Oral Health

Talk with your kids about Oral Health
How to Talk to Parents About the Importance of Dental Health
Importance of Childhood Oral Hygiene & the Role of Parents
Teenagers and Oral Piercing - Is it Safe?
Tobacco and Oral Health
Talking with Kids about Oral Health - 2
Data Highlights
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Talk with your kids about Oral Health

Dental decay is the most common chronic disease in young people between the ages of 5 and 17, according to the Centers for Disease Control and Prevention (CDC). And while younger children typically attend dental appointments with their parents, teens have more control over their free time and may not choose to visit the dentist for regular checkups.

As a result, many teenagers don't get the dental care they need or the proper education to make smart decisions about their oral hygiene habits. The Academy of General Dentistry offers the following teeth tips for teens and their parents:

1. Limit soda drinking. Teens are drinking more soft drinks than ever, both in school and at home. Soda consumption among this age group has steadily increased in recent years. Sugar in sweetened sodas can cause cavities, and acidic flavor additives (found in both unsweetened and sweetened sodas) can also erode and damage tooth enamel.

Besides decreasing soda consumption, teens can limit the harmful effects of soda in two simple ways: sipping soda through a straw cuts down on the contact the beverage has with teeth, and rinsing the mouth with water after drinking soda can reduce the risk of cavities.

2. Play it safe. Contact sports can cause oral injuries, but teens can prevent injuries by wearing a mouth guard while playing sports. More than 200,000 injuries to the mouth and jaw occur each year, and dentists regularly recommend the use of mouth guards in a variety of sports activities. Whether a mouth guard is custom-fitted by a dentist or bought at a store, teens should keep it clean by rinsing it often and storing it in a ventilated container.

3. Avoid oral piercings. Tongue piercing remains a trend despite the dangers to oral health. People with tongue piercings chip their teeth on the jewelry while eating, sleeping, talking and chewing. The fracture can be confined to tooth enamel and require a filling, or it may go deeper, which can lead to a root canal or tooth extraction.

Infections are also common with oral piercings. The tongue can swell after being punctured, and in some cases can become infected and swell to such a degree that it interferes with breathing. Unclean piercing equipment can cause other infections, such as blood-borne hepatitis.

4. Make time for healthy habits. Teens eat quick meals in the form of "nutrition" bars and fast food to stay alert and on schedule between school, extracurricular activities and part-time jobs. However, these habits can permanently damage oral and overall health. Teens should have access to healthy snacks such as apples and carrot sticks and low-fat cheese. Keeping a travel-size toothbrush in a locker or backpack can help teens keep up good teeth-cleaning habits by brushing after meals and snacks.

Chewing sugarless gum with xylitol (a natural sweetener) after meals or snacks can also help cleanse the mouth. Drinking water throughout the day can help cleanse the teeth of excess bacteria and food debris.

Just like adults, teens should visit their dentist at least twice a year. Regular dental visits and cleanings not only help keep teeth bright and shiny (a boost to any teens self-esteem), they can also help catch minor problems before they become worse.

E-cigarettes, Teenagers and Oral Health

More teenagers have tried Electronic Cigarettes than adults, with statistics showing as many as 10% of high school students having tried the latest trend in smoking compared with only 2.7% of adults. E-cig use has exploded in the past few years, and many people claim to have stopped smoking traditional cigarettes because of them. While many users also believe e-cigarettes to be safer than regular cigarettes, no definitive studies have proven that they are a safe alternative.

When looking at e-cigarettes and oral health, especially in relation to teenagers, it’s important to remember that an e-cigarette is still primarily a nicotine delivery device and there’s little debate as to the effects of nicotine on the body.

The truth is, no one is completely sure about the long-term health effects of e-cigarettes which can make them a particular concern for adolescents. Many teenagers are smoking e-cigarettes because they feel they are safe or cool. Regardless of how it’s delivered, however, nicotine is still a highly addictive drug that should be avoided by everyone, especially growing teens. With few laws banning their use among young people, it’s important to educate your children about the potential hazards of this growing trend.

DIP and oral health

Spit Tobacco Facts

Spit tobacco (a.k.a. smokeless tobacco, dip, snuff, chew, and chewing tobacco) contains ingredients that can cause serious health problems. Users can suffer from periodontal (gum) disease, cavities (tooth decay), leukoplakia (white patches and oral lesions which can lead to oral cancer), and are at greater risk for oral, throat, stomach and pancreatic cancer.

The amount of nicotine in one dip, or chew, of spit tobacco can deliver up to 5 times the amount found in one cigarette. For example, a thirty-minute chew gives you the same amount of nicotine as three cigarettes and a two can/week snuff dipper delivers the same nicotine as a 1 1/2 pack-a-day cigarette habit.

A spit tobacco addict will suffer withdrawal from nicotine when he or she tries to quit using. Stress, irritability, sleep problems, cravings, appetite increase, and stomach and intestinal disorders are common in people trying to quit tobacco use.

Spit tobacco users are 50 times more likely than non-users to contract cancers of the cheek, gums, and inner surface of the lips.

Exposure to tobacco juice can induce cancers of the esophagus, larynx, stomach, pancreas, and prostate.

How to Talk to Parents About the Importance of Dental Health

Encouraging parents and caregivers to prioritize oral hygiene is an important way for you to help prevent oral disease in children. In a few minutes during a well-child visit, you can educate families about nutrition, preventing saliva transfer from parent to child, good brushing habits, and the need to establish a dental home where families can find routine preventive care.

Here are a few suggestions for things you may want to address with families:

  • Talk to caregivers about the importance of oral health care, including age-appropriate brushing habits, early detection of decay, and good nutrition
  • When talking to families, be aware of their attitudes toward dental care and address any questions or concerns they may have about caring for their child’s oral health
  • Keep messages clear, short, and simple
  • Use a variety of methods to help parents learn about oral heath and get the skills they need to prevent dental disease. Exam room posters, picture handouts, and hands-on demonstrations are all effective ways to communicate your message
  • Encourage parents to take an active role in caring for their child’s teeth at all stages—even before the first tooth erupts
  • Inspire parents to model good oral health practices like brushing their teeth twice a day, flossing once a day, visiting a dentist regularly, and eating healthy foods

Importance of Childhood Oral Hygiene & the Role of Parents

The foundation for healthy permanent teeth in children and teenagers is laid during the first years of life. Poor diet, poor habits of food intake and inadequate toothbrushing habits during the first 2 years of life have been shown in several studies to be related to tooth decay in children. The development of caries in primary teeth further increases the risk of developing caries in permanent teeth.

Therefore it is essential to establish a proper oral hygiene routine early in life to help ensure the development of strong and healthy teeth. Parents, as consistent role models, are key for setting a daily routine and to making their children understand the importance of oral hygiene. Toothbrushing should be presented as a habit and an integral part of the daily hygiene routine. Children are very sensitive to social stimuli such as praise and affection, and learn best by imitating their parents. Physiological and mental development affects the oral care of children.

Importance of the primary dentition

Primary teeth start to erupt in children from the age of six months. The primary dentition is complete by approximately two and a half years of age. The enamel of primary teeth is less densely mineralized than the enamel of permanent teeth, making them particularly susceptible to caries. Primary teeth are essential tools, both for chewing and learning to talk. They help to break up food into small pieces, thereby ensuring efficient digestion. A full set of teeth is an essential prerequisite in learning correct pronunciation. Primary teeth also play a vital role in the proper alignment and spacing of permanent teeth; it is therefore imperative that they are well cared for and preserved until normal ex-foliation takes place. Establishing a proper oral care routine early on in life sets the foundation for the development of healthy and strong permanent teeth. In addition to good oral hygiene, diet also plays a key role in keeping teeth healthy. In this respect it is not only the quantity of sugar that is important, but also the frequency of consumption. As much as possible, children should be limited in the amount of sweets between meals, especially in the evening or at night.

New permanent teeth

Although permanent teeth are already partly formed in children aged 0 to 3 years, eruption only occurs later in life (from about 6 years on) when the 32 permanent teeth (16 in the upper and 16 in the lower jaw) replace the 20 primary teeth. During this time root resorption and crown shedding of primary teeth take place. With the eruption of the first permanent teeth (from about 6 years on), the mouth contains a mixture of both primary and permanent teeth, which puts children at increased risk of caries. Often the eruption of this permanent tooth is not realized neither by the child nor by the parents, because it is positioned behind the last primary molar and is not replacing any primary tooth. Although enamel is fully formed at eruption the surface remains porous and is inadequately mineralized. Subsequently, a secondary mineralization occurs (second maturation), in which ions from the oral cavity penetrate hydroxyapatite and increase the resistance of the enamel against caries. Furthermore, any primary teeth with caries form reservoirs of bacteria, which can easily attack the immature enamel of the new permanent teeth. During the eruption, the occlusal surfaces of the new permanent teeth are on a lower level than the primary teeth. Toothbrushing becomes more difficult than before, given the coexistence of loose primary teeth, gaps and newly erupting permanent teeth. The jaw is also growing significantly, making space for more teeth. The cleaning of the narrower interdental spaces becomes more important with increasing numbers of permanent teeth.

Role of Parents

Parents have a key role in helping their children to develop a proper oral hygiene routine in the first years of their life. Parents should lead and supervise their children’s toothbrushing approximately for the first 12 years, until motor and mental functions allow the child to routinely perform a proper toothbrushing technique alone. After brushing the teeth for their children for the first 2 years of life, parents will have to use playful motivation to encourage their children to brush their own teeth from about 3 years onwards – the time when children want to brush their teeth alone. Each time the child has finished brushing, parents should re-brush the hard-to-clean areas. At the age of around 6 years, children are able to brush their teeth using a proper brushing technique. In this phase, parents have to continue supervising the regular brushing efforts of their children. The special anatomical situation of changing dentition makes it indispensable that parents still need to help their children in the daily toothbrushing task until eruption of the second molar (around the age of 12).

Development stages of children from the age 0-12

As soon as the first primary teeth erupt into the oral cavity, parents should begin brushing their children’s teeth. From the age of two years, teeth should be brushed twice daily with smaller than a pea-size amount of children’s toothpaste. Small children tend to swallow a large amount of toothpaste, so that there is a risk of developing dental fluorosis. Supervised application of the amount of toothpaste to the toothbrush is important. Due to the risk of fluorosis, the fluoride content of toothpaste for children up to the age of 5–7 years was reduced in most European countries (250 ppm to 750 ppm). Beginning with the eruption of the new permanent teeth, children should be switched from a low fluoride containing children’s toothpaste to a higher fluoride containing toothpaste (1000 ppm to 1500 ppm). This ensures the best caries protection as possible for their new permanent teeth.

Teenagers and Oral Piercing - Is it Safe?

Oral piercing may be trendy among teenagers, but the side effects can be hazardous to their teeth and mouth. And many don?t take the time to learn about the risks and dangers associated with oral piercing.

A swollen tongue is a common side effect of tongue piercing. The American Dental Association points out that, "In extreme cases, a severely swollen tongue can actually close off the airway and prevent breathing." Pain, infection and increased saliva are other common side effects of oral piercings.

Infection often accompanies oral piercings because of the abundance of bacteria that live in our mouth. Hepatitis can also be transmitted through unsanitized piercing instruments and equipment.

Once the mouth jewelry is in place, it can also cause problems. According to the Academy of General Dentistry, tongue piercing commonly causes fractured teeth. Teeth can easily become fractured or chipped from the jewelry bumping against the teeth. This can happen while the teen is talking, eating or even sleeping. A filling can usually be placed if the fracture is small and limited to the tooth enamel. If the fracture goes deeper, a root canal might be needed. In some cases, the tooth might even have to be extracted. Aside from possibly fracturing or chipping the teeth, mouth jewelry can pose a choking hazard if it becomes loose.

If your teenager is contemplating oral piercing, ask your dentist to discuss and examine the side effects with him. If your teenager already has oral piercings, schedule routine dental check ups so that your dentist can keep an eye out for fractured teeth or other problems.

Tobacco and Oral Health

If the warning labels on cigarettes, cigars, chewing tobacco and other tobacco products haven’t gotten the point across, let us reaffirm their message: smoking and tobacco are bad for your body and bad for your oral health.

Smoking and chewing tobacco risk factors:

  • Mouth and throat cancer
  • Gum disease
  • Delayed tooth adjustment with orthodontic work
  • Poor healing after oral surgery
  • Receding gums
  • Tooth decay
  • Failed dental implants

The best thing you can do for your teeth, mouth and health is to quit using tobacco; it’s the only way to decrease your risk of these and other tobacco-related health problems. It’s not easy because the nicotine in cigarettes, cigars, and pipe and chewing tobacco, is very addictive. But you can do it. And when you do you’ll be happier and healthier, and have a smile of which you can be most proud!

Impact of Smoking on Oral Health

When you take a puff of that cigarette, cigar or pipe, think beyond what it’s doing to your lungs and your heart. Think about what it’s doing to your mouth and teeth. Cigarette smoke contains over 4,800 chemicals, 69 of which are known to cause cancer. As you inhale, the smoke lingers in your mouth before you exhale, even if you don’t inhale fully. Imagine what those 4,800 chemicals hanging around in your mouth can do to your teeth and gums. A lot. And none of it good.

Smoking directly affects your oral health because it:

  • Reduces blood flow to your gums
  • Reduces the Vitamin C levels needed to keep your gums healthy
  • Raises the temperature in the mouth, damaging and killing important cells

Smoking causes:

  • Bad breath
  • Stained teeth and tongue
  • A dulled sense of taste and smell
  • Delayed healing after a mouth wound or having a tooth extracted
  • Difficulties in correcting crooked teeth or misaligned bites
  • Gum disease, bone loss and tooth loss
  • Oral cancer

Smokers are bound to have dental problems. And with every puff, the problems get worse. Even if you feel you can’t quit fully, at least try and reduce the amount you smoke. That will help.

Impact of Smokeless Tobacco on Oral Health

If you think going smokeless with chew or snuff is better for your health, it’s not. By design, chew sits in your mouth along the gum line, right inside your cheek. All the chemicals that make chew so addictive irritate your gum tissue, causing it to pull away from your teeth. This irritation makes your gums more prone to gum disease. When the gum tissue pulls away, you’re at greater risk for tooth decay. Sugars are often added to enhance the flavor of smokeless tobacco, too, so that increases your risk for tooth decay. And chew is often made with sand and grit, which wears downs your teeth.

Chewing tobacco is bad for oral health because it:

  • Eats away at your gums, causing gum recession and bone loss
  • Increases your risk of gum disease and tooth decay
  • Causes leathery white patches and red sores in the mouth that can turn into cancer
  • Causes bad breath
  • Yellows teeth
  • Dulls the sense of taste
  • Slows the healing process after dental work, especially if it’s a tooth extraction or other oral surgery procedure

Smokeless tobacco users are up to 50 times more likely to develop oral cancer, especially in areas where tobacco is held in your mouth. You simply can’t brush or floss a statistic like that away. So, if you want to smile more and be happier about your teeth, mouth and overall health, the best thing to do is quit the dip.

Smoking and Bad Breath

Blame it on all those chemicals in cigarettes and tobacco. But there’s no way around it. Smokers and people who chew have bad breath. Every time you inhale, or every time you place a pinch of chewing tobacco in between your check and gum, you’re inviting tar and nicotine to hang out in your mouth. And they do. They find every crevice to cling to, including your teeth, gums, tongue and side of your cheeks. Brushing and flossing may help a little, but with every cigarette or pinch, you start all over again.

Smoking also dries out your mouth. When your mouth is dry, the saliva that should be flowing to be rinsing away the bacteria is missing. And without that saliva, bacteria hangs in your mouth. You’ve got bacteria, tar, nicotine and a bunch of other chemicals all clinging to your teeth, cheeks, gums, and tongue with nothing to help wash it away. A breath mint, or even a good tooth brushing isn’t going to make all that smell good. But quitting smoking and chewing tobacco will!

Tobacco and Oral Cancer

It’s not a pleasant topic to talk about. But it’s the truth. Smoking and chewing tobacco is the major cause of mouth, throat, esophagus, pharynx, larynx, tongue, lips and salivary gland cancer. All tobacco products, including cigarettes, cigars, pipe tobacco, chewing tobacco, and snuff, contain toxins and carcinogens which are poisonous substances and cancer-causing agents. The nicotine in these tobacco products is addictive. So in essence, when you smoke or chew, you become addicted to poison. Your body can only take so much of something that continues to be bad for it. So the more you smoke or chew, and the longer you smoke or chew, the higher at risk you become for getting cancer.

The primary risk factors for head and neck cancers are tobacco and excessive alcohol consumption, but the human papilloma virus (HPV) has recently been associated with increasing throat cancer in non-smoking adults. According to the Center for Disease Control, as many as 60–70% cancers of the neck, throat and tonsils may be linked to HPV, and many of these may be caused by a combination of tobacco, alcohol, and HPV.

When you visit your Dental Associates dentist for your regular check-ups, an oral cancer evaluation is part of the routine exam. When asked questions about your alcohol and tobacco use, answer honestly, as that will help evaluate your risk.

Oral cancer symptoms:

  • Lumps or rough spots on the lips, gums, or other areas inside the mouth that do not heal
  • Velvety white, red, or speckled (white and red) patches in the mouth
  • Unexplained bleeding in the mouth
  • Unexplained numbness, loss of feeling, or pain in any area of the face, mouth, or neck
  • Persistent sores on the face, neck, or mouth that bleed easily and do not heal
  • A soreness or feeling that something is caught in the back of the throat
  • Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
  • Hoarseness, sore throat or change in voice that does not go back to normal
  • Ear pain
  • A change in the way your teeth look or dentures fit.
  • Loose teeth

Your best defense against oral cancer is to stop using tobacco, whether you’re a smoker or a dipper. It’s not easy because tobacco is highly addictive. But if you have a plan, set goals and find a good support network to help you, you can do it. Talk to your dentist or doctor, too. They may be able to offer you resources and even medication to help. When you quit using tobacco, you’ll be at less risk for gum disease, bad breath, stained teeth and cancer. You’ll be happier and healthier, and have a huge reason to smile!

Talking with Kids about Oral Health - 2

a. Children with cavities may be in pain but they often do not tell us. Also, untreated cavities, even in baby teeth, can lead to serious infections that can need emergency treatment.

b. Cavities in baby teeth lead to more cavities in permanent teeth.

c. If baby teeth do not get fixed they may need to be pulled out. This means the permanent teeth will not have enough room and your child’s teeth may end up crooked and without enough space.

Start a discussion of the things that a parent can do to help achieve their wish for the child.

1. Let's take a look at the list and discuss the ideas.
  • Take your child to the dentist to get their teeth fixed
  • Brush your child¡¦s teeth every night with a toothbrush and a small pea sized amount of fluoride toothpaste for children over two years and a smear for children under two years
  • Have your child only drink plain white milk or water between meals
  • Make sure your child only has one snack between meals and make sure it is sugar free.
  • Don¡¦t put your baby/child to bed with the bottle or sippy cup.

2. Now that you have looked at the ideas on the list, which of these do you think will be the best for you and your child?¡¨

3. You think (restate ones selected) will work for your family?

4. What do you think you will need to make these work?

5. Can we come up with a plan? (Listen to parent and write down steps he/she identifies. You may want to restate some of the steps and clarify when needed. For example ¡V I understand you want to brush child¡¦s teeth once a day ¡V what time of day do you think will work best? Then re-state.)

6. Review plan, together.

7. Is this the right plan for your family?

8. Okay, now we have a plan. How can I help with your plan? (Write down the things you need to do).

For the parent that did not choose getting their child's cavities fixed as an option

1. Tell me about your choice to not get your child¡¦s cavities fixed.

2. Use reflective listening ¡V restate and or ask for more information about her choice. Revisit some of the information used above as necessary.


A family will not follow through with a behavior unless they chose to participate. Your goal is to help them reach their own correct decision

Data Highlights

Tooth decay is the most common chronic illness among school-age children,4 times more common than childhood asthma. While the American Academy of Pediatric Dentistry recommends that children have a dental visit by the time their 1st tooth appears and no later than their 1st birthday, 37% of 2- and 3-year-olds in California have never been to the dentist. These rates are even lower for California’s poorest young children, as only 1 in 3 children, ages birth-to-3, enrolled in Denti-Cal (the dental component of the state’s Medicaid program) have seen a dentist.

By kindergarten, over 50% of children in California have already experienced dental decay and 28% have untreated decay. California students miss an estimated 874,000 days of school each year due to dental problems, costing schools over $29 million each year. Children who reported having recent tooth pain were 4 times more likely to have a low grade point average.
Source: www.childrennow.org/index.php/learn/oral_health/

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