Back to School Trivia: What is the most common chronic childhood disease from ages 6-19?

Although largely preventable, dental caries (cavities) is the most common chronic disease in children in the United States: it is 4 times more common than early childhood obesity, 5 times as common as asthma, 7 times as common as hay fever and 20 times more common than diabetes. Over fifty-three million people live with untreated tooth decay in their permanent teeth.  

What is Tooth Decay?

Tooth decay is caused by a bacterial infection. This bacteria is transmissible from parent to child, among siblings or anyone sharing food and drink. The bacteria colonize the mouth and with the formation of plaques, adhere to the teeth. Plaque is the byproduct of food which forms the soft, sticky film on our teeth. This advanced bacterial plaque breaks down sugars and produces lactic acids, which cause tooth decay, a process of demineralization or loss of tooth structure. As a result, the tooth weakens and eventually forms a hole and breaks through the tooth which is known as a “cavity”. Besides brushing, flossing and proper oral hygiene, the three best prevention measures we have against cavity formation are sealants, fluoride, and balanced healthy nutrition.

Sealants

Sealants are thin plastic coatings that are painted on the chewing surfaces of teeth, protecting the pits and fissures on back teeth that are hard to clean with a toothbrush and are a high risk for decay. Sealants effectively inhibit the colonization of bacteria on the chewing aspects of teeth. The American Dental Association recommends children have sealants on their permanent molars,“6 year molars”, “12 year molars”, and any teeth presenting with deep pits and grooves. If a child under 6 already has a high rate of cavities, sometimes sealants are indicated on baby teeth as well, to protect the permanent teeth underneath. Teenagers and young adults who are prone to decay may also benefit from sealants. 

Fluoride

Brushing teeth is of limited benefit without the use of fluoride toothpaste. Fluoride benefits children and adults of all ages, and comes in the form of fluoridated tap water, toothpaste, mouth rinse, and professionally applied gel and varnish. Professionally applied fluoride is generally recommended for prevention, or moderate to high cavity-risk patients. Fluoride works by binding to the tooth and creating a crystal like barrier on the teeth that is much harder than enamel or outside layer of the tooth. The remineralization effect of fluoride is of prime importance, because it results in a reversal of the early tooth deterioration process and it gives rise to an enamel surface that is more resistant to decay and bacterial acid attacks. Meaning fluoride is a mineral that can not only prevent tooth decay from progressing; It can even reverse, or stop, early tooth decay.

Saliva and Nutrition

Your child’s diet is important in preventing cavities. Remember, every time we eat or drink something that contains sugar or starch, the bacteria in our mouth use the sugar and starch to produce acids. These acids begin to eat away at the tooth’s enamel. Our saliva is designed to  help fight off this acid attack by washing away food/bacteria, buffering the drop in the pH after we eat, preventing demineralization, and enhancing remineralization of the teeth. But if we eat too frequently throughout the day, especially foods and drinks containing sugar and starches, the repeated acid attacks will eventually cause the tooth to lose minerals and eventually develop an imbalance creating a perfect environment for cavities to grow. Limiting between-meal snacks and beverages (besides water) will reduce the incidence of this and give the teeth a chance to repair themselves. 

We know growing kids love to eat, so when sending them to school try to avoid snacks that have added sugar, are sticky or high in carbohydrates. Examples of these snacks are raisins, fruit snacks, bagels, muffins, granola bars, dried fruit with added sugar, applesauce, cereal, cookies, crackers and chips, Don’t forget about drinks too, one of the biggest factors in cavity prevention is frequency. Steadily sipping on soda, juices, Gatorade, sports drinks, and even flavored water throughout the day can alter the pH in the mouth and increase the risk for cavities.

Snacks we recommend are; meats and cheese, cottage cheese, eggs, low sugar yogurt, fresh fruit, fresh veggies, nuts, hummus, avocado, olives. A healthy balanced diet is key, and treats are okay on occasion! However, it’s important to remember, as your kids get tired during after the school day, the most important time for brushing is before bedtime, because less salivation occurs during sleep!

• References

1. U.S. Department of Health and Human Services. Oral health in America: a report of the Surgeon General. http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/Report/ExecutiveSummary.htm. Updated March 7, 2014. Accessed August 22, 2016.
2. BA, Thornton-Evan G, Xianfen L, Iafolla TJ. Dental caries and sealant prevalence in children and adolescents in the United States, 2011-2012. 
3. http://www.cdc.gov/nchs/data/databriefs/db191.pdf. Published March 2015. NCHS Data Brief. Accessed August 22, 2016.
4. Roberts-Thomson KF, Spencer AJ. Public knowledge of the prevention of dental decay and gum diseases. Aust Dent J. 1999;44(4):253-258.
5. Prabhakar AR, Dodawad R, Os R. Evaluation of flow Rate, pH, buffering capacity, calcium, total protein and total antioxidant levels of saliva in caries free and caries active children—an in vivo study. Int J Clin Pediatr Dent. 2009;2(1):9-12.
6. Azarpazhooh A, Main PA. Pit and fissure sealants in the prevention of dental caries in children and adolescents: a systematic review. J Can Dent Assoc. 2008;74(2):171-177.