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Smart Snacks for Healthy Teeth

October 25th, 2012

What's Wrong with Sugary Snacks, Anyway?
Sugary snacks taste so good — but they aren't so good for your teeth or your body. The candies, cakes, cookies, and other sugary foods that kids love to eat between meals can cause tooth decay. Some sugary foods have a lot of fat in them too. Kids who consume sugary snacks eat many different kinds of sugar every day, including table sugar (sucrose) and corn sweeteners (fructose). Starchy snacks can also break down into sugars once they're in your mouth.

How do Sugars Attack Your Teeth?
Invisible germs called bacteria live in your mouth all the time. Some of these bacteria form a sticky material called plaque on the surface of the teeth. When you put sugar in your mouth, the bacteria in the plaque gobble up the sweet stuff and turn it into acids. These acids are powerful enough to dissolve the hard enamel that covers your teeth. That's how cavities get started. If you don't eat much sugar, the bacteria can't produce as much of the acid that eats away enamel.

How Can I "Snack Smart" to Protect Myself from Tooth Decay?
Before you start munching on a snack, ask yourself what's in the food you've chosen. Is it loaded with sugar? If it is, think again. Another choice would be better for your teeth. And keep in mind that certain kinds of sweets can do more damage than others. Gooey or chewy sweets spend more time sticking to the surface of your teeth. Because sticky snacks stay in your mouth longer than foods that you quickly chew and swallow, they give your teeth a longer sugar bath.

You should also think about when and how often you eat snacks. Do you nibble on sugary snacks many times throughout the day, or do you usually just have dessert after dinner? Damaging acids form in your mouth every time you eat a sugary snack. The acids continue to affect your teeth for at least 20 minutes before they are neutralized and can't do any more harm. So, the more times you eat sugary snacks during the day, the more often you feed bacteria the fuel they need to cause tooth decay.

If you eat sweets, it's best to eat them as dessert after a main meal instead of several times a day between meals. Whenever you eat sweets — in any meal or snack — brush your teeth well with a fluoride toothpaste afterward.

When you're deciding about snacks, think about:

  • The number of times a day you eat sugary snacks
  • How long the sugary food stays in your mouth
  • The texture of the sugary food (chewy? sticky?)

If you snack after school, before bedtime, or other times during the day, choose something without a lot of sugar or fat. There are lots of tasty, filling snacks that are less harmful to your teeth — and the rest of your body — than foods loaded with sugars and low in nutritional value. Snack smart!

Low-fat choices like raw vegetables, fresh fruits, or whole-grain crackers or bread are smart choices. Eating the right foods can help protect you from tooth decay and other diseases. Next time you reach for a snack, pick a food from the list inside or make up your own menu of non-sugary, low-fat snack foods from the basic food groups.

How Can You Snack Smart? Be choosy!
Pick a variety of foods from these groups:

Fresh fruits and raw vegetables
Berries
Oranges
Grapefruit
Melons
Pineapple
Pears
Tangerines
Broccoli
Celery
Carrots
Cucumbers
Tomatoes
Unsweetened fruit and vegetable juices
Canned fruits in natural juices

Grains
Bread
Plain bagels
Unsweetened cereals
Unbuttered popcorn
Tortilla chips (baked, not fried)
Pretzels (low-salt)
Pasta
Plain crackers

Milk and dairy products
Low or non-fat milk
Low or non-fat yogurt
Low or non-fat cheese
Slow or non-fat cottage cheese

Meat, nuts and seeds
Chicken
Turkey
Sliced meats
Pumpkin seeds
Sunflower seeds
Nuts

Others
(these snacks combine foods from the different groups)
Pizza
Tacos

Remember to:
Choose sugary foods less often
Avoid sweets between meals
Eat a variety of low or non-fat foods from the basic groups
Brush your teeth with fluoride toothpaste after snacks and meals

Note to Parents
The foods listed in this leaflet have not all been tested for their decay-causing potential. However, knowledge to date indicates that they are less likely to promote tooth decay than are some of the heavily sugared foods children often eat between meals.

Candy bars aren't the only culprits. Foods such as pizza, breads, and hamburger buns may also contain sugars. Check the label. The new food labels identify sugars and fats on the Nutrition Facts panel on the package. Keep in mind that brown sugar, honey, molasses, and syrups also react with bacteria to produce acids, just as refined table sugar does. These foods also are potentially damaging to teeth.

Your child's meals and snacks should include a variety of foods from the basic food groups, including fruits and vegetables; grains, including breads and cereals; milk and dairy products; and meat, nuts, and seeds. Some snack foods have greater nutritional value than others and will better promote your child's growth and development. However, be aware that even some fresh fruits, if eaten in excess, may promote tooth decay. Children should brush their teeth with fluoride toothpaste after snacks and meals. (So should you!)

Please note: These general recommendations may need to be adapted for children on special diets because of diseases or conditions that interfere with normal nutrition.

For additional copies of this pamphlet contact:

National Institute of Dental and Craniofacial Research

Orthodontic Treatment Leads to Improvement in Quality of Life

October 9th, 2012

This article provides a valid research basis for concluding that orthodontic treatment does lead to an improvement in quality of life.

How Does Orthodontic Treatment Affect Young Adults' Oral Health-Related Quality of Life?

Palomares NB, Celeste RK, et al: Am J Orthod Dentofacial Orthop; 2012;141 (June): 751-758

Background: When patients ask you what the benefits of orthodontic treatment are, what do you tell them? Would you have a valid basis for telling them that it leads to an improvement in quality of life?

Objective: To assess the oral health-related quality of life of patients who completed orthodontic treatment compared with subjects awaiting orthodontic treatment.

Participants: The sample for this study consisted of 2 groups of patients. The treatment group consisted of 100 consecutive patients who concluded orthodontic treatment at least 6 months before the study and the second group was a control group of 100 patients with similar orthodontic problems who were awaiting the initiation of orthodontic treatment.

Methods: Data were collected through face-to-face interviews, self-completed questionnaires, and oral examinations by a trained orthodontist. The oral health-related quality of life assessment (a validated assessment form) was administered to each subject and the scores were statistically evaluated.

Results: Statistical analysis revealed that the non-treated young adults had mean oral health impact profile scores over 5 times greater than the treated group, indicating that the untreated group had a significantly poorer oral health-related quality of life than did the patients who received orthodontic treatment.

Conclusions: Patients who complete orthodontic treatment have a higher oral health-related quality of life than patients who do not receive orthodontic treatment.

Reviewer's Comments: I thought this was an excellent study. From just seeing the changes in patients that they have treated, I believe most orthodontists would feel comfortable saying that orthodontic treatment usually results in an improved quality of life. It is helpful, however, to be able to refer to a valid research study that reaches the same conclusion when talking to patients.(Reviewer–John S. Casko, DDS, MS, PhD).

Braces? At My Age?

September 18th, 2012

WebMD Feature By Peter Jaret Reviewed By Alfred D. Wyatt Jr., DMD

Feel a little self conscious about your crooked teeth? You aren’t alone. Thankfully, braces aren't just for kids any more. Today, adults make up nearly 20% of brace wearers, says Michael B. Rogers, DDS, president of the American Association of Orthodontists.

Although there are many reasons for adults to consider braces, most people simply want to look and feel their best. Here are a few leading reasons to make a trip to the orthodontist:

 A straighter smile. It’s no surprise that many people want to perfect their pearly whites to achieve a winning smile. And, those smiles pay off. A recent study compared people's reactions to photos that were manipulated to show either straight or crooked teeth. People with straight teeth rated higher on scores of leadership, popularity, and sports ability. (The only score that didn't change was intelligence.)

Shifting teeth. Just because you had braces as a kid doesn’t mean you’re off the hook. "Teeth tend to move a little throughout your life," Rogers says. "Your teeth may shift a little back toward their original positions."

Better oral health. It’s no surprise that straight teeth are easier to brush and floss. So -- if you’re doing your part -- expect less decay and healthier gums, says Pamela K. McClain, DDS, president of the American Academy of Periodontology. Antibacterial mouth rinses can also help keep your teeth and gums free of plaque-causing bacteria that can lead to gingivitis, an early, mild form of gum disease.

Braces can help people manage some more serious issues, too, like bite problems that cause jaw pain. In some cases, braces are necessary to change the position of neighboring teeth for a new bridge, crown, or implant.

New Options

Thankfully, we’ve come a long way from the days when kids were called "Brace Face." Today’s options are barely noticeable. They include:

  • Ceramic braces made of a clear material that is much less obvious than traditional metal braces.
  • Customized plastic aligners that fit like tooth guards over teeth, gently moving them into a new position.

 What to Expect

How long you'll need to wear braces depends on what you have done. Most treatments range from 6 to 20 months. Once teeth are in the desired position, you are likely to need to wear a retainer. Many orthodontists now recommend permanent retainers that are fitted and attached to the back of teeth.

Poor Hygiene in Orthodontic Patients May Be Dangerous

August 29th, 2012

 Take Home Pearl: Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Background:

Orthodontic appliances create the potential to harbor unwanted bacteria when oral hygiene is poor. Objective:

To attempt to isolate Enterococcus and Escherichia coli from the mouths of orthodontic patients with poor hygiene. Design:

Clinical study with control group. Participants:

46 orthodontic patients with fixed appliances in place and 55 healthy control volunteers. Methods:

A supragingival plaque sample was obtained from each mouth. For the orthodontic patients, the plaque was sampled using a gingival scaler to the bracket base; for the control subjects, it was swabbed from the supragingival area. The plaque was grown in media specific for Enterococcus and E. coli to identify the presence of these microbes. Resistance to antimicrobial medications was tested for 11 specific antibiotics, and polymerase chain reaction was used to test for genes known to be involved in antimicrobial resistance. Results:

No Enterococcus or E. coli was present in the mouths of the healthy control subjects. Twenty percent of orthodontic patients were positive for the presence of Enterococcus or E. coli, and all of these patients had poor oral hygiene. Many of the bacteria isolated from the orthodontic subjects were found to be resistant to common antibiotic agents, and many had genes identified with resistance. Conclusions:

Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Reviewer’s Comments:

The presence of these unwanted bacteria may not be dangerous for a healthy adolescent patient but could be problematic for someone who is immune compromised or otherwise not in good health. This is another good reason to promote good hygiene in patients with orthodontic appliances. Reviewer:

Brent E. Larson, DDS, MS

Orthodontic appliances create the potential to harbor unwanted bacteria when oral hygiene is poor. Objective:

To attempt to isolate Enterococcus and Escherichia coli from the mouths of orthodontic patients with poor hygiene. Design:

Clinical study with control group. Participants:

46 orthodontic patients with fixed appliances in place and 55 healthy control volunteers. Methods:

A supragingival plaque sample was obtained from each mouth. For the orthodontic patients, the plaque was sampled using a gingival scaler to the bracket base; for the control subjects, it was swabbed from the supragingival area. The plaque was grown in media specific for Enterococcus and E. coli to identify the presence of these microbes. Resistance to antimicrobial medications was tested for 11 specific antibiotics, and polymerase chain reaction was used to test for genes known to be involved in antimicrobial resistance. Results:

No Enterococcus or E. coli was present in the mouths of the healthy control subjects. Twenty percent of orthodontic patients were positive for the presence of Enterococcus or E. coli, and all of these patients had poor oral hygiene. Many of the bacteria isolated from the orthodontic subjects were found to be resistant to common antibiotic agents, and many had genes identified with resistance. Conclusions:

Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Reviewer’s Comments:

The presence of these unwanted bacteria may not be dangerous for a healthy adolescent patient but could be problematic for someone who is immune compromised or otherwise not in good health. This is another good reason to promote good hygiene in patients with orthodontic appliances. Reviewer:

Brent E. Larson, DDS, MS