Dental Health affects School Performance and Self-esteem

A recent nationwide study published in Pediatrics demonstrated a significant correlation
with reductions in school performance and psychosocial well-being. Children with dental problems were more likely to have problems at school and to miss school, and were less likely to do all required homework. Dental problems were associated with shyness, unhappiness, feeling of worthlessness, and reduced friendliness. The effects of dental problems on unhappiness and feeling of worthlessness were largest for adolescents between 15 and 17 years.

Conclusion
Preventing and treating dental problems and improving dental health may benefit child academic achievement and cognitive and psychosocial development.

A reminder to start early.  The first tooth deserves a dental home.  If you are going to prevent tooth decay, you have to start before the decay starts.

Winning With Smiles Children's Dentistry

It is Not Just About Cavities

Oral Health.  It is not just about cavities.  Here are two significant briefs from the literature highlighting that oral health has wide reaching implications for your total health.

  
Risk for Two Birth Defects Affected by Overall Quality of Pregnant Woman's Diet.  Medical News Today – October 4. The overall quality of a pregnant woman's diet is linked with risk for 2 types of serious birth defects, according to a new study in the Archives of Pediatrics & Adolescent Medicine.

In the study, women who ate better before and during pregnancy gave birth to fewer infants with malformations of the brain and spinal cord, or orofacial clefts, such as cleft lip and cleft palate. “Our study showed for the first time that the overall quality of the diet, and not just a single nutrient matters in terms of reducing the risk of birth defects," say researchers. The study is also the first to connect diet quality with reduced risk for cleft lip or cleft palate. 

Oral Health of Diabetes Patients Closely Linked to Heart Disease and Cancer Risk.  Medical News Today – October 3.  A new report in the British Dental Journal reveals that many individuals who suffer with diabetes are not aware that their oral health is closely connected to their risk of developing complications. According to the authors, inflammation from gums that are swollen can increase the severity of diabetes, increase deaths from oral cancer, and make cardiovascular disease worse. In addition, diabetes that is longstanding and poorly controlled seems to speed up the development of gum disease. However, a survey of 229 adults visiting a diabetes clinic discovered that the majority were unaware of any connection between dental health and their condition. Only 13% of participants were aware that swollen or tender gums could be affected by the disease, and only 12% knew there might be a connection between the disease and loose teeth.

Good oral health habits as well as good eating habits are just the beginning of living healthy productive lives.  What you put in your mouth and how you care for your teeth will have a definite impact on the quality of your life forever.  It is not just about cavities.
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To learn more, contact WinningWithSmiles.com or call 530-878-2357

Bad Teeth...Bad Grades!

A recent study at USC and published in the Journal of Public Health verifies that children with poor oral health have, on average, lower grades. They also miss more days of school due to tooth aches and dental appointments. It also pointed out that parents of these students miss more days of work due to the need to care for their children's dental appointments.

One of the tragedies here is to know this is so simple to prevent, though without adequate information, parents find it difficult to accomplish. An early start (age 1) with good instruction will demonstrate to parents how simple it is to give children an excellent start to a lifetime of good oral health.  Cavity free, healthy, beautiful smiles.

Tips for Optimum Oral Heath During Pregnancy

Pregnant?  Your and your baby’s optimum oral health and general health can begin today!

In a previous blog I emphasized how important oral health is to the health of your pregnancy and your baby.  What can you do now, even before a good dental examination to maximize your oral health?

Gum Chewers and Mint Poppers 
If you chew gum or use mints, be sure to buy ones with xylitol as the first ingredient, and preferably the only sweetener in the ingredients list.  Xylitol is well documented as a cavity-preventing sweetener.  Find xylitol (gum, mints, toothpaste, etc.) at your health food store, Internet, and checkout stand (spry, glee, ice cubes, frost, epic, & more).

2 Minutes 2 Times

Brush your child's teeth for 2 minutes, 2 times a day!

As I have told you in previous blogs, doing fillings and crowns on teeth does not improve oral health or dental health. Effective prevention of dental disease requires a little simple education of the patient and the desire to have healthy, cavity free beautiful smiles. With that in mind the California Dental Association and American Academy of Pediatric Dentists and 12 other organizations have started a nationwide educational program designed to help patients improve their own oral health and prevent cavities.


2min2x.org is the website it will originate from and where you can find all the information needed to create oral health for you and your children. It includes great videos to educate, entertain and motivate your children to want and achieve good oral health.  Check it out!

Winning With Smiles - Pediatric Dentistry
Meadow Vista, California 95722

Setting Your Child’s Cavity Risk Early

Few people realize that cavities are the result of a contagious disease. As infants, when we are teething those precious little baby teeth, we are also being exposed to the kinds of bacteria that cause cavities. These bacteria typically come from our closest caretakers, like moms, dads, nannies and siblings. Typically via slobbery kisses, shared spoons, and other close encounters. It is inevitable so don’t panic about it. However, there are numerous ways to insure this contagion will not destroy your child’s teeth.

First, reduce the amount of bad bacteria being transferred to the child. Parents with clean healthy mouths and no recent cavities will have fewer of the cavity causing bacteria in their saliva. Learn how to truly clean your teeth when brushing and flossing. Also, if you are a gum chewer or mint popper, find Xylitol gum and mints on the internet and health food stores. There are numerous studies showing dramatic reduction of the cavity causing bacteria in the mouths of those who put Xylitol (a natural sweetener) in their mouths several times daily.

Secondly, don’t feed those bacteria and promote their growth. These bacteria thrive on sugars and simple carbohydrates (cooked starch). It has been shown that frequent (frequency is the issue here!) exposure to simple carbohydrates promotes the preferred growth of the cavity causing bacteria (mutans streptococcus, sobrinus streptococcus, etc.). If we promote these bacteria early, they establish in high numbers and will continue to be in high numbers in the saliva and on teeth for a lifetime. Juice is an especially common mistake in sippy cups and bottles. Let’s not do that to our children. When your children are ready to give up milk and formula in the bottle, move to water. Do not, I repeat, do not start them on juice or any other sweetened beverage when they move away from milk, unless your pediatrician has specifically written a prescription for your child to have juice because of some metabolic reason. Ask your pediatrician and they will confirm this. The American Academy of Pediatrics does not support the use of juice as a snack or hydration beverage until age 4. Even at age 4 there is a word of caution and recommendation for continued use of water.

Thirdly, clean your child’s teeth effectively each day. It has been shown that the more the plaque (a biofilm of over 600 different bacteria) builds on the teeth, the more it promotes the acid loving bacteria that cause cavities. By simply disrupting this biofilm each day and forcing it to rebuild will prevent it from maturing to the level that it harbors and promotes the growth of the acid loving bacteria that make cavities. As the plaque matures and stagnates, it supports acid loving bacteria which begin to flourish and dominate the plaque. As acid loving bacteria numbers grow, they begin to control the plaque growth and with a higher balance in the saliva, they cause a more rapid maturing of the plaque into a destructive acid loving plaque which dissolves holes in the calcium rich enamel of your teeth. Once established, this balance can be extremely hard to change and may remain for a lifetime. Don’t let it start.

Give your kids a healthy start. Help them become water drinkers as a habit and you will create a lifetime of better health for them. Clean the gum line and between teeth daily to promote a healthier bacterial balance in your mouth’s dental biofilm. If you like gum or mints, discover Xylitol.

Give Your Teeth a Rest

I get a chuckle when children come into the office the week after Halloween or Easter.  They have eaten a bunch of candy in the last week and are worried that it made some cavities.  The reality is cavities take months or more commonly years to form.  When the complex biofilm of bacteria develops in the nooks around your teeth it creates acids as a byproduct of sugar metabolism.  These acids dissolve calcium out of tooth enamel.  As the disease progresses the enamel first develops a white mark as the calcium is dissolved out.  The enamel is softening and beginning to look like white chalk.

Next the microscopic voids where calcium has dissolved begin to collect stain and the mark on the tooth darkens brown or black.  Eventually the softening of enamel reaches the point that pieces of enamel begin to chip out and leave a hole, the cavity.  Depending on your habits, this process can take months or years or never become a cavity at all.

Each time we put simple carbohydrate (sugar or cooked starch) in our mouth the dental biofilm will function at a high metabolic rate for about 40 minutes.  During this time the high acid production is attacking all teeth.  Calcium is being dissolved out of our teeth in large quantities.  Don't despair!  Saliva has the ability to capture and hold that calcium in super saturation.

After the 40 minutes of high acid output, the biofilm bacteria hibernate and wait for their next sugar meal.  Now the saliva can neutralize the remaining acid.  When the mouth is neutral, the calcium balance favors calcium uptake and so the enamel recaptures the calcium that was lost during the acid attack.

If we eat 3 meals and a snack each day our teeth are under attack for about 5 hours each day and they here 19 hours to REST and RECOVER the calcium they lost.  A good balance with good rest time.

Grazers, however, especially children, have acids attacking their teeth all day with little or no recovery time.  If a child eats 3 meals and also has a sippy cup of juice to sip (hourly) between meals, her teeth will be under attack all day.  No recovery period for the teeth to regain lost calcium.  If the child goes to sleep sipping something, it will pool in the mouth and feed the bacteria all night.  The acids are attacking all day and all night!  This is why I have seen teeth with no detectable cavity on exam or x-ray develop a cavity so large and deep it requires a root canal treatment and crown within 6 months.

Give your teeth a rest!  Eat 3 meals and a snack and give your teeth a chance to rest and recuperate between meals.  If you like sweet beverages have them with meals where the sugar and acids get buffered by the other food.  For snacks use protein (nuts, seeds, cheese) and complex raw carbohydrate (carrots, celery, cauliflower, broccoli, jicama), perhaps with a nut or cheese spread.  Calories with robust nutritional support and no simple carbohydrates to threaten teeth.  Between meal beverage?  Water.  Only water.  That is what the human body needs.

Next:  1) Setting your cavity rate early.  2) Changing your cavity rate.

Sports/Energy Drinks - Are We Addicting Our Kids to Them?

We all want more energy and more alertness on the playing field, whether it is sports, debate, cards, or just joking around.  It is not surprising the distinction between sports drinks and energy drinks is blurring.  The concerns for our youth with growing bodies and developing physiologic systems are multiple.  The sugars in these drinks are addicting enough and challenging to the insulin endocrine system.  The energy drinks, however, are fundamentally different due to many additives in them.

The most obvious concern is caffeine.  Energy drinks typically contain 10 mg (to 16 mg) per ounce.  This totals 240mg (to 390 mg) for a 24 oz. drink.  Note: The amount of caffeine necessary to create measurable physiologic changes in a full size adult is about 50mg.  Also note: Cardiac arrest (heart failure) has been anecdotally associated with drinking large energy drinks.  Although the direct causal relationships has not been proven (obviously difficult research to do if someone’s life is at risk), the implications are obvious.  For some young children with sensitive myocardium (heart muscle) the potential threat is clear and catastrophic.

Are we addicting our children's physiologic developing systems to caffeine?  The amount of caffeine for full size adults to develop an addiction is about 100 mg per day.  In a recent study of 228 families with young children, 75% of the children consumed caffeine.  For those children who consumed caffeine, the average daily consumption for 5 to 7 year olds was 52 mg and for 8 to 12 year olds it was 109 mg.  Yikes.  An additional note about caffeine for youth.  Caffeine consumption in youth age 5 to 12 has been correlated with decreased average sleep.  Sleep studies have linked inadequate sleep with ADHD type behavior.

Guarana, an additional ingredient in energy drinks contains both caffeine and guaranine, a stimulant that acts very much like caffeine in our bodies.  The amount of guaranine (nor Guarana) is not listed in these drinks.  Guaranine has documented cardiac side affects like caffeine and the medical literature recommends patients under cardiac care consult their physician before taking any Guarana supplements.  I have not seen a potency comparison between caffeine and guaranine, but the cardiac affect of the 2 is additive.  Should we be allowing our growing athletes to consume these addictive substances?

Taurine, another ingredient, an amino-acid, is more difficult to pinpoint.  The literature contains a broad list (with some warnings) of the possible effects and mechanisms of this stimulant.  Though we know it stimulates changes in physiologic function within cells, the specific results are ambiguous in the research literature.  It is added to these beverages because of its stimulant value.  It is concerning to me when I realize children with developing physiologic systems are consuming supplemental amounts of taurine.  All of these ingredients (Caffeine, Guarana, Taurine) came to us from ancient cultures in which the shaman discovered the mood altering capabilities of these herbal plants. 

Once again I come to some basic tenets of sports (and energy) drinks.

Water - the basic ingredient of these drinks - is usable and vital to our bodies.  Next time try plain water, it is nature’s best.

Sugar (fructose, sucrose) - We don't need more if we eat regular meals.  Most of us are damaged by the excess empty calories.  Children getting extra calories from beverages become picky eaters because they are not really hungry at meal time.  And they become overweight despite their activity level.

Electrolytes - If we eat real food at our meals, we don't need more electrolytes.

Energy stimulants (Caffeine, guaranine, taurine) we don't need.  A college student might appreciate it if studying late and some of us need a “wake up” in the morning.  However, our youth, including the college student and young athlete, don't need artificial stimulants (energy?) for physical activity.

Next blog: Give Your Teeth a Rest.       

Dr. Scott Thompson  - Pediatric Dentistry 

 www.winningwithsmiles.com

Sports Drinks - How to Dissolve Your Teeth

 This is about those wonderful fruity flavors.  In order to create the flavors in today’s beverages, those tangy and/or fruity flavors, the makers use fruit juice as their base or they add organic acids that come from organic juices.  Reading the label you will usually find citric, ascorbic, or malic acid; often several.  Also, there is commonly a fruit juice concentrate which will have high amounts of organic acids.

"Organic "systems are designed to maintain stability.  In other words, if nature establishes a fruit with a certain acid level, there is also a "buffering" system that holds that acid level constant.  This reserve system is huge so that living systems can resist significant insults from the outside world and still survive.  For example:  Comparing a glass of Coca Cola (inorganic) with apple juice (organic), the apple juice will require 8 times as much base (antacid) to upset the balance and neutralize the apple juice compared to the Coke.  It is this lasting power that makes it possible for sports drink acids to do so much damage to teeth.

The other crucial ingredient is how we use these drinks ... sipping.  Sports literature expounds the value of maintaining hydration during physical activity.  This has translated into sipping patterns to maintain hydration during sports.  Large bottles (lots of calories) are at game side for frequent gulps during game breaks.  The athlete is bathing her teeth in acid attack.  This frequently translates into a sipping style of hydration every day for many of us, especially our youth.  Athletes in sports that allow a hydration pack on their back are bathing their teeth continuously with enamel dissolving acids.

The most alarming example I witnessed was a patient of mine.  For 13 years this bright and personable boy had been a cavity free patient in my practice.  He is quiet, studious and has a real creative talent with computers.  He developed a habit of coming home from school, doing his homework and then his computer graphics and programming.  He was bathing (sipping) his teeth in organic acids (sports drinks and other beverages) all afternoon and evening several days a week.  In the short period between 2 regular cheek-ups his teeth deteriorated so severely he needed several crowns. And it was not cavities nearly so much as he just dissolved the enamel off of his teeth.

My simple rules of thumb.

Hydration - nature designed us to use water.

Electrolytes-we get plenty of them if we eat “real food.”

Calories.  We get enough in our meals so be careful about snacking.  Our bodies store plenty of glycogen to get us through long periods of exercise and exertion.

Next week:  Sports Drinks becoming energy drinks with dangerous implications. 

Sports Drinks - Not What You Might Hope They Are.

Have you checked out the ingredients of your "sports drink?"  Basically you will find:  1) water,  2) sugar of some kind,  3) organic acids (or citrus juices) for the tangy taste, and  4) some electrolytes.

The water is obvious and great.  We need to rehydrate during and after sweaty exercise.  No problem.

Sugar of some kind?  The amount of Calories we burn during exercise is not as much as you might think.  A jogger running for an hour only uses about 400 Calories.  (Just 1 scone at your favorite coffee shop will replace that!)  A marathon runner will run for 3 hard hours before he depletes his easily available glucose energy storage in his muscles.  Sports event players don't need sugar of any kind in their water.  To the contrary, adults and kids alike are consuming hundreds of excess (un-necessary) calories, empty calories (containing no nutrients to help adequately metabolize the calories), with these drinks.

The sipping nature that many people employ drinking these sports drinks is also boosting the sugar loving, cavity causing germs in our mouths.  The bacteria that cause cavities will thrive at high metabolic rates for 40 minutes following a simple sugar exposure.  Assuming 3 meals and 2 snacks, the teeth are under acid attack 4 hours.  The other 20 hours each day the teeth are recovering calcium from the saliva.

People who sip sports drinks from backpacks or before, during and after sports events and celebrations have their teeth under attack a majority of the day with inadequate recovery times to maintain healthy enamel.  Screw cap lids make it possible to sip these beverages all day and for those children who do, the teeth have no opportunity to recover the calcium lost during the constant acid attack of the bacteria.  Their cavity rates begin to soar.

The human condition has evolved over several millennia with water to hydrate us.  In the last couple decades sports drinks have not made us healthier or improved our sports performance.  However, they have:

1)  Done huge damage to our teeth and oral health.

2)  Contributed heavily to an overweight and obese population, especially our kids, that pediatricians and other physicians and health care workers are working desperately to change.

3)  Been a significant contributor to the growing problem of Type II diabetes in our children.

A third and highly “hyped” ingredient is electrolytes.  Electrolyte replacement with these sports drinks is not necessary and inefficient besides.  With a mere 25 cent envelope of Emergen-C I can:  1) replace those electrolytes and more,  2) get a healthy dose of vitamins and minerals as well,  3) get only 25 Calories in the bargain, and  4) gulp it down in short order any time during the day so it is not bathing my teeth for hours.  The real bottom line, however, is that our daily diet gives us adequate electrolytes each day so unless you are an extreme athlete doing strenuous exercise several hours each day, you don’t need to be concerned about electrolytes.  If you are truly concerned about chemical balance, the 3^rd article in this series on sports drinks will address a few additives of real “concern” that are in these sports drinks.

The last primary ingredient in sports drinks is organic acids (citric acid, ascorbic acid, malic acid, etc.)  Next week I'll tell you how to dissolve the enamel off your teeth the easy way with sports drinks.