Category Archives: Cavity Prevention

Kids and Halloween Candy – A Dentist’s Perspective

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A lot of parents that are particularly conscious of their children’s oral health may worry about their consumption of candy around Halloween time.  Should parents be worried?  The key to kids and candy is moderation.  Sugar, although harmful to everyone’s teeth, is fine in moderation.  The key to avoiding cavities is to pay attention to the frequency in which children consume candy.  For example, on Halloween and for a week or so thereafter, most kids have an abundance of candy to eat.  It’s better for their teeth to allow them a few scheduled times throughout the day to consume candy, as opposed to eating it all day long.

As I mentioned in my previous blog, Does Chewing Sugar-Free Gum Decrease Your Risk of Cavities?, cavities are formed by demineralization of the teeth.  After you eat, the pH in your mouth drops.  This increase in acid is a by-product of the bacteria that reside within our mouths that feed on sugar and other carbohydrates we consume.  The acid then causes demineralization of enamel, which turns into decay.  After one eats, the low pH can remain for 20-60 minutes.  Therefore, if kids take 20 minutes to gorge on candy, after their last piece the pH can remain low for up to an hour.  However if they were to snack on candy all day long, their pH can stay low ALL DAY, resulting in an enormous risk for greater decay.

Prior to writing this blog, I looked at numerous articles currently written about kids and their Halloween candy.  One of my favorites was an article on MSNBC’s Today’s Health Blog, “Let kids gorge on Halloween candy, dentists say”.  This article suggests letting kids gorge on Halloween candy once or twice a day, instead of allowing them to bathe their teeth in sugar all day long, producing a very acidic oral environmental where bacteria will surely thrive.  The article also stated:  ”Candy is not necessarily the worst thing for your teeth, anyway. The factors that really lead to cavities are stickiness and acidity. Potato chips and pretzels, for example, are worse offenders than chocolate, because these cooked carbohydrates cling to your teeth — giving mouth bacteria something to feast on longer and thus generating more acid.”

The one very detrimental mistake I found in most articles though, suggested that you have your children brush their teeth immediately after eating candy.  The acid present in the mouth after one eats, in conjunction with the bristles moving swiftly across one’s teeth, essentially rubs the acid into the teeth.  This could causes severe erosion of the tooth structure if done repeatedly and often, and could actually increase one’s risk of decay.  A better alternative to this, would be to chew sugar-free gum immediately after, which encourages an increase in pH within 20 minutes as opposed to an hour.  After about 30 minutes, you can then have them brush their teeth.  If you don’t want your kids chewing gum, then wait at least 1 hour before having them brush their teeth.  At the end of an hour it is a good idea to have them brush, just not before then.

Here are some tips mentioned by Delta Dental’s website in their article, “Sugary, sticky Halloween treats can play tricks on children’s teeth”

Tips for limiting the effects of sugary treats

  • Choose candy that can be eaten quickly and easily to limit the amount of time sugar is in contact with the teeth.
  • Steer away from sticky candies like gummy fruit snacks, caramel, taffy, popcorn balls and other candies that expose the teeth to sugar for long periods of time.
  • Limit consumption of sour candies that may contain acids (such as citric acid) to intensify the sour flavor. These acids can contribute to dental erosion and cavities.
  • Encourage children to eat a small amount of candy in one sitting followed by a glass of water or a thorough tooth brushing. [**remember to wait for at least one hour before brushing!]
  • Encourage children to eat a good meal prior to trick-or-treating, so there will be less temptation to fill up on candy.
  • Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
Some dentists may advise their patient’s to not let their kids have any candy.  Like Mansfield, Ohio dentist Dr. Craig Callen, who is running a cavity-preventing drive around Halloween.  He says he will offer $1 for every pound of candy from trick-or-treaters.  Although his motive for the drive to decrease the risk of decay in children around Halloween is surely admirable, I don’t think a total abolishment of candy for children during Halloween is necessary.  Let your kids indulge once a year, just be smart about it.

Why Vegetarians May Have to Work Harder to Maintain Good Oral Health

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While reviewing the website www.knowyourteeth.com sponsored by the Academy of General Dentistry I came across an article highlighting oral health concerns dentists carry for their vegetarian patients. Many dentists ask their patients about their diet, and find those that are vegetarian tend to be very knowledgeable about nutrition. The concerns however, tend to be directed towards children on vegetarian diets that may be lacking essential nutrients, and with adults that also may be lacking essentials needed for proper tooth and gum health.

According to Dr. Ludwig Leibsohn, some vegetarians, particularly those who do not consume any food of animal origin, can experience deficiencies in calcium, vitamin D, riboflavin, vitamin B12 or complete proteins. Studies show that by eating the right amount of fruits, vegetables, grains and legumes, they can get the nutrients they need. “An adult on a vegetarian diet for a prolonged period can be at increased risk for periodontal (gum) disease from a lack of vitamin D and calcium,” says Dr. Leibsohn. To reduce this problem, Dr. Leibsohn suggests that vegetarians seek counsel from a nutritionists and take a multi-vitamin daily.

Another concern for vegetarians is their potential lack of Vitamin D. Teeth can become more susceptible to decay and periodontal disease with a lack of Vitamin D. Although Vitamin D is produced with sun exposure, if one is out of the sun often and not consuming any in their diet there is a possibility of a deficiency. According to Dr. Leibsohn, adding vegetable margarines or soy milk to one’s diet will solve this problem.

In conclusion, it’s important to have an open line of communication as a patient with your dentist and any other doctor’s you see. If we have all the information, it allows us to better asses your health conditions as a whole and suggest any additional care needed.

Read the article for yourself here:
Dentists Should Advise Vegetarians on Good Oral Health

Does chewing sugar-free gum decrease your risk of cavities?

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Santa Fe Dentist

Chewing Sugar-free Gum Prevents Cavities

I’ve had many patients ask me how to decrease their risk for cavities.  A simple way to avoid cavities is to chew sugarless gum for 15-20 minutes after eating a meal.  How does this help?

After you eat food your pH level in your mouth drops, making your mouth a more acidic environment. This gives bacteria a better environment to thrive in. Chewing sugar-free gum after eating enhances salivary flow. The increase in salivary flow enhances the buffering capacity of saliva to bring the pH in the mouth back to neutral more quickly. In addition, findings have suggested that chewing sugar-free gum after eating promotes remineralization and inhibits demineralization of tooth structure. Several studies have shown that those that chew sugar free gum after eating have a significant reduction in number of caries (cavities) when compared to a control group.

There are two main types of sugar-substitutes used in sugar-free gum.Santa Fe Dentist
1. Sorbitol
2. Xylitol
From a chemical standpoint they are both very similar and are classified as sugar alcohols. Sorbitol is less expensive for manufacturers, and thus tends to be more widely used. These two sugar alcohol’s can be separated by one important factor. Sorbitol is low-cariogenic vs xylitol which is non-cariogenic.
Low-cariogenic: this means that the item, in this case, sorbitol, has a low capacity to promote caries (cavities).
Non-cariogenic: something that is non-cariogenic actually inhibits caries formation, such as xylitol.
Both options would be a good option to replace regular gum, but in terms of caries prevention, a gum made with xylitol would be better.

Some xylitol-containing chewing gums for your caries prevention:
1. Spry Gum(this gum has the highest concentration, and thus most effective use of xylitol)
2. Emerald Forest Chewing Gum(this is also a good option)
3. Trident
4. Ice Breakers
*Although trident and ice breakers gum doesn’t offer as much xylitol as spry and emerald forest, they are easier to find at any drug store or grocery store and still should be incorporated as part of your caries prevention.

Santa Fe Dentist

Chewing gum that has the American Dental Association seal of approval
1. Dentyne Ice Sugarless Gum
2. Stride Sugarless Gum
3. Trident sugar-free Gum
4. Wrigley’s Extra sugar-free Gum
5. Wrigley’s Orbit sugar-free Gum
*Although these contain the ADA seal, they do not necessarily all contain xylitol. Some of them contain sorbitol.

To reference a JADA article in 2006 titled, “The use of sorbitol- and xylitol-sweetened gum in caries control”:
‘The ability of chewing gum to aid in caries control comes from the chewing action itself—which stimulates saliva flow—and the noncariogenic sugar substitutes used as sweeteners. Sugared gum is cariogenic (meaning it causes caries aka cavities), so all gums used in caries-control regimens need to include a nonsugar sweetener. The rationale is that when sugar is plentiful in a person’s diet, cariogenic bacteria such as mutans streptococci thrive in plaque flora, but they can become suppressed when the person’s diet is low in sugars. Xylitol-sweetened chewing gums are being studied for their anticariogenic action—that is, whether they actively assist in remineralizing early carious lesions as opposed to playing just a neutral role.’

For more information click the following links:
Sorbitol vs Xylitol
The effects on chewing sugar free gum after meals on clinical caries
The use of sorbitol- and xylitol-sweetened chewing gum in caries control
Maintaining Mutans Streptococci Suppression
ADA’s List of Approved SF Gums

Dental Care From Birth to Four Years Old

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By Mikaeya Truesdell, DDS

When you have a new little one in your life to love and care for there are so many things you must learn, so many questions you will most likely have.  Because of the abundance of information exchanged during this time one important thing that may be overlooked is your child’s dental health.  The American Academy of Pediatric Dentistry recommends that children have their first dental visit by age one as it is a good idea to get your child familiar with this routine.  I have included here a few key oral hygiene points here as well as suggestions of how to properly care for your child’s dental health from the ages of newborn- four years old.

You should first notice your child’s teeth coming in around age of five to six months, however these teeth begin forming in the womb at around the fourth month in utero.  This means that as a mom you should be very careful about what types of medicines you are taking and make sure you are keeping yourself nourished.  The first teeth to come in are usually the bottom two teeth followed by the top two teeth.  The last teeth to come in are usually the back second molar teeth, which typically come in by age two.  It is important that as these teeth are coming in you are brushing them for your child as they are typically not going to be old enough to do this themselves.  It is recommended that you use a non-fluoridated/child’s toothpaste until your child is old enough to spit out the excess as opposed to swallowing it.  At around age three it is a good idea to start a flossing routine because this is around the age where the back molars start to come close together and food can get trapped between them and start cavities.  The most important point here is that even if your child is not yet eating solid foods the milk/formula that they are consuming contains sugars that can start cavities in the teeth so brushing routines should start as soon as the teeth come in.

A cavity develops when the teeth are exposed to an acidic (sugary) environment for an extended period of time.  As far as diet is concerned you should avoid giving your child excess sugars including those that can be found in juices and crackers/candies. When your child does have juice it is a good idea to dilute this with water as that lessens the sugar content.  Another very important thing to remember is that you should never put your child to bed with a bottle or sippy cup.  If you must do this there should only be water in the bottle or sippy cup.  When children are sleeping they are unable to wash away the liquids from their teeth and thus if they are drinking sugary drinks during the night the sugar sits on their teeth until the morning.  This is one of the most common reasons for early childhood tooth decay.

Some final points include trying to avoid dental trauma.  Although you will find that children are very accident-prone it does not hurt to try to prevent what you can!  One important thing that I am sure everyone is aware of is that you must keep your child away from all electrical cords.  Children will instinctively put these in their mouths and they can acquire a very severe lip burn that takes many months to recover from.  Another thing to watch for is when your child starts learning to ride a bike or do any other sort of sport activity; mouth guards and helmets are a VERY smart idea.  If your child does encounter any sort of dental trauma at this age such as a chipped/knocked out front tooth call your dentist as soon as possible so an xray and any further treatment necessary can be done.

I hope this has given you a little taste of what to expect for your child from a dental perspective when they are young.  As emphasized before the most important thing to develop at this time in your child’s life is a dental routine to include at home brushing as well as semi annual dental visits.  And it never hurts to cut back on the sugars!

Smoking DOES Cause Tooth Loss

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An article written in JADA (The Journal of the American Dental Association) in October 2010 discussed a study done in New South Wales, Australia studying the long-term effects of smoking.  With the data of 103,042 participants they were able to come to interesting conclusions.

The results of the study indicated a significant increase of complete tooth loss (“edentulism”) in smokers compared with nonsmokers.  Their most startling claim: ”Current smokers were at more than twice the risk of experiencing complete tooth loss compared with never smokers.”  In addition, they discovered, that although the risks are much lower with people that have stopped smoking for 30 or more years, they remain at a higher risk than those that had never smoked.

Furthermore, they learned that although people may not be smokers, being in an environment with others that are can be detrimental.  Researchers found individuals that have never smoked but are around ETS (Environmental Tobacco Smoke) for six or more hours a week, are almost one and a half times more likely to lose teeth than nonsmokers not around ETS.

Lesson?  If you want to keep your teeth, I’d stay away from the cigarettes.  And if you’re already a smoker, I’d try quitting.  You don’t want to lose your pretty smile!

Learn more about the study here