Wednesday, November 26, 2014

Inadequate Dental Care for Preschoolers in Canada

An interesting article came out from the Canadian Institute of Health Research regarding preschoolers and inadequate dental care.  The study ran from September 2011 to January 2013 and found that less than 1% of children received adequate dental care as recommended by 12 months of age.

It’s a common misconception that baby teeth are not important to the development of permanent teeth but important to know that's entirely false. Infected baby teeth can cause malformation and discoloration of permanent teeth; not to mention significant pain for the child.

Oral hygiene when younger is incredibly important in creating the bacterial biofilm that adult teeth will be introduced to. Once you have a specific mix of cavity producing bacteria established in the oral environment it can be extremely challenging to change it over time.

The Canadian Dental Association recommends that a child come see the dentist at around age 1 but statistically the Journal of Pediatrics shows less than 2% of kids have seen a dentist by 24 months.

Are we going to do treatment on a 2 year old? No but we can notice if there are the start of cavities that are beginning to develop and where it can be important for parents to focus their brushing habits.

I have had 3 year olds that have been neglected, left to suck on baby bottles all night, that we have had to send for treatment at BC Children’s hospital for treatment under general anaesthesia to address cavities. Don’t think just because your child never complains of pain that everything is OK. It’s important to have a trained professional look and assess.

In situations where there is pain dental health complications can be significant:
  1. Difficulty eating
  2. Poor nutrition
  3. Poor growth
  4. Difficulty sleeping
  5. Behavioral difficulties
The most common surgical procedure performed in hospitals is extracting teeth in preschoolers. If these cavities can be caught earlier then these teeth could be saved.

It’s also important that pediatricians and family doctors provide counseling and do preliminary screening on all preschoolers to assess a childs risk of dental disease. If there are any potential problems spotted then a child can be sent to a dentist for an immediate evaluation.

Tuesday, November 11, 2014

50 Shades of Floss

More commonly known is that you should brush your teeth twice a day, less commonly known is that you really should be flossing a minimum once a day but ideally 2-3 times a day. I know… I know… who has time for that! It’s the same problem we all have when health gurus tell us we should exercise 4-5 times a week: it's hard to fit in all the things we need to do in the course of week much less a day. I don’t pretend that at this moment you’ll read this and take it as an affirmation to make a unilateral change to your morning and bedtime routine but I hope it will open your mind to the possibility that this simple act could reduce years of possible hardship and keep your teeth young and healthy for your entire life.

So where to start – lets have a multiple choice game (Yes I’m tricking you into getting interested in flossing by associating it with a game – you got me)

1. What percentage of your tooth surfaces are cleansed by brushing?
   (a) 60%
   (b) 70%
   (c) 80%
   (d) 90%
   (e) 97%

2. Flossing cleans how many surfaces of a tooth?
   (a) 1
   (b) 2
   (c) 3
   (d) 4
   (e) 5

3. Which type of floss is better?
   (a) Nylon
   (b) Teflon
   (c) Same

4. A person with wide spaces between their teeth should use:
   (a) Floss that look like a flat wide piece of tape
   (b) Thin floss that looks like a small string
   (c) A shoelace

5. How long of a piece of floss should you use?
   (a) 4-7 inches
   (b) 8-11 inches
   (c) 15-18 inches
   (d) 22-25 inches

The Answers:

1. (a) Brushing takes care of removing 60% of the plaque on your teeth. Flossing takes care of the other 40% and this plaque can't be removed by any amount of brushing or rinsing with mouthwash.

2. (b) A tooth has 5 surfaces – One top, two sides, one front and one back. If you don’t floss it’s like washing your car on the top front and back and just leaving the sides. Doesn’t seem to make sense to do that so that’s why we always stress flossing because it literally doesn’t make sense not to.

3. (c) Nylon and Teflon are two different products that will accomplish the same task.

4. (a) Large spaces are generally associated with recession and root exposure. The flat tape will work better to gently remove plaque on those areas without traumatizing the gums. If your teeth are close and tight then use a thin floss.  There is also Gore-Tex floss that will pass through the tightest of contacts.

5. (c) Using a piece of floss, 15-18 inches long, slide it between the teeth and wrap it around each individual tooth in a C-shape and gently polish in an up and down motion. If you haven’t flossed regularly don’t worry if your gums bleed, that’s normal. If it’s persistent after a few days it could be a sign of periodontal disease.

If you lack the manual dexterity to floss then try soft wooden plaque removers, which look similar to tooth picks, or a two-pronged plastic floss holder. Both allow you to floss with just one hand.