Jennifer Robinson

We often take our oral health for granted until something goes wrong. But suddenly, when we’re faced with exorbitant bills for cavity fillings or braces, or when we realize we are reluctant to smile for fear that someone will see our teeth or gums, those little white things in our mouths seem a little more important.

Although they are the hardest substance in our bodies, teeth are not invincible and must be taken care of. Our mouth’s health affects everything about our lives because it enables us to eat, talk, and smile.

BASIC HOME DENTAL CARE

Most consulted sources say to brush your teeth at least twice a day and floss once a day. Some dentists recommend more or less brushing, but all agree that the important thing is to brush thoroughly and correctly. In addition, watch your diet and smoking habits, which are as important as cleaning..

BRUSHING CORRECTLY
Many people cause damage to their teeth and gums because they don’t really know how to brush or floss. “Place your toothbrush next to your teeth at a 45-degree angle and gently brush in a circular motion—not up and down,” advises Macon dentist, Dr. Ashley P. Walker. Up and down brushing wears down your tooth structure and can lead to receding gums, or expose the root of your tooth, he says. “Brush all surfaces of your teeth—front, back, top, and between other teeth, rocking the brush back and forth gently to remove any plaque growing under the gum.... Brush about 3 minutes,” he reminds us. Don’t forget the other surfaces of your mouth, including the gums, the roof and floor of your mouth, and most importantly, your tongue, to remove the trapped bacteria.

CHOOSING A TOOTHBRUSH AND TOOTHPASTE
Today, drugstores carry more types of toothbrushes and toothpaste than you can count. Dentists generally recommend a toothbrush with soft, rounded bristles that will not cause gum damage. For a child, cartoon, specially-shaped, or colorful toothbrushes can jazz up brushing sessions. Just make sure the brush also fits the above description

Replace a toothbrush every two to three months and after every cold/sickness so as not to pass along bacteria. If the bristles become bent and worn-out, continued use of the toothbrush can also harm your gums.

Electric toothbrushes have become increasingly popular in recent years, but there is no proof that they are better. However, electric toothbrushes can help poor brushers clean better, so some dentists, including Dr. J. Alex Bell, Jr., of Warner Robins, recommend these brushes for some patients.

Toothpaste can be more a matter of preference. There are dozens of flavors, each added with fluoride, whitening agents, plaque- or tartar-reducing substances, and even fun sparkles for children. Generally, a basic fluoride toothpaste is the safest way to go. However, too much fluoride, whitening agent, or abrasive substance (including baking soda) can harm your teeth or gums, so check with your dentist about the best paste for you and your family.

DON’T FORGET TO FLOSS
Like brushing, flossing should be done gently to avoid gum injury. Break off a lengthy amount of floss, wrap most of it around a finger, and slowly unwind the floss as it is used. From the gum upward, gently scrape the side of each tooth with the floss. Move around the mouth in the same pattern each flossing session so no teeth will be forgotten. Buy shred-resistant floss so it will not get lodged between teeth.

If you do not floss regularly, it is normal for the gums to bleed slightly at first. Soreness and bleeding will discontinue once a routine is established.

AVOIDING TOOTH DECAY
How many of our parents repeatedly told us to brush our teeth after eating candy so we wouldn’t get cavities?

Tooth decay is the most common dental problem in the world, including Middle Georgia. Teeth begin to decay when acids in bacteria and food are left on the teeth (creating “plaque”), and are then left to eat away at the outer “enamel.” The resulting softening eventually leads to the formation of small holes, or cavities, in teeth.

Warning signs of a cavity are discoloration, pain or sensitivity in or near a tooth, or a visibly noticeable hole. Usually examination by a dentist is the only way to catch a cavity early on. Later, when a cavity is large, the decay is often recognized by sensitivity to sweets and/or cold items, Dr. Bell said. See a dentist immediately if you notice one of these signs in your mouth, or if your child complains about one of these symptoms.

Cavities are caused by a number of factors, including: failure to brush, floss, and/or eat well; failure to go to the dentist; and/or genetic or structural differences. Quality brushing, a better diet, stopping smoking, fluoride, and regular check-ups can prevent most decay, and these methods are discussed below.

WATCHING WHAT YOU EAT

THE BAD
Many eating and drinking habits can positively or adversely affect dental health and development. Sugar is the most notorious adversary of dental health.

“Take away the sugar and you break the decay process,” Dr. Bell said, adding that people should avoid candy, sodas, and other obvious sources of sugar, but also beware “hidden sugars” in foods like breads, cereals, or cough drops.

While we cannot (and should not) eliminate all sugar from our diets, sugar intake should be limited. According to the traditional Food Guide Pyramid, people with a 1600-calorie diet should consume no more than six teaspoons of sugar per day and those on a 2200-calorie diet less than twelve teaspoons. Most Americans’ diets go far above the recommended sugar intake. A regular soda contains about ten teaspoons of sugar alone!

Brush thoroughly soon after consuming sugary foods or drinks. Dr. Walker recommends rinsing with water after meals and snacks if it’s impossible to brush immediately. Also, when drinking sodas, protect teeth by using a straw, Dr. Walker says.

Frequent snacking contributes to tooth decay, especially if the snacks are non-nutritious. Avoid sugary, especially sticky, foods at snack times and meals. Foods like dried fruits and granola bars may contain nutritious ingredients, but they can cause damage if left on teeth, Dr. Walker said.

THE GOOD
As you limit sugar intake, replace sugary foods with those that can improve dental health. These include:
Milk
Aged cheeses (especially cheddar, Swiss, or Monterey Jack)
Fresh fruits (especially fresh cranberries)
Vegetables (especially celery or high-fiber green vegetables like spinach, lettuce, or broccoli)
Popcorn
Legumes and nuts
Green tea

ANOTHER ENEMY: TOBACCO
An important and oft-overlooked oral enemy is tobacco. According to the January 9, 2004 Morbidity and Mortality Weekly Report, over 23% of Georgia adults currently smoke. Tobacco use can lead to tooth decay and a host of other problems.

“Smoking and tobacco use are detrimental to the delicate gingival tissues of the mouth by causing irritation and inflammation as well as receding gum lines,” Dr. Walker explained. “Chronic use of tobacco may also lead to cancerous conditions in the oral cavity.”

FLUORIDE
The best single substance for fighting tooth decay is fluoride, a chemical found naturally in all water sources. Systemically, fluoride is absorbed into the structure of the enamel while teeth are forming, making them more resistant to decay. For the best results, each tooth needs to be exposed to dietary fluoride form the tine it’s under the gum until its development is complete—about two years after it comes in. This chemical compound strengthens and protects teeth by helping retain calcium and slowing tooth decay. Today, this chemical compound can be found in home water supplies, toothpastes, mouth rinses, mineral supplements, and special dental treatments.

According to Mark Wyzalek of the Macon Water Authority, all established Georgia water systems contain fluoride by law. However, fluoride is not added to bottled water.

“It worries me that the trend of drinking bottled non-fluoridated water may have an effect on our dental health, especially in our children,” Dr. Bell said. Because of this trend, if your family does not drink tap water, make sure you obtain fluoride from another source.

Don’t forget, though, that as with most dietary substances, moderation is key and too much fluoride can cause problems, particularly in young children. According to a 2002 report by the American Dental Association (AAPD), children’s overexposure to fluoride can cause “enamel fluorosis,” or disruption of proper formation of tooth enamel.” Too much fluoride can also cause nausea and darkening of the teeth. Dr. Walker recommends avoiding fluoride toothpaste for children younger than two years old. The AAPD recommends that fluoride content should range between 0.7 and 1.0 ppm. Ask your dentist before giving your children extra fluoride besides what they naturally obtain from drinking water.

CHILDREN’S DENTAL HEALTH

BABY & TODDLER TEETH
You should begin caring for your babies’ mouths even before they are born. Did you know certain sicknesses and drugs during pregnancy can negatively affect the development of your child’s teeth? Check with your doctor so you can make healthy decisions for your baby while pregnant. “Proper prenatal health is a foundation for good dental health,” Dr. Bell said.

For newborns, to prevent bacteria build-up, wipe a damp washcloth across their gums after every feeding or at least before bedtime. When teeth begin to come in, use a soft, child’s toothbrush with a pea-sized amount of toothpaste to clean your child’s teeth and gums.

“Dental problems can begin early,” said Dr. Walker, “They may begin in infancy. Detecting conditions such as bottle tooth decay, teething problems, gum boils or irritations, and prolonged thumb sucking can help prevent issues that may be more difficult to treat as the child gets older.” He cautions parents against letting their child fall asleep with a bottle of milk or juice.

Nor will you want to allow your older child to go to bed with a film of milk, juice, or food in the mouth, even if it means re-brushing, says Dr. Sheila Shah, a Macon Family Dentist.

As soon as 2 teeth are nearly touching side by side, it’s time to floss twice a day, according to Shah. “Make flossing fun by selecting a flavored floss, such as grape or bubble gum,” she advises, “And make flossing comfortable by “sawing the floss through the tight spot instead of pushing and popping it through.”

“Even when the child gets older and wants to brush their own teeth, the parents need to supervise and if necessary go back over with the toothbrush to make sure the child did not miss any areas,” Dr. Bell said. Allow your child to brush his or her own teeth starting at age two or three, but continue helping him or her until about age eight.

Diet is equally as important. Researchers studied the charts of more than 4,000 preschoolers aged 2- to 5-years-old. Their results, published in the January 2004 issue of the Journal of the American Dental Association, clearly show that even children who are not poor but who don’t eat a balanced diet have more cavities. Healthful eating habits, including eating breakfast, getting lots of fruits and vegetables, etc., definitely cuts down on cavities.

“A diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at extra risk of tooth decay, stated Dr. Walker, “Harmful starchy foods include breads, crackers, pasta, and such snacks as pretzels, and potato chips.” Not only can too many carbohydrates contibute to general health problems, but some such as soft drinks, can actually contribute to the erosion of tooth enamel, he says. “Remind your children to rinse their mouths with water after meals, especially during school, in order to leave their teeth free of sugar and acid,” Dr. Walker said.

THE FIRST TRIP TO THE DENTIST
The American Dental Association recommends a child see a dentist before his or her first birthday. In any case, earlier visits allow a dentist to catch trouble spots before they become full-blown problems. Baby (primary) teeth serve a number of important functions. Not only do they help your child learn to chew properly, they also help children learn proper pronunciation and speech habits. The primary teeth also help guide the eruption of the permanent teeth. A baby tooth usually stays in place until a permanent tooth underneath pushes it out and takes its place. If a baby tooth should be lost too early, the space needed for the permanent teeth may disappear. Therefore, if a tooth is lost accidentally or through disease, a space maintainer should be installed to ensure that there will be enough room for permanent teeth when they erupt.

Few people enjoy going to the dentist, and the first visit can be particularly nerve-racking. Dr. Bell suggests you ease your child’s mind about dental visits by first letting your child sit in on your check-up. See “Easing Your Child’s Fear of the Dentist” on page 42 for more tips.

OLDER CHILDREN’S TEETH AND SEALANTS
Children should be able to brush and floss on their own by age eight. However, parents should still occasionally check for brushing or teeth problems.

The American Academy of Pediatric Dentistry and most dentists recommend dental check-ups for children (and adults) every six months. Some may need to see the dentist more often, especially if your child has braces.

As your child’s teeth develop, some dentists will recommend “sealants” as a cavity-prevention method. Sealants are secured on molars’ chewing surfaces to keep bacteria out. Because children’s molars usually have especially deep fissures/pits when they first come in, they are prone to bacteria or food build-up unreachable by a toothbrush. Not to mention, children rarely do a great job of brushing and are, unfortunately, often delving into sugary foods.

According to Dr. Bell, dental care for your children begins with your own oral care. “Children should see their parents taking care of their own teeth,” he said. So, set a good example by following the guidelines of this article, and your whole family will have healthy smiles.