Diet and tooth decay Prevention

Transcription

1 Diet and tooth decay Prevention Santa Clara County Dental Society Indian Health Center San Jose Gardner Family Health Network

2 WHAT IS TOOTH DECAY? WHAT IS A CAVITY? Tooth decay or a cavity of dental caries is the destruction of the outer surface (enamel) of a tooth by bacteria that live in plaque, which is a sticky, whitish film formed in the mouth. 2

3 DID YOU KNOW? Tooth Decay or Early Childhood Caries is the most widespread chronic disease of childhood Over 19% of children ages 2-19 have untreated cavities!! Tooth decay is 20 times more common than diabetes. 5 times more common than asthma 4 times more common than earlychildhood obesity US Department of Health and Human Services. (2005) Oral Health in America: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health. 3

4 WHAT DOES A TOOTH DECAY OR A CAVITY OR CARIES LOOK LIKE? 4

5 What is Plaque? Plaque is a sticky colorless film that coats your teeth. It is made up of by bacteria naturally occurring in the mouth. These bacteria are attracted by sugary food or drink or when easily fermentable carbohydrates are eaten (e.g goldfish, crackers, cookies) If you run your tongue along your teeth, you may be able to feel this plaque forming several hours after you've brushed. 5

6 WHAT CAUSES A CAVITY? Bacteria Diet (Sugar- Carbs) Tooth 6

7 WHY DO WE NEED TO TREAT CAVITIES IN BABY TEETH? WHAT S THE BIG DEAL!! THEY ARE GOING TO FALL OUT ANYWAYS!! 7

8 WE NEED BABY TEETH TO STAY HEALTHY BEFORE WE GET PERMANENT TEETH BECAUSE Eating and nutrition Holding Space Speaking Smiling Self-esteem Most Permanent teeth erupt from ages 6-13 years. TILL THEN BABY TEETH ARE NEEDED!! 8

9 Enamel is thinner Decay process is quicker Teeth abscess quickly Often multiple abscessed teeth Primary teeth hurt just as much as permanent teeth PRIMARY TEETH VS ADULT TEETH 9

10 WHEN CAVITIES PROGRESS there is PAIN & INFECTION!! Children learn to live with the pain Missed preschool and school days Inability to concentrate; impairs school readiness Can affect sleep and overall health and well-being Cannot chew & digest food Failure to thrive and delayed growth patterns

11 EARLY CHILDHOOD CARIES 11

12 DENTAL ABCESSES 12

13 Plaque attacks The bacteria in the plaque produce acids & remove minerals in your tooth's hard, outer enamel. This causes tiny openings or holes in the enamel the first stage of cavities. Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer and less resistant to acid than is enamel & the cavity progresses faster! 13

14 Destruction continues Then the bacteria move to the inner tooth material (pulp) that contains nerves and blood vessels. The pulp becomes swollen and irritated from the bacteria. The bone supporting your tooth also may be affected. When decay advances to this extent, you may have severe toothache, sensitivity, pain when biting or other symptoms. Your body also may respond to these bacterial invaders by sending white blood cells to fight the infection. This may result in a tooth abscess. 14

15 EFFECTS OF EARLY CHILDHOOD CARIES

16 Risk Factors: EARLY CHILDHOOD CARIES Diet high in easily fermentable carbohydrates & sugar Giving milk or formula at night time in bottle or sippy cup or snacks before bedtime. Maternal smoking during pregnancy Long periods between dental visits 16

17 CARIES IS A DISEASE BUT IT IS PREVENTABLE!! IT IS AN INFECTION AND IS INFECTIOUS!! The mouth is sterile at birth. Bacteria are passed to the child by the caregiver. White spots on the teeth are often the first sign of decay. 17

18 Early Childhood Caries Highly preventable by: Limiting bedtime beverages/snacks Seeing a Dentist every 6 months Limiting Frequency of eating Eating fresh, nutritious fruits, vegetables, whole grains Taking fluoride supplements Brushing twice/day & flossing once/day with fluoride toothpaste 18

19 LIMITING CARBOHYDRATES Sugary foods and drinks soda, juice, kool-aid Limit simple carbohydrates like white crackers, goldfish, cookies Need to limit the total sugar intake 19

20 Frequency eating Cut down on how often a child eats sugary foods and drink. Give them the sugary foods or drinks as part of a meal instead of between meals if you can. Having sugary foods and drinks too often puts the teeth at risk of tooth decay due to ph change in saliva. 20

21 Sticky Foods Foods that tend to stick to the teeth pose greater risks of decay than those that clear the mouth quickly. Surprisingly, chips and crackers adhere longer than jelly beans and caramels. 21

22 DID YOU KNOW???? A small piece of cheese at the end of the meal can help combat the acids produced from carbohydrate foods during the meal. 22

23 Sodas Sodas have refined sugar that not only offers no nutritional benefits, but is known to cause cavities. One can of Coke has 10 spoons of sugar! Soda also contains phosphoric acid which interferes with the body s ability to absorb calcium, essential for strong teeth and bones 23

24 Soda To decrease the effects of soda on the teeth: Drink soda through a straw Rinse the mouth before and after drinking soda Limit how much soda an adolescent drinks 24

25 Diet & oral health A cause for concern: Rising consumption of soft drinks is displacing milk in the diet of teenage girls which can lead to an increased risk of osteoporosis in later life. 25

26 Saliva The teeth and oral tissues are constantly bathed in saliva. The production of saliva increases when food or drinks are consumed. Its presence is vital to the maintenance of healthy oral tissue. 26

27 Sucrose(SUGAR) Content of Some Medications Ampicillin 33-45% Amoxicillin 33-50% Ceclor 60% Keflex 60% Dicloxacillin 46-62% Erythromycin 45-70% Pen VK 40-65% Bactrim 50% 27

28 COMMON RISK FACTORS FOR OBESITY AND DENTAL DISEASE Lack of Breastfeeding Lack of Access to Healthy Foods Water The Role of Sugar-Sweetened Beverages Impact on Children from Low-Income Communities Can not afford fruits & Vegetables 28

29 STRATEGIES TO REDUCE DENTAL DISEASE AND OBESITY Ensure consumption of five fruits and vegetables per day; Encourage and support breastfeeding; Encourage dietary counseling by appropriate health care providers; Reduce consumption of sweetened beverages. Increase physical activity to at least one hour each day Limit screen time to less than two hours a day Increase body mass index testing Establish a dental home by the time a child is a year old Provide topical fluoride and fluoridated water Provide regular oral health screenings and hygiene instruction 29

30 Erosion is defined as the loss of hard tooth tissue caused by acids other than those produced by bacteria involved in dental caries. Erosion can be Internal or External Internal gastric reflux eating disorders like bulimia - regurgitation External Acidic foods, drinks or medicines - citrus fruits and their juices, vinegary foods such as pickles, carbonated soft drinks. Apple juice is very acidic. Coke is very acidic as well. Unusual eating or drinking habits such as sucking on segments of citrus fruits and swishing or holding drinks in the mouth may be a greater factor in tooth erosion than the amount consumed. 30

31 PREGNANT PATIENTS Pre-natal: Poor oral health during pregnancy may increase the risk of having premature and/or low-birth weight baby 31

32 WEANING Recommend using a cup at 6 months of age Consider weaning at months of age Don t let baby sleep with the bottle Don t let baby walk around with a bottle or Sippy cup all day Breast milk has sugars. Remember the number of exposures to food and liquid have a great impact on the decay process. 32

33 CLEANING THE TEETH AT HOME Begins when first tooth erupts An adult should help brush a child s teeth until child is around 8 years old. Flossing can be done independently by kids at 11 years of age

34 WATER FLUORIDATION WHY IS IT FLUORIDE: Decreases growth of bacteria in plaque Inhibits demineralization Enhances remineralization Most of Santa Clara County IMPORTANT? does not have fluoridated drinking water. Exceptions are Evergreen, Alviso, north part of Milpitas, Santa Clara, Sunnyvale(North of El Camino), Mountain View and Palo Alto 34

35 XYLITOL A naturally occurring sugar from birch trees Inhibits the caries bacteria Diabetic safe, heat stable (can cook with it) but not safe for dogs 6-10 grams per day

36 CHEWING XYLITOL GUM 3-5 TIMES/DAY FOR 10 MINUTES ONLY/TIME IS VERY GOOD!! Increases flow of saliva in the mouth Cleans the mouth of food debris Relieves dry mouth discomfort Hemps reduce plaque & neutralize plaque acids Helps remineralize enamel to strengthen teeth Helps reduce plaque 36

37 Kids first visit to the Dentist The American Academy of Pediatric Dentistry recommends that all children should have their baby teeth looked at by a dentist BY 1 YEAR OF AGE!! 37

38 INFANT EXAM BEFORE FIRST BIRTHDAY Technique allows mother to support the child, keep a hold of the hands and be in clear sight. Show caregivers any signs of tooth decay Teach them to lift the lip monthly to check for chalky white spots or 38 brown spots

39 Infant oral health appointment A review of the infant's diet and nutrition The need for fluoride supplementation considering dietary and other sources of fluoride Instructions for cleaning the baby teeth and gums Discussion regarding pacifier, finger, or other oral habits Injury prevention and trauma Oral development and normal eruption patterns Risk factors for decay in the child's baby teeth 39

40 Avulsed teeth Knocked-Out (Avulsed) Teeth: If a tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in cold water (either tap or clean bottled water). Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it. Call a dentist immediately! 40

41 Oral Habits Thumb sucking Crowded, Crooked teeth or Bite problems Must stop sucking by age 2 years Pacifiers helps Jaw growth Easier to stop the habit BUT NEED TO STOP BY 3 YEARS OF AGE Mouth breathing Children Dry mouth Snoring (tonsils physician referral) Malocclusion 41

42 Medi-Cal/Denti-Cal Covers Children are fully covered for Dental work till their 21 st B Day: Exam & Xrays Cleanings Sealants Fillings Root Canals Many other procedures Adults many procedures covered but different coverage than children Undocumented people often only have Emergency Medi-Cal which covers evaluation for toothahe, extractions. Very limited coverage. 42

43 Thanks Anu Minocha DDS Dental Director, Indian Health Center & George Barghouth, DDS Dental Director Gardner Family Health Network St. James / CompreCare / South county clinics