This Month's Topic: Strong and Healthy Teeth
by Dominick DePaola, DDS, PhD, ScD

Why do kids have fewer cavities today? Does this mean that parents can ease up?

It's mostly due to fluoride. Even though cavities are not as extensive as they used to be, they're still a huge problem. Should parents ease up? Absolutely not! Thirty percent of all children develop some kind of a cavity between the ages of 5 and 17 years. The number of school hours lost to dental disease and treatment is 52 million! And on school surveys, dental pain is often a common reason mentioned for children missing school.

When should parents begin taking their children in for regular dental check ups?

This is a debatable one. There are people who advocate bringing children in as early as a year of age, and certainly not later than 3 to 6 years of age. You want to get children to the dentist before the first molar forms and before all the teeth are in the mouth. I recommend taking children to a pediatric dentist or a general dentist who treats children before they are 3 years old.

Are all sweet foods created equal when it comes to causing cavities?

• Any food that has sugar can cause bacteria in plaque to form acids, and therefore cavities. It doesn't matter whether the sugar is natural or added to a food. The bacteria in plaque don't recognize the difference - sugar is sugar. However, sticky foods such as cookies and caramel candies are more likely to cause cavities. It's not that they are different from other foods; it's because they are not cleared from the mouth quickly. They stick to the surfaces of the teeth and linger. For example, chocolate milk, which contains sugar, is much less likely to cause cavities than a sticky, sweet food because it's a liquid. It clears from the mouth faster.
• The "frequency," or how often sweets are eaten, is also important. Eating sweets often between meals puts one at high risk for tooth decay. Eating sweets with meals reduces this risk dramatically. If children want sweets, the best time to have them is at the end of a meal.

How can kids snack and minimize their risk for cavities?

This is a very complicated question to answer. The list of foods that form small amounts of acid it is very short! It's unrealistic to have children eliminate all sugar-containing foods, and I don't think it is a good strategy. The bottom line is for children to snack intelligently. They need healthy snacks from the Food Guide Pyramid in order for them to meet their daily nutrient and calorie needs. Also, keep this in mind:

• In addition to the stickiness of a food, consider how often children snack. The frequency that snacks and sweet foods are eaten is critically important. The more that snacks and sweets are eaten between meals, the greater the risk for developing cavities!
• Consider the child. If you have a child who snacks all day, encourage more frequent brushing and plan more frequent visits to the dentist.
• Saliva is the single most important element in protecting against cavities. So anything you can do to stimulate saliva flow helps to prevent cavities. That's how foods like cheese protect the teeth. Sugarless gums are also great because they stimulate saliva and help to clear food from the mouth.

What should children do if they can't brush after snacking?

Have them swish and rinse with water, and spit into a sink. It clears food particles from the mouth between brushing. They still need to brush and floss to get rid of plaque.

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