Infants.  Many articles have discussed the establishment of preventive programs for the oral health care of infants.  These articles have focused on the need for early intervention of preventive measures, especially dental health education for parents to minimize the incidence of oral diseases during infancy.  It is recognized that the best opportunity to obtain the attention of parents is just prior to or just after a baby’s birth, when motivation and interest are probably at their highest level.  Surveys of expectant and nursing mothers indicate that many are misinformed or inadequate in their practice of proper dental health habits and that information disseminated at this time may encourage acceptance of new attitudes and practices.  Because preventive dental health programming should be included along with the initial dental examination, most pediatric dentists recommend that the infant be seen as soon after birth as is convenient for the family, and this appointment should be followed with subsequent visits at regular intervals for reinforcement.  Typically these visits include:

• Thorough examination of the infant’s mouth. • Discussion with the parents about expected growth and development of the dentition, with reference to normal timing and pattern of primary tooth eruption. • Discussion of fluoride supplementation. • Discussion of diet and feeding habits to prevent nursing caries. • Discussion of sucking habits an use of pacifiers. • Discussion of possible oral trauma and precautions for its avoidance. • Demonstration of recommended oral hygiene practices.

In 2004 the American Academy of Pediatrics announced their recommendation that pediatricians perform an oral assessment, including anticipatory guidance and establishment of a dental home for children one year of age deemed at risk for dental decay. This parallels earlier recommendations by the American Academy of Pediatric Dentistry, the American Dental Association and the Arizona Society of Pediatric Dentistry calling for the first oral examination to be performed no later than a child’s first birthday. These recommendations reflect a growing knowledge of the need for early intervention and treatment of oral disease as well as an understanding that oral health is an integral part of a child’s overall health.

Toddles, Children & Adolescents.  General preventive measures can be taken to avoid the development of cavities.  First, limiting the consumption of carious foods such as pastries, candy, ice cream, sodas, juices, and all other carbohydrates and sugar-containing foods to specific times of the day.  When cavity-causing foods are consumed, the teeth should be cleaned immediately to minimize the possibility of acid production.  When an individual does not have availability to a toothbrush, they can simply rinse their mouth out with water to help dilute and rinse carious debris.  Next, implementing a regular homecare regimen, including brushing with a fluoridated toothpaste 2-3 times a day, flossing prior to bedtime and using cleaning aids such as toothpicks to dislodge impacted food debris from between the teeth.  Lastly, regular visits to the dentist will help to diagnose the early development of dental decay, provides a professional application of an acidic fluoride and helps to reinforce homecare instructions.

Saliva is your body's best mechanism for fighting the destructive forces of acids formed by plaque. As previously discussed, saliva acts as a buffer and re-mineralizing agent.  Sugarless gum is one way to increase the flow of saliva in your mouth in between brushings.  Using chewing gum sweetened with 100% Xylitol also increases the protection supplied by your saliva.  Sucrose and Xylitol have very similar compositions and therefore are both regularly consumed by cavity causing bacteria within the mouth.  However, Streptococcus mutans is unable to metabolize Xylitol into a product that can be used for energy.  Therefore, it is tricked into eating a food that ultimately kills them and therefore decreases an individuals vulnerability to developing cavities.

Making these preventive measures a regular part of your child’s daily routine will, ultimately, provide them with the best possible chance to avoid the development of dental decay.

Nutrition
We definitely don’t expect children to completely avoid eating all the foods that make being a kid the best time of our life.  Twinkies, chocolate bars, root beer, Mountain Dew, candy, and so on…..  But, it is our duty as adults to help educate our children how to eat in moderation and how to make better decisions at particular points in time.  Since dental decay has been directly linked to the consumption of sugary foods between meals, it is important for parents and children to make better choices when snacking.  Research has shown that consuming sugary foods at mealtimes, while avoiding these when snacking, dramatically decreases the possibility of developing cavities.  Educating our kids starts with make better choices ourselves.  We recommend that parents also eliminate some foods, especially sodas from the house entirely.

We preach that children should especially avoid frequent consumption of sugary foods, especially those with a “sticky” quality.  Typically the longer a food stays or sticks onto your teeth, the greater the likelihood it will precipitate the development of a cavity.  Healthy snacks that are low in sugar include plain milk, fresh fruits, raw vegetables, dark breads, whole grains, enriched cereals and sugar free candies & gum.  Sugary foods, especially juices and sodas, are best consumed at meal time and brushed away immediately afterwards.

MYTH:  Cavities are caused primarily by eating candy.
Very often we hear from parents say, “I don’t understand why little Sally has so many cavities, as she rarely eats candy,” or after we diagnose cavities we commonly hear, “no more candy for you!”  Most people think dental decay is mostly caused by the consumption of candy.  This is a definite myth.  It is actually more likely that other surgery foods are the primary cause of decay, ones that are eaten on a regular and frequent basis.  We find that these foods typically include; juices, soda, flavored milk, chewy fruit snacks, or surgery cereals. 

It is also important for parents to understand that even some sweet foods that we promote as better choices, especially plain milk and fruits, also contain some natural sugars.  However, these sugars tend to be less cariogenic, as our oral bacteria produce a less potent acid after their metabolism.  Like sucrose-containing foods, it is still important to remember to clean these less cariogenic foods off our teeth following their consumption, especially prior to bedtime. 
Studies are showing that dental disease is just as related to overeating as heart disease, obesity, diabetes, and hypertension.

Just like regular brushing, flossing, and semi-annual dental checkups, proper nutrition plays a critical role in the development of your child's dentition.  A balanced diet is one of the most important things you can provide your children to help ensure they maintain strong teeth, healthy gums and a beautiful smile for a lifetime.

A healthy diet means a balanced diet that supplies all the nutrients your child needs to grow and develop. This includes fruits and vegetables; breads and cereals; milk and dairy products; and proteins found in lean meats, fish, and eggs.

A balanced diet is essential for healthy gum tissue around the teeth.  A diet high in certain kinds of carbohydrates, such as sugars and starches, may place your child at increased risk for tooth decay.  Harmful starchy foods include breads, crackers, pasta, and such snacks as pretzels and potato chips.

Kids who consume too much soda and not enough nutritional beverages are prone to tooth decay in addition to serious ailments later in life, such as diabetes and osteoporosis.  Drinking carbonated soft drinks regularly can contribute to the erosion of tooth enamel.  Soft drinks contain sticky sugars that bacteria in our mouths use as an energy source.  They break down into acids and adhere to tooth surfaces.  Using a straw when drinking soda can help keep sugar away from teeth.

Remind your child to rinse his or her mouth with water after meals, especially during school, in order to leave their teeth free of sugar and acid.

A balanced diet does not necessarily assure that your child is getting enough fluoride.  Fluoride protects teeth from tooth decay and helps heal early decay.  Fluoride is in the drinking water of most towns and cities within the United States.  During your child’s visit to our office, we will discuss your home’s particular fluoride content.  If it doesn't contain an adequate level of fluoride, we will discuss providing your child with a prescription for supplemental fluoride drops.  

Here are the essentials for maintaining a well balanced diet:

DO

• Eat a balanced diet.  One that includes fruits and vegetables; breads and cereals; milk and dairy products; lean meats, fish, and eggs.  Crunchy, healthy fruits such as carrots and apples not only provide great nutrition, but also are a natural way to clean the teeth.
• Minimize starchy foods such as breads, crackers, pasta, pretzels and potato chips.  Remember, some foods that contain sugar or starch are much safer if they are consumed with a meal, not as a snack.
• Be aware that some presumably healthy foods, such as peanut butter, jelly, catsup, salad dressings, raisins, pudding, dried fruits, chocolate milk, ice cream, fruit strips, milk shakes, and granola bars contain sugars that can break down and promote tooth decay. Ensure that your child brushes after eating these kinds of snacks.

DON'T

• Eat sweet or sticky foods between meals.  Sticky foods, such as dried fruit or toffee, have more cavity-causing potential because they are not easily washed away from the teeth by saliva, water or milk.
• Eat a diet that's high in carbohydrates like sugar and starches. This puts your child at a much higher risk for tooth decay.
• Allow your child to eat any of these kinds of food without brushing immediately afterward: cake, gummy bears, cookies, sherbet, candy, popsicles and chocolate bars.
• Allow your child to drink excessive amounts of soda.
• Put your child to bed with a bottle containing formula, milk, juice or other sweet liquid. As your child sleeps, the liquid begins to pool in her mouth, essentially bathing her new teeth in enamel-destroying bacteria and other harmful substances. A bottle with water is a much more sensible alternative.

Xylitol
Xylitol is a toothfriendly sugar.  In addition to not encouraging cavities, xylitol may actively aid in repairing minor cavities caused by sucrose and carbohydrates.  Recent research confirms a plaque-reducing effect and suggests that the compound attracts (tricks oral bacteria into thinking it is sucrose) and then starves the harmful micro-organisms, allowing the mouth to remineralize damaged enamel.  Xylitol based products are allowed by the U.S. Food & Drug Administration to make a claim that it does not promote dental caries.  Xylitol also has shown potential as a treatment for osteoporosis and in preventing ear infections.

Xylitol was first derived from Birch trees in Finland in the 19th century and was popularized in Europe as a safe sweetener for diabetics that would not impact insulin levels.  In the late 20th century, xylitol in granular form began to be mass produced in the United States under the brand name, “Ultimate Sweetener” which was derived from beet plants from California.  Today, however, maize sources are most common, with a majority of the world’s supply coming from China.

Xylitol has been found to:

• Fight and lessens the occurrence of inner ear and sinus infections.
• Fight and reduces the presence of plaque.
• Fight the development of cavities.
• Reduce the secretion of plaque acids.
• Facilitate the remineralization of tooth enamel.

Using chewing gum or candy sweetened with 100% xylitol increases the protection against cavities.  Sucrose and xylitol have very similar compositions and therefore are both regularly consumed by cavity causing bacteria within the mouth.  However, Streptococcus mutans is unable to metabolize xylitol into a product that can be used for energy.  Therefore, it is tricked into eating a food that ultimately kills them and therefore decreases an individuals vulnerability to developing cavities.  Many products currently contain some xylitol, however, it is ideal to find those that are sweetened entirely with this product.