Oral health. takes a team approach

Transcription

1 THE GLOBE AND MAIL TUESDAY, APRIL 29, 2008 A special information supplement CDA 1 Oral health takes a team approach I t was a lonely world for dentists when the father of modern dentistry France s Pierre Fauchard began to write about oral care as a discipline separate from medicine, and most dental practitioners worked alone or with just one helper. That was in the 1700s. How times have changed. Over the past five decades, and particularly in recent years, the face of dentistry has evolved dramatically, with oral care teams now extending even beyond dentists offices to involve an array of specialists, including, perhaps to Dr. Fauchard s chagrin, MDs. According to Canada s top dentists, the profession s team approach is at the heart of optimum oral care and the general health of all Canadians. Until about the mid- 1950s, dentists tended to do everything themselves, says Dr. Darryl Smith, president of the Canadian Dental (CDA). With changes in thinking and technology, it became obvious that the most effective and efficient way to deliver the best oral care was to add other people to the team. Today, most dentists head up teams that include dental assistants, hygienists, administrative staff and specialists who each contribute expertise to patient care an efficient model increasingly seen in the broader health care community in the emergence of primary health care, in which physicians lead teams of trained health care practitioners such as nurse practitioners, nurses and nutritionists. The evolution of oral health teams developed in lockstep with modern approaches to preventative oral care, which aim to stem problems such as cavities and gum disease. As a result, the role of dental assistants expanded beyond assisting dentists with treatment procedures to also handle a variety of tasks in accordance with their training from helping with equipment and instruments to mixing compounds. Dr. Don Friedlander, CDA vice president, and a dentist in Ottawa for almost 30 years, says his practice includes two dentists, four dental hygienists, two dental assistants and two receptionists. He says the combined efforts promote a creative, supportive and enjoyable working environment. Patients benefit from the working collaboration of our team. They get the specific care they need and it works well for us because we all have similar approaches. Dr. Larry Levin, president elect of the Ontario Dental, has worked as a dentist in Hamilton for 39 years. The team can help the practice achieve excellence by providing better access for patients, while achieving the highest level of care because everyone is doing what they are superbly trained to do, he says, When team members are operating in their areas of expertise, it frees up dentists to do tasks that only they can provide. Behind the scenes, up to nine different dental specialists including orthodontists and maxillofacial and oral surgeons to periodontists and public health dentists may collaborate with general practitioners to provide comprehensive care, he says. Further, Dr. Smith, who leads a practice in northern Alberta, sees the team extending even further to include the support of laboratory technicians, equipment makers and suppliers who support what are essentially small hospitals. Perhaps the most significant development in recent years, however, stems from the growing and important recognition that dental health is part of overall health, says Dr. Smith. Consequently, there is a strong relationship between physicians and the dentists, because we are treating similar diseases, such as bacterial infections, which can cause gum disease for example. This important development has led to dentists now interacting with other health professionals, such as physiotherapists in treatment of joint problems of the jaw. Finally, adds Dr. Smith, parents and caregivers are getting involved, completing the extended team now helping ensure Canadians benefit from comprehensive oral care. Dr. Friedlander adds, The time for working in vertical silos is over. Nowadays we are communicating across professional lines and we re getting better outcomes for patients. He says Canada s standard of care is world class. Our dentists, hygienists and assistants have a terrific safety record. This type of one-stop shop has a solid track record with Canadians who enjoy convenient access to very high standards of oral health care. Dr. Levin says at his office, the 8:15 morning huddle allows the team to discuss the issues of patients who are coming in, and how to do the best for them. He likens the general practitioner to the quarterback who pulls the office and external teams together to deliver outstanding patient-centred care. Dr. Friedlander agrees. The dentists education, knowledge of the patient s medical and dental history and current needs help dentists align everyone s contribution and ensures that patients receive comprehensive and high-level care. The time for working in vertical silos is over. Nowadays we are communicating across professional lines and we re getting better outcomes for patients. INCIDENCE AMONG YOUTH RISING Early detection of oral cancer crucial to survival O ral cancer is more common and dangerous than you might think. Yet with early detection the impacts of this potentially deadly disease can be mitigated, says a top cancer expert involved in a team dedicated to combating oral cancer. The number of diagnosed oral cancer cases in Canada is greater than many other cancers including cervical, Hodgkin s lymphoma, ovarian, liver and multiple myeloma, to name a few. While the disease is more common after age 40, incidences among younger people are rising. And although oral cancer is most common in smokers and people who both drink alcohol and smoke, Dr. Michele Williams of the BC Cancer Agency says, More than 25 per cent of oral cancers occur in people who do not smoke and have no other risk factors. Despite advances in the treatment of oral cancer, the five-year survival rate in Canada is only 62 per cent a marginal improvement in survival over the last several decades. The problem is that many oral cancers are diagnosed at advanced stages, says Dr. Williams, who notes that survival is much better when the condition is diagnosed early. Dentists are uniquely positioned to detect oral cancer early and to make a real difference in the fight against this devastating disease says Dr. Williams, a member of an oral cancer prevention group that includes a team of clinicians and scientists dedicated to the CDA LOBBY EFFORTS ADVANCE PUBLIC INTERESTS Dentists encourage Canadians to save for future care W hen the federal budget was tabled in February, Canadian dentists were pleased to see that the government had decided to create a new vehicle to promote savings among Canadians. Now, the CDA is encouraging Canadians to use the government s proposed Tax-Free Savings Account (TFSA) to allocate funds for their future oral health care. The CDA says saving for long-term oral care is vital, especially for self-employed Canadians who don t subscribe to a dental insurance plan, and for nearly all Canadians as they enter retirement, a time when health coverage is typically reduced or terminated. Creating an environment that includes the non-taxation of dental benefits has been a priority issue of CDA for the last decade, says Dr. Darryl Smith, president of the Canadian Dental. The CDA was delighted to see that the TFSA was part of the last federal budget. This type of plan will allow people to use the tax system as an incentive to fund their own health care needs. For several years, the CDA had encouraged the federal government to implement a Personal Wellness Investment Fund (PWIF) a concept specifically oriented to help individuals allocate money for health services not covered under the Canada Health Act. The CDA says government has met most of the goals of the PWIF through the TFSA in the new budget. See ORAL CANCER page CDA 4 See CDA LOBBY page CDA 2 INSIDE CDA 2 Canadian Dental President Dr. Darryl R. Smith says saving for future oral health care needs is part of prudent planning. CDA 4 Devastation of early childhood caries easily avoided, say dentists. CDA 5 Oral health is in your hands. Look for the Seal. From toothbrushes to toothpastes, whitening products to dental floss, oral care products that have earned the Canadian Dental Seal of Recognition will effectively contribute to your oral health. Make an informed choice. Find a list of oral health products recognized by CDA at

2 CDA 2 A special information supplement THE GLOBE AND MAIL TUESDAY, APRIL 29, 2008 SAVING FOR FUTURE ORAL HEALTH NEEDS VITAL Planning for our dental health needs it s more than just brushing Employer-supported pension plans or post-retirement health care benefits are no longer guaranteed. Setting money aside for the predictable costs of oral care is part of smart, responsible planning. By Dr. Darryl R. Smith, President, Canadian Dental H aving spent 30 years practising dentistry, there are common themes I have heard from my patients again and again. One is Fix me up, Doc. I am going to retire next year and my dental plan will disappear. Hopefully, these patients have always appreciated what good dental health means, as their future needs will be few. Unfortunately, this is not always the case; many patients have not made the commitment necessary to ensure a life of both dental and overall wellness. For these people, the long-term costs both financial and in terms of quality of life can be significant. It doesn t have to be that way. Planning for wellness has so many benefits. For example, the two most common dental diseases caries (cavities) and periodontitis (gum disease) are largely preventable. Avoiding dental disease not only helps make the costs of dental treatment predictable, it is also fundamentally vital to our general health. Coupled with regular visits to your dentist, habits such as brushing with a fluoride toothpaste, flossing, using a mouth rinse, maintaining a healthy diet, and not using tobacco all contribute to a disease-free mouth and better health. Unfortunately, many people don t make the connection between oral and general health. Partially, this is because we see a dentist for our dental care needs, but the rest of the body is our physician s domain. Dentistry s success at repairing the teeth and gums has also led many of us to consider tooth damage/loss as acceptable. It s important that we change this mindset at a societal level, and look to dentists for ongoing guidance, care and preventive medicine. The bottom line is that we all pay financially for our health care needs, either directly through employee deductions or by paying at the dentist s office, or indirectly through taxes. While the costs of dental care are only a fraction of Canada s total health care bill $10 billion of the some $160 billion Canadians spend annually on health care the cost of dental care will continue to be affordable provided we do our parts. One thing is sure: Canadians are blessed with dental care ranked among the world s finest. Canada s efficient model of dental care services delivery, facilitated primarily through independent offices, has enabled us to benefit from topquality care while avoiding the access issues seen in our publicly funded health care system. For 50 years, Canada s dentists have also demonstrated public leadership by promoting community health measures such as water fluoridation, tobacco cessation, healthy diets and public education targeted at expecting mothers and schoolaged children. I m pleased to say that, in general, government policy has been supportive and had a positive effect on the cost of dental services. Allowing dental plan premiums to be nontaxable benefits, and expanding access to dental services to disadvantaged Canadians are good examples. Governmental shortcomings, however, have resulted in a lack of funding for both dental schools and research two areas critical to the future of oral health of all Canadians. This brings me back to where I started. We Canadians look forward to retirement, but often do not plan for it as well as we could. Changes in the past 20 years mean that employer-supported pension plans or post-retirement health care benefits are no longer guaranteed. As a result, it is vital that Canadians save for their futures through Registered Retirement Saving Plan (RRSP) and new measures such as the recently proposed Tax-Free Saving Account (TFSA). I encourage all Canadians to embrace the TFSA and use it to save for their long-term dental care needs. Just like other choices we make that contribute to our long-term well-being, setting money aside for the predictable costs of oral care is part of smart, responsible planning measures that enable us to otherwise avoid the undesirable consequences and high costs of neglect. NATIONALLY, MORE WOMEN GRAVITATING TO PROFESSION Quebecers rank dentistry their top job choice I n a recent survey in Quebec, respondents put dentistry first when it came to desirable work attributes. Elsewhere in Canada, statistics indicate that more women than ever before are making dentistry their career choice. The results of a Jobboom survey placed dentistry at the top of the list of the 25 best jobs in Quebec based on criteria such as opportunities for professional development, autonomy, participation in decision-making, being part of a work team, flexible hours and salary. Jobboom, a specialist in online recruiting, based its findings on the feedback of 1,763 survey respondents, according to Le Journal de Montréal. Dentistry offers more flexibility than any other branch of medicine, and that supports CDA LOBBY from CDA 1 We have to start somewhere, said Dr. Smith. When passed into legislation, the TFSA will allow Canadians to stash away up to a well-balanced life making it an attractive career choice for women, says Dr. Deborah Stymiest, president-elect of the Canadian Dental (CDA). When I graduated 25 years ago, the class was about 20 males to four females. Today, in the 10 dental schools in Canada, out of 456 graduates per year, about 58 per cent are women, says Dr. Stymiest, who also works as a dentist in Fredericton, New Brunswick. While currently there are more men practising, we will begin to see a significant shift in the numbers of actual dentists as these female students begin to work. Despite the advice of a high school counsellor who suggested Dr. Stymiest choose a more traditional female-oriented career, Dr. Stymiest was $5,000 per year in a tax-efficient shelter. While money saved for a TFSA be invested using after-tax dollars, the subsequent interest earned will be tax-free and the total savings principal plus interest may be used however an individual chooses. Now, the CDA is working to educate Canadians as to why they should use this new vehicle to help prepare for their long-term health needs. Canadians have to consider how they will pay for things like pharmaceuticals, home care, dental care, etc. down the road, and they need to plan for it, said Dr. Smith. In other areas of advocacy, CDA is particularly mindful of the dental health needs of Canada s more marginalized population segments, including First Nation people and war veterans. In the case of the latter group, the CDA welcomed the news that enhancements to the Veterans Affairs Canada (VAC) dental plan have been Close contact recently announced by the federal government. Effective April 1, 2008, the VAC has reinstated 100 per cent reimbursement rates for covered VAC services. Like every plan, there will be exceptions to coverage, but intent on pursuing her goal. She found support in her father, a Cape Breton miner, who urged her to follow her dreams. It was the best decision of my life, she says. As a way of giving back, she became involved in the organizational side of the profession. She will soon progress from being president of the New Brunswick Dental to become the CDA s first woman president. Dr. Diane Legault, president of the Quebec Order of Dentists, says that the CDA s choice demonstrates that the face of the profession is changing (to include more women). Obviously, we re there. Dr. Legault, who began pursuing her career in dentistry in 1979, says, Dentistry requires that you be fit, as well as having the hands of a sculptor, the empathy of a psychologist, a scientific mind, intellectual curiosity, and management and business skills. But, it was the autonomy and control over the work environment and scheduling that clinched the deal. I wanted to raise my children in the country, and it was relatively easy to move my practice from Montreal to the Eastern Townships. With the increasing number of women in the profession and the rising costs of technology, many dentists are opening group practices, she adds. The resulting flexible scheduling and shared office costs are favourable to both patients and dentists. Dr. Stymiest sums up, It s a wonderful career with a little bit of everything. We re never bored. To learn more about oral health, contact the CDA or your provincial or territorial dental association. Canadian Dental British Columbia Dental Alberta Dental and College Manitoba Dental College of Dental Surgeons of Saskatchewan Ontario Dental Ordre des dentistes du Québec Newfoundland and Labrador Dental New Brunswick Dental Society Nova Scotia Dental Dental of Prince Edward Island Northwest Territories/Nunavut and Yukon Dental s it is certainly much better than it was said Dr. Smith, citing the need to continue co-operative oral health efforts with governments. The CDA says it plans to continue its work advocating in the interests of public health. Dentistry offers more flexibility than any other branch of medicine, and that supports a wellbalanced life making it an attractive career choice for women. This report was produced by RandallAnthony Communications Inc. ( in conjunction with the advertising department of The Globe and Mail. Richard Deacon, National Business Development Manager, rdeacon@globeandmail.com.

3 The Canadian Dental s Seal of Recognition How oral health products earn the Seal and what this means to you and your family. What does the Seal stand for? Consumer products carrying the Canadian Dental (CDA) Seal of Recognition are recognized for specific oral health benefits such as the reduction of gingivitis or hypersensitivity and the prevention of tooth decay. As a consumer, when you choose a product bearing the Seal, you know that product has been reviewed by CDA and will effectively contribute to your oral health. The Seal provides consumer information on a wide range of oral health products such as toothbrushes, toothpastes, oral rinses and dental floss. How do products earn the Seal? CDA has developed a set of guidelines for the review of products in each recognition category. These guidelines set the standard that products must meet to earn the Seal and specify the type of research evidence that must be provided to demonstrate the standard has been met. A complete description of the various categories of recognition is available on the CDA website at What oral health products currently carry the Seal? Here is a list of products currently recognized by CDA: Oral Rinses and Mouthwashes Crest Pro-Health Oral Rinse (Cool Wintergreen, Refreshing Clean Mint) Listerine Antiseptic Advanced Mouthwash Listerine Antiseptic Mouthwash (Original, Cool Citrus, Cool Mint, Fresh Burst, Vanilla Mint) Listerine Antiseptic Tartar Control Mouthwash Listerine Antiseptic with Fluoride Mouthwash Peridex Oral Rinse Toothbrushes Colgate 360 Toothbrush Colgate Massager Toothbrush Colgate MaxFresh Toothbrush Colgate Navigator Toothbrush Colgate Sensation Whitening Toothbrush Colgate Total Professional Toothbrush Colgate Twister Fresh Toothbrush Oral-B Advantage Toothbrush Oral-B Cross Action Pro-Health Toothbrush Oral-B Cross Action Vitalizer Toothbrush Oral-B Indicator Toothbrush Oral-B ProfessionalCare 7500 Power Toothbrush Oral-B ProfessionalCare 8850 DLX Power Toothbrush Oral-B Pulsar Toothbrush Oral-B Pulsar Pro-Health Toothbrush Oral-B Sonic Complete Power Toothbrush Oral-B Triumph with Smart Guide Power Toothbrush Oral-B Vitality Power Toothbrush (Dual Clean, Precision Clean, Sensitive) Sulcabrush (Regular, Travel) Toothpastes Aquafresh Sensitive Toothpaste Crest Cavity Protection Regular Toothpaste Crest Complete Clean Mint Gel Toothpaste Crest for Kids Cavity Protection Sparkle Gel Crest Extra Whitening with Tartar Protection Clean Mint Toothpaste Crest Multicare Whitening Toothpaste Crest Pro-Health Toothpaste (Clean Cinnamon, Clean Mint, Night) Crest Sensitivity Protection Mint Toothpaste Crest Tartar Fighting Toothpaste Colgate 2 in 1 Toothpaste and Mouthwash Kids (Strawberry, Watermelon) Colgate 2 in 1 Toothpaste and Mouthwash Whitening Colgate Cavity Protection Toothpaste (Regular, Winterfresh) Colgate Fluoride Toothpaste for Kids Colgate Luminous Toothpaste (Crystal Clean, Paradise Fresh) Colgate MaxFresh Whitening Toothpaste (Cool Mint, Kiss Me Mint) Colgate MaxFresh Burst Toothpaste (Peppermint, Spearmint) Colgate MaxFresh Whitening Liquid Gel Toothpaste (Cool Mint, Kiss Me Mint) Colgate Sensation Sparkling White Baking Soda and Peroxide Toothpaste Colgate Sensitive Toothpaste (Whitening Cool Mint, Original Fresh Stripe) Colgate Sparkling White Toothpaste (Mint Zing, Vanilla Mint) Colgate Total Advanced Health Toothpaste (Original, Intense Fresh, Gel, Whitening Gel) Colgate Total Toothpaste (Original, Fresh Stripe) Colgate Total Plus Whitening Toothpaste Sensodyne Toothpaste ProNamel (Mint Essence and Fresh Wave) Sensodyne Toothpaste for Sensitive Teeth: Sensodyne-F Toothpaste (Fresh Mint, Whitening plus Tartar Fighting, Ultra Fresh, Revitalizing Whitening, Brilliant Whitening, Cool Mint Gel, Baking Soda Clean) Sensodyne Original Toothpaste Dental Floss Oral-B Satin Floss Crest Glide Floss Denture Adhesive Fixodent Denture Adhesive (Control, Free, Fresh, Original) Medicated Tooth Coatings Prevora Medicated Tooth Coating by CHX Technologies Inc. The following have applied for and earned the Seal of Recognition for the above oral health products. * For more information on the CDA Seal of Recognition, visit the CDA website at

4 CDA 4 A special information supplement THE GLOBE AND MAIL TUESDAY, APRIL 29, 2008 TO BLEACH OR NOT TO BLEACH Blinded by the white Bleaching is a cosmetic procedure with a very specific protocol and was never intended for daily use. The effects need to be carefully monitored. PREVENTIVE MEASURES EASILY IMPLEMENTED Devastation of early childhood caries avoidable, urge dentists T here s splendid perfection in the toothless grin of a happy baby. However, by the time teeth have appeared in a growing number of Canadian children, that perfection is marred by early childhood caries a fast-progressing, potentially devastating dental disease. Once known as baby bottle syndrome, early childhood caries is considered to afflict kids under the age of risk who have one or more missing or decayed teeth. This infection process happens when sugars including those from breast D o whitening products and bleaches make your teeth healthier as well as brighter? No, but there may be other valid reasons to use these products in the quest for a nicer smile. The key is to consult your dentist, and know when enough is enough. For people acutely embarrassed by discoloured teeth, using a whitener or bleach can bolster their confidence says Dr. Benoit Soucy, CDA director of membership and professional services. It does improve the quality of life of these patients, he says. Before rushing to the store, however, it s important to distinguish between whitening and bleaching products. Whitening toothpastes, gums and rinses are sold over the counter in drugstores and grocery stores. Rather than actually changing the colour of your teeth, these specially formulated toothpastes simply clean the surface of your teeth better than other products, helping prevent your current colour from worsening. They can still be useful products, especially when they also fight tartar and tooth decay, but they may not give you the dazzling smile of your dreams. To actually change the colour of your teeth, you may want to consider bleaching. You can use mild bleaches available in stores, or get your teeth bleached with a more concentrated preparation at the dentist s office. But even if you decide to do it yourself, the CDA strongly advises consulting your dentist first. You have to be careful before you start, says Dr. Soucy. For instance, if you have cavities, damaged enamel or exposed roots, bleaching can lead to irritation even, in milk are exposed to teeth for prolonged periods. According to pediatric dentists Drs. Sarah Hulland and Ian McConnachie, early childhood caries which is on the rise throughout the world can damage children s overall health. It is responsible for the majority of required general anesthetic cases in children across Canada. And it is, they say, entirely preventable. The solution lies in good oral hygiene, healthy eating practices and early detection. It s about starting a whole pattern of oral health care extreme cases, to a root canal. Age also plays a factor, says Dr. Soucy. The younger you are, the larger your pulp chambers are, he explains. That means that sensitive pulp is closer to the surface of the tooth, so bleaching may cause more tooth irritation in younger patients than in older ones. It s also a good idea to consult your dentist to make sure you re not spending money on products that won t achieve the effect you want, says CDA president Dr. Darryl Smith, a dentist in Valleyview, Alberta. There are potential problems with bleaching, he explains. Its effectiveness varies with each individual. Bleaching won t change the colour of fillings, nor can it fix problems unrelated to enamel colour. Sometimes it s the position of the teeth that is creating shadows [and dimming the smile], says Dr. Smith. Your dentist can also recommend an appropriate bleaching schedule. Since bleaching has to be done regularly to maintain those pearly whites, some people may be tempted to bleach far too often when they re doing it at home. Bleaching is a cosmetic procedure with a very specific protocol and was never intended for daily use. The effects need to be carefully monitored, says Dr. Smith. Finally, he urges people to realize that everyone s teeth are different and that it isn t necessary to have a movie star smile to be happy. You can literally change the colour of the teeth until they re beyond natural, he says. In the end, he argues, it s much more important to ensure your teeth are healthy. right from the beginning, says Dr. Hulland. The dental community, says Dr. McConnachie, is focused on early prevention and recommends parents bring children for their first visit by age one. Early visits help educate parents, identify those kids whose teeth are naturally more at risk and treat those who show signs of being affected before the problem escalates. They also can help discourage destructive behaviours. People need to remember that a sippy cup is just a glorified baby bottle. It gets the sugar behind the teeth. Kids may as well be sucking on a bottle or a lollipop for that matter, says Dr. Hulland. Frequent eating and a diet high in sticky, processed foods and sugars is also very hard on kids teeth. Processed foods often contain considerably more sugar than people are aware. Ultimately, both Drs. Hulland and McConnachie agree that the devastation of early childhood caries is needless and well worth the effort required prevent it. 5 steps to good oral health Help reduce the risk of oral disease by following these 5 steps. 1. See your dentist regularly Regular checkups and professional cleanings help prevent problems and stop small problems from worsening. 2. Eat a balanced diet Healthy food promotes wellness and good oral health. Avoid excess sugar. 3. Check regularly for warning signs Gum disease is a leading cause of adult tooth loss. The warning signs include red, shiny, puffy, sore, sensitive or bleeding gums, and persistent bad breath. Oral cancer s warning signs include inexplicable bleeding, open sores, white or red patches, numbness or tingling, and small lumps and thickening on the sides or bottom of your tongue, the floor or roof of your mouth, the inside of your cheeks or on your gums. Report these warning signs to your dentist. 4. Don t smoke or chew tobacco Tobacco promotes gum disease and tooth loss and may lead to serious problems such as oral cancer. 5. Practise good oral hygiene Using a soft-bristle toothbrush, brush your teeth and tongue at least twice a day with fluoride toothpaste to remove plaque and bacteria. Floss every day. Choose oral care products with the Canadian Dental (CDA) Seal of Recognition. ORAL CANCER from CDA 1 prevention of oral cancer development through improvements in detection, diagnosis and care. The first sign of oral cancer is often a (sometimes) painless, tiny white or red spot or sore anywhere in the mouth, including the lips, gum tissue, cheek lining, tongue and the hard or soft palate. At more advanced stages, symptoms may include a sore that bleeds easily or does not heal. Additional symptoms can include pain, tenderness or numbness anywhere in the mouth or lips and difficulty chewing, swallowing or moving the tongue or jaw. Regular dental check-ups, including an examination of the entire mouth, are essential to early detection of pre-cancerous and cancerous conditions. An annual oral cancer screening examination is recommended for all adults 40 years of age and older. The exam is painless, quick to perform and can be done at the time of the regular dental check-up, Dr. Williams says. Oral cancer is a disease of the soft tissues of the mouth, not the teeth, so all individuals regardless of whether they have their natural teeth or not should be screened regularly, she adds. In terms of new treatments, Dr. Williams says the oral cancer prevention team is working hard to transfer research findings to the dental chairside. Presently a variety of therapies are used to address the disease in its advanced stages, including surgery, radiation and chemotherapy. The earlier the disease is caught, however, the better the chances that damage to the mouth and jaw due both to the effects of the disease and medical intervention may be mitigated. To learn more about Dr. William s team s experience and its vision for oral cancer care, see this month s special issue of the Journal of the Canadian Dental, now available online at Hey parents, are you providing the best dental care for your kids? Parents play a key role in keeping their children s teeth healthy and clean. Preventive care starts at home. Here are some ways to promote oral health in children: Clean teeth It is important that parents clean their children s teeth when they are very young, and do it with them as they get older. Avoid sugar Sugary foods and drinks mix with bacteria in the mouth, forming a mild acid that attacks tooth enamel, leading to cavities. Visit your dentist CDA encourages a visit to the dentist within 6 months of the eruption of a child s first tooth or by one year of age. Help prevent early childhood tooth decay Once a child has teeth, he or she is susceptible to tooth decay. Mother's milk, formula, cow s milk and fruit juice all contain sugars. Avoid letting your child fall asleep with a bottle of milk, formula or juice or with breast milk still in his or her mouth. Pacifiers and thumb sucking Sucking helps babies relax, but by age two or three, he or she has less need to suck. Foremost, never put sugar, honey or corn syrup on a soother.

5 THE GLOBE AND MAIL TUESDAY, APRIL 29, 2008 A special information supplement CDA 5 BRUSHING AND FLOSSING JUST THE START Oral health is in your hands People with periodontal disease may need to have their teeth cleaned every three months, while an annual visit may suffice for people whose teeth and gums are in good shape. Y ou probably brush your teeth several times every day. That s a great first step toward ensuring good oral health, but it s not the only action needed to ensure oral wellness. Almost all Canadians brush their teeth, because that s something that people have grown up with, says Dr. Euan Swan, manager, dental programs at the Canadian Dental (CDA). On the other hand, another key to good oral health requires a bit of practice and dexterity. Flossing s a little harder to do, Dr. Swan concedes. But he emphasizes that people who floss at least once every 24 hours can remove the plaque between teeth that toothbrushes can t reach, stopping it from developing and maturing. Another key task is rinsing with an appropriate mouthwash. Depending on your needs, your dentist may recommend a fluoride rinse to combat tooth decay or an antimicrobial rinse to stave off gum disease. The CDA calls these three steps the gold standard of oral hygiene. According to Canada s first-ever Oral Health Report Card, a Decima Research study commissioned by Johnson & Johnson published in 2007, 40 per cent of Canadians know that these steps are key, but only 21 per cent actually carry out all three. Saving your teeth isn t the only reason to meet the gold standard. Poor oral hygiene is linked to a range of disorders elsewhere in the body, including heart disease, diabetes and respiratory disease. It may even play a role in pre-term, low birth-weight babies. As well as the gold standard, the CDA says four other approaches can help ensure good oral health. First, you should see your dentist regularly. How regularly? You probably went every six months as a child, but that standard is changing. We ve come to realize there are some individuals who are at greater risk of dental disease and some who are at less risk, says Dr. Swan. People with periodontal disease may need to have their teeth cleaned every three months, while an annual visit may suffice for people whose teeth and gums are in good shape. Second, eat a well-balanced diet. Nutritious foods will help you fight gum disease and tooth decay, and avoiding sugar helps prevent cavities. Third, check your mouth regularly. Bleeding gums and open sores that don t heal within 10 days are two symptoms of possibly serious problems that you should discuss with your dentist. And finally, don t smoke or chew tobacco. It s not kind to your teeth or your gums, says Dr. Swan. For more information, see Your Oral Health on the CDA s website at CDA Seal of Recognition, a symbol you can trust Y ou ve likely seen that official symbol on your toothpaste or dental floss the one with the maple leaf, a triangle and traditional medical insignia inside a circle of text stating Canadian Dental Recognized but what does it mean, exactly? The CDA Seal of Recognition means that consumers can be assured they are getting products that contribute to oral wellness. Manufacturers seeking the coveted CDA seal must submit their products for review by a scientific committee, which analyzes clinical and laboratory evidence according to strict guidelines. If there is any doubt, the CDA may ask for additional data and further testing before deciding the fate of an application. Dr. Louise Desnoyers, a Montreal dentist and member of the CDA Seal of Recognition Working Group for 14 years, says, When given, the seal supports highly specific claims of efficacy. She says first and foremost the program is educational. The main goal of the Canadian Dental in using the seal is to help the public and dental professionals make informed choices about personal and professional products. CDA recognizes 15 categories of products including toothbrushes, toothpastes, flosses and rinses, denture adhesives and professional products such as surgical gloves and prescribed oral rinses. What do 80% of Canadian dental professionals have in common? They all recommend the Brand * Visit for innovative solutions to help improve your family s oral health or ask your dental professional. They ve been recommending the Brand from Sunstar since * Data on file Sunstar Americas, Inc.

6