy as this could contribute to erosion of enamel!.)
  3. Avoid hard or sticky candies that stay in the mouth a long time and feed those nasty bacteria.
  4. Substitute healthier snacks when possible.
  5. Don’t allow late night snacking before the kids (you too!) go to bed.
  6. Make sure you brush and floss before bedtime.
  7. Insist on fluoride treatments for the kids when at the dental office. (The CDC has called fluoridation of public water supplies one of the top 10 public health advances of the last century!)

I hope you enjoy the holiday and don’t wind up paying the unanticipated costs of overindulgence.


Best wishes,
Larry Stone, DDS

Sugar and health – Everything You Were Afraid To Know


And what you can do about it.

Sugar is not just the bane of your average dentist but of the entire health care community as well. There is an excellent article in this month’s (August 2013) issue of National Geographic outlining the history and general relationship of sugar and health.

Although the American Heart Association recommends a daily intake of no more than 150 calories (9 tsp.) for men and 100 calories (6 tsp.) of sugar for women, consumption has ballooned from an average of 333 cal./ day in 1970 to 363 cal./ day in 2011. That’s over 22 teaspoons a day for the average American! And America is the top consumer of high-fructose corn syrup, the worst form of sugar. That is the equivalent of 51 pounds of sugar per person annually!

The result of all this sugar intake is not just an alarming increase in the tooth decay rate in children but an increase in the incidence of “metabolic syndrome” in American adults, possibly affecting as much as one third of the population! Metabolic syndrome is a condition characterized by obesity, high blood pressure, type 2 diabetes, and an increased risk of heart attack. I won’t go into how this happens (you can read about it yourself if interested) except to say the primary culprit is — you guessed it — sugar!

The solution is obvious — eat less sugar. But this is difficult in a society that puts sugar in everything from ketchup to cornbread. The solution I recommend is Xylitol, a natural sweetener that is FDA approved.
It is also safe for diabetics, prevents ear infections, increases the activity of white blood cells and prevents cavities! You can get all the information you need regarding xylitol by going to: www.Xylitol.org or by contacting our office for more references. We keep an entire list of products containing xylitol that I would be happy to share with you.

To your health!