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Keeping Your Child’s Teeth Healthy

Oral health expert offers tips on preventing tooth decay

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By Robert Preidt

Sunday, February 21, 2016

SUNDAY, Feb. 21, 2016 (HealthDay News) — There are a number of things parents can do to help their children enjoy a lifetime with healthy teeth and gums, a dental expert says.

Start by creating a foundation of a balanced diet, limiting snacks, and brushing and flossing each day, said Stephen Mitchell, director of predoctoral pediatric dentistry at the School of Dentistry at the University of Alabama at Birmingham. Of course, regular dental checkups are also crucial.

Tooth decay is the most common chronic disease among American children. It’s four times more common than asthma, Mitchell said. Consuming too many drinks with natural or added sugar can lead to tooth decay, he explained.

“Look at the nutrition label. If the calorie count is higher than 10 per serving, parents should be careful,” Mitchell said in a university news release. High-calorie drinks should be limited to one or two times a day, he advised.

Each day, children should have three balanced meals that include fruits, vegetables, grains, proteins and dairy. This will reduce their need to snack during the day, and lower their risk of tooth decay.

“Make sweets a treat. On a normal day, parents should limit their children to a combination of one or two sugary drinks, desserts or candies,” Mitchell said.

Misuse of sippy cups is another hazard.

“Tooth decay, especially ‘baby bottle tooth decay,’ is all about the amount of time a child’s teeth are exposed to sugars,” Mitchell said. “If you use a bottle or sippy cup, use it while the child is at the table for mealtime. Do not allow children to carry the cup around with them, and never allow them to sleep with it.”

Parents should brush their young children’s teeth for two minutes twice a day and focus on where the teeth and gums meet. It’s crucial to floss between baby or permanent teeth that touch together.

Parents should brush their children’s teeth until they are 6 or 7 years old, when they are coordinated enough to brush on their own. Parents should do an inspection after children brush their teeth.

February is National Children’s Dental Health Month.

SOURCE: University of Alabama at Birmingham, news release, Feb. 1, 2016

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AAP Adds Fluoride Varnish to Anticipatory Guidance Schedule

Pediatricians should make sure children’s teeth are getting varnished with fluoride, the American Academy of Pediatrics (AAP) recommends.

The academy added the recommendation to the 2015 version of its Recommendations for Preventive Pediatric Health Care, which it published online August 31 and in the September issue of Pediatrics.

“Once teeth are present, fluoride varnish may be applied to all children every 3 to 6 months in the primary care or dental office,” write the authors, who were from the AAP’s Committee on Practice and Ambulatory Medicine and the Bright Futures Periodicity Schedule Workgroup.

The fluoride varnish recommendation is the only change the committee made this year to their checklist of care children should receive at routinely scheduled visits with pediatricians.

The varnish recommendation is not new. The AAP first endorsed the guidelines on fluoride use from the Centers for Disease Control and Prevention in 2001. It provided reasoning for the recommendation in a 2014 clinical report published in Pediatrics.

Fluoride has both risks and benefits for children, and pediatricians must be aware of these to promote their patients’ oral health, write Melinda B. Clark, MD, and Rebecca L. Slayton, DDS, PhD, the authors of the 2014 report.

Although largely preventable, dental caries remains the most common chronic childhood disease in the United States. In this condition, acid produced by bacteria erodes the enamel of the teeth, creating cavities. Fifty-nine percent of 12- to 19-year-olds have at least one cavity, according to the 2014 report.

Caries can progress to local infections, occasionally causing serious illness or even death. It causes children to miss hours of school and caregivers to miss hours of work, and it increases the risk for systemic illnesses such as diabetes.

Early childhood caries is the single greatest risk factor for caries in the permanent dentition.

Although the oral health of Americans has been improving in general, dental caries among children aged 2 to 4 years increased between the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys, Dr Clark and Dr Slayton write.

Research long ago established the effectiveness of fluoride in stopping the progression of the disease. It promotes enamel remineralization, reduces enamel demineralization, and inhibits bacterial metabolism and acid production, they add.

The only proven adverse reaction is fluorosis, or subsurface hypomineralization and porosity between the developing enamel rods, they note. Typically, fluorosis causes striations or opaque areas that are not readily visible in mild cases. Moderate and severe forms of fluorosis can cause pitting and brittle incisal edges, but these are rare in the United States.

Fluoride varnish is a concentrated topical fluoride that both dental and nondental health professionals can brush onto their patients’ teeth. It sets on contact with saliva. It is well tolerated by infants and young children and has a prolonged therapeutic effect.

The concentration of fluoride varnish is 22,600 ppm (2.26%), and the active ingredient is sodium fluoride.

Research on fluoride varnish has led to recent endorsements. In May 2014, the US Preventive Services Task Force gave the evidence for the efficacy of fluoride varnish a “B” grade, meaning “There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.”

Because many children do not receive dental care at young ages, pediatricians have a unique opportunity to help their patients avoid caries by applying this varnish, Dr Clark and Dr Slayton conclude.

Pediatrics. Published online August 31, 2015.

Click here to see Medscape article

Pediatricians Offer New Dental Recommendations

American Academy of Pediatrics urges fluoride use on first teeth to prevent decay
By Robert Preidt

Monday, August 25, 2014 HealthDay Logo

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MONDAY, Aug. 25, 2014 (HealthDay News) — All children should start using toothpaste with fluoride when their teeth appear, regardless of their risk level for cavities, according to new recommendations from the American Academy of Pediatrics (AAP).

Up until age 3, children should use a smear (the size of a grain of rice) of toothpaste. After age 3, a pea-sized amount may be used. Parents should put the toothpaste on young children’s toothbrushes and supervise and help them with brushing.

Beginning at the time teeth appear, fluoride varnish should be applied by doctors or dentists every 3 to 6 months, according to the AAP.

Over-the-counter fluoride rinses are not recommended for children younger than 6 years, due to the risk that they may swallow more than the recommended levels of fluoride, the experts explained.

Dr. Melinda Clark, along with colleagues at the AAP’s Section on Oral Health, published the new recommendations online Aug. 25 in the journal Pediatrics.

Tooth decay is the most common chronic disease in American children, and fluoride is effective in preventing cavities in children, the AAP said.

SOURCE: American Academy of Pediatrics, news release, Aug. 25, 2014

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