Ran across this video today. It’s basic, but a good synopsis of the dangers of sugar. Check it out if you have a few minutes.
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.
What does fluoride do?
According to the American Dental Association, fluoride benefits both children and adults. Here’s how:
Before teeth break through the gums, the fluoride taken in from foods, beverages and dietary supplements strengthens tooth enamel making it stronger and more resistant to cavities. This provides what is called a “systemic” benefit.
After teeth erupt, fluoride helps rebuild (remineralize) weakened tooth enamel and reverses early signs of tooth decay. When you brush your teeth with fluoride toothpaste, or use other fluoride dental products, the fluoride is applied to the surface of your teeth. This is provides what is called a “topical” benefit.
In addition, the fluoride you take in from foods and beverages continues to provide a topical benefit because it becomes part of your saliva, constantly bathing the teeth and helping to rebuild weakened tooth enamel.
How and where do we get fluoride?
Fluoride is naturally present in variable concentrations in ground water, ie water from a faucet or water generally used to cook with. A certain amount of fluoride does occur naturally in rivers etc. Bottled water, distilled, or deionized water generally does not contain fluoride.
In addition, fluoride is provided in most toothpastes, as well as some mouth rinses. This is a very important part of cavity prevention, so be sure fluoride is in the toothpaste that you use.
What is community water fluoridation?
Water fluoridation is the process of adding additional fluoride supplements to a community’s water source. Years ago, the government decided to add some fluoride to certain communities with naturally occurring low fluoride levels due to the high prevalence of cavities throughout the population. About 72% of the US is served by fluoridated water systems. Once fluoride was added to community’s water source, the cavities rate was significantly decreased. Simply by drinking tap water, people can decrease they risk of decay.
Not drinking tap water? If you’re an individual who only drinks bottled water, you may be at risk for not receiving an adequate amount of fluoride to decrease your risk of decay. Talk to your dentist about this. They may suggest fluoride supplements, or a change in toothpaste with an increased percent of fluoride concentration.
What puts you at risk for decay?
There are many things that can increase your rate of decay, or number of cavities.
1. Poor oral hygiene.
The number one cause for cavities is poor oral hygiene. This means those that don’t take good care of their teeth, ie proper brushing twice and day and flossing once a day.
Such as high intake of sugar or certain foods that lend itself to a better environment for bacteria to thrive within the mouth such as fruit, crackers, breads, potato chips. Also, eating many meals throughout the day increases your risk due to a change in the acid level of the mouth, which takes 30 minutes to stabilize after eating.
Soda, even diet soda, when consumed throughout the day can be very detrimental to teeth. As can any other beverages with high acidity or large quantities sugar. This includes fruit juices.
4. Medications that cause dry-mouth.
Bacteria tend to thrive in mouths with very little saliva.
5. Uncontrolled diabetes.
There are many factors that play into one’s risk for decay. For a thorough evaluation to be sure you’re not at high risk, visit your dentist.
Ways to receive additional fluoride.
Again, as noted from above, fluoride supplements are available. In addition, your dentist may want to occasionally treat your teeth with fluoride. This usually done with a fluoride gel, placed in trays that you sit with for under 5 minutes. In addition, there is also a fluoride varnish that can be placed onto your teeth which is meant to be brushed off the next day.
If you are at a higher risk for decay, your dentist may want to change your toothpaste to a higher concentration of fluoride such as Prevident 5000 or have you use additional products like MI Paste.
The ADA provides answers for your fluoride questions:
American Dental Associations Take on Fluoride
I read an article last week titled “Why Your Dentist Costs So Much”… and I thought I’d write a quick blog from a dentist’s point of view as to why it’s so expensive to get dental treatment. I agreed with many of the points I found in the article, so I borrowed their basic titles.
1. Dental care is not a commodity
Dentistry is not like buying socks or going to the grocery store. It’s a highly technical profession integrating art and science. Dental school for students is a four-year program, post-undergraduate. This is the same amount of time it takes a medical student to receive an MD. In addition to that, the price one pays to go to dental school has become astronomical, especially considering that few if any students have time to work while in school, so the loans they accrue must include their price of living. Depending on what city they’re in, this can add a substantial amount to their overall price to become a dentist. It takes many dentists 30 years to pay off all their loans!! It’s a high price to pay to become a dentist.
2. Overhead costs are huge
On average, anywhere from 55%-80% of what a patient pays goes towards the expense of what it costs to run a modern dental office. The materials, instruments, rent or mortgage, computers, machines, costs for licenses, insurance, payroll for hygienists, assistants, office managers, receptionists; it all adds up very quickly. Many people would be shocked at the cost it takes to run a practice and at the very small margin of profit that dentist’s benefit from. And then consider all that, plus loans!
3. Lab Fees
On top of the overhead, dentists have to pay lab fees to a lab for the fabrication of many fixed and removable dental appliances. This includes fees for crowns, dentures, partials, night guards, etc. While some dental labs may offer cheap prices for crown fabrication, this does not mean that the crown is of high quality. And while fees may vary based on regional location, they’re never “cheap”. For instance, a fee for a crown from a lab can cost the dentist up to $500.
4. Dental Insurance is much different from Medical Insurance
Most dental insurance companies tend to just be a maintenance plan, covering the cost of exams, x-rays, and cleanings but requiring the patient to pay 20-50% of any restorative work like fillings or crowns. In addition to that, most people’s maximum annual benefit is around $1000, meaning once the patient has had enough work to reach that maximum, the patient is required to pay 100% of the remaining work to be done. Most people expect their dental insurance coverage to be much better than what it is, or to be similar to their medical coverage. I’ve seen many patients shocked and even angry at their insurance when they realize that they will have to pay a substantial amount to get all the work they need done.
Side note: Most dentists do what they do because they love it. And we want you to care about your teeth. Your teeth are not only a significant part of your appearance but also your health. Studies are released everyday linking severe gum and bone disease such as periodontitis to other health problems like heart disease. If you have an active infection in your mouth, it’s important to get it treated. Bottom line? Find a dentist you can trust, and one that cares for your overall health.
I can’t tell you how many times I’ve heard a patient say, “I’d love to do all the treatment, but I just can’t afford it.” In the most recent ADA News an article was written offering tips to practices on how to assist patient’s and their financing. So, how can our office and other offices help people afford their treatment in these trying economic times?
1. Offer more payment options
Most practices accept credit cards and more than 65% offer a third-party financing program. Offering patients payment plans allows them to get the healthcare they need, in order to rid their bodies of infection and eat and live comfortably with healthy teeth or fitted prosthetics. Cindy Hearn, vice president of the financing program CareCredit says, “Patients appreciate being offered a variety of payment options that allows them to choose the one that best fits their lifestyle and financial needs, especially in today’s economic environment.” I have found this to be true in my experience as well. Patients want to take care of their teeth and oral health, and this allows them some breathing room to be able to set up a financial plan to do so.
CareCredit seems to be the most common third-party financing program, and is the only payment plan endorsed by the ADA Business Resources. Many practices have utilized CareCredit for years in order to better assist their patients. The allure to CareCredit, besides its prestigious endorsement by the ADA, is their gentle and fair approach to patients. Their reporting process is reliable and easy to understand, alleviating patient’s stress. (Our office is currently a provider for CareCredit, for more information please see the end of this post.)
2. Put patients at ease
It’s important for dentists and their staff to fully educate the patient on their needed treatment and the prices that accompany it. In addition, if the office offers various payment plans, the patient should be made aware of these plans in order to assist them in paying for their treatment. The best way to do this is to give the patient a written financial policy prior to any treatment. It is then wise to discuss the treatment fee’s and payment options with the patient, to work together to create a plan and schedule. At my office this is top priority, and we always strive to work together with the patient. A dental office should be a caring compassionate environment where the doctor, staff and patient can all work together to provide the patient with the best treatment possible. We don’t want the patient to be surprised with any fees they were unaware of before treatment commences.
3. Patient payment program
Offering the patient CareCredit or other financing options, like holding their credit card for monthly withdrawals can be helpful for patients. In addition to CareCredit, my office also offers EPS90: a 90 day no credit check EZ payment plan. This can help those patients that may have questionable credit and would prefer to utilize a no credit check financing plan.
For more information as to what payment plans my office offers, or to schedule, visit the following page for our office info: Services and Scheduling
As the prevalence of technology increases, so does the studies on what it’s doing to our brains. On May 9th 2011 the NY Times published an article titled, “Fixated by Screens, but Seemingly Nothing Else.” The article described a concern many parents are having: their children can’t seem to focus on anything for any length of time, except for the television or computer screen. They’re asking, why do my children, with so many signs and symptoms of ADHD (Attention Deficit Hyperactivity Disorder), have no difficulty focusing on the television for so long? Many studies have ensued to explore this very issue.
Scientists have discovered that a child’s ability to stay focused only on a screen is actually characteristic of ADHD. But the question becomes, is the child’s obsession with the screen causative or correlative – or both? Dr.Christopher Lucas, associate professor at New York University School of Medicine says that the type of concentration a child brings to the television, computer or video games, is not the same type of concentration that allows one to be successful in school or real life. He elaborates that their focus on the screen is “sustained attention with frequent intermittent rewards” opposed to real life concentration of “sustained attention in the absence of rewards.”
The high of video games and their frequent intermittent rewards provides the brain with a rush of dopamine. Those with ADHD may have a dopamine deficit, causing those children to more easily become hooked. One study, as noted in the NY Times, sited that when an ADHD patient is treated with methylphenidate (Ritalin), which increases dopamine activity in the brain, they played video games less. Thus indicating the likelihood that these children with ADHD are actually self-medicating with video games.
On the flip side, some research has indicated that those who play video games more often, both children and college undergrads, are actually more likely to develop attention problems later. They said that due to the quick pacing of video games and their frequent rewards, those that play them often may find real life to be boring and under-stimulating.
Elizabeth Lorch, professor of psychology at University of Kentucky found that children with ADHD were able to recall facts from a televised story but not the narratives. This not only creates problems academically, but sheds light on possible social difficulties due to their inability to see causal relations. Some of these kids are rejected by their peers, quite possibly due to their inability to understand and connect with the people around them. This can create a self-perpetuating loop, running kids back to the video games, increasing their social detachment and causing further difficulties in focusing their attention in the future.
Solutions? Monitor the amount of time your children spend in front of the screen. Try creating an environment of more frequent rewards. And if you suspect your child does have ADHD, have them see a physician or a pediatrician. It may be appropriate for a child to be on a small dose of mediation and have a stronger, healthier social lifestyle than to be in front of a screen self-medicating all day.
Wisdom teeth will start to erupt anywhere from the age of 12-26. The average age of their removal is 16-18 years old. The wisdom teeth, or “third molars”, usually do not have enough room to fully erupt. When they do erupt they could cause a number of issues. First, they could cause crowding of your other teeth. Another problem, is when the wisdom teeth grow halfway in causing inflammation and an infection of the gum behind the second molars. Third molars also have a high predilection to become decayed and cause decay behind the second molars.
There are two good reasons for leaving wisdom teeth. Number one: if it appears they’re going to fully erupt and be cleansable, as determined by you and your dentist. If you have fastidious oral hygiene, perhaps your third molars can be left in place. The second reason for leaving wisdom teeth is if they remain under the tissue within the bone with no expectation of eruption (let sleeping dogs lie).
As to the question of when to remove wisdom teeth, it depends on the positioning of the upper third molars. If their eruption is at or near the enamel of the second molars it makes their removal much easier. Therefore all four wisdom teeth could be removed at the same time. If the lower wisdom teeth are causing pain, and the upper wisdom teeth have not adequately erupted, then consideration should be given to removing the lower wisdom teeth only.
Some dentists take out wisdom teeth, while others may refer you to an oral and maxillofacial surgeon. If you’re experiencing pain with your wisdom teeth, upper or lower, it would be wise to seek guidance from your dentist.