A Whiff of Reality: Kids Can Have Bad Breath

Baby’s breath is so sweet that a flower is named for it, but as your child grows, it’s likely that he or she will have not-so-sweet breath at some point. It might even smell downright bad. Usually the cause of bad breath (halitosis) is quite benign. The culprit could be foods like onions, cheese, orange juice or soda. Some medications also contribute to halitosis-like symptoms. And if your child is an adolescent, chronic bad breath can be the result of smoking or the use of other tobacco products.

But once these causes have been ruled out, the next culprit to consider is the bacteria in your child’s mouth. Your child needs to floss daily and brush at least twice a day, for two minutes each time, to effectively get rid of food particles upon which these bacteria feed. If there is enough nutrition available for the bacteria, they’ll stick around in your child’s mouth and release sulfur compounds that have an unpleasant aroma.

And it is especially important to brush the tongue, especially the back third of it. Odor-causing bacteria congregate there, as well as on tooth surfaces.

A condition such as enlarged adenoids that results in your child’s breathing through the mouth can contribute to halitosis, as well. Less saliva (called dry mouth) means fewer antibacterial compounds swishing regularly through the mouth. In general, drinking water regularly can ensure that the mouth stays hydrated enough to help prevent bad breath.

Other medical conditions, of varying degrees of rarity, can cause halitosis. They include

  • chronic post-nasal drip; bacteria thrive on the accompanying mucus and other secretions
  • diabetes can cause the breath to have an acetone smell, akin to that of nail-polish remover
  • strep throat (and other oral infections)
  • kidney or liver failure

While an antibacterial mouthwash can offer a quick and temporary fix for one or two instances of bad breath, a visit to us is in order if the halitosis recurs frequently and diligent oral hygiene doesn’t solve the problem. Halitosis should not be present at a young age, and halitosis in children means that something is definitely wrong. So make sure that you are well aware of what’s going on with your child, and seek proper care and treatment to eliminate halitosis.

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Dental Health Screenings Important for Children

A dental health screening is a brief examination of your child’s teeth, gums, tongue and soft tissue of the mouth performed to identify abnormal conditions so the child can come to the dental office for treatment. Screenings should occur regularly after the first tooth has erupted.

A dental screening by someone other than a dentist—often first performed in the pediatrician’s office—is usually the first dental care a child receives. These screenings are usually performed by a dental hygienist, pediatrician, nurse or physician’s assistant. People who serve at-risk children are often trained to screen the mouths and teeth of young children. Some states require proof of a dental screening before a child can enroll in school.

Dental health screenings help to identify tooth decay, infected gums and other oral problems. While 89% of America’s one-year-old children have had an office-based physician visit, only 1.5% of the same aged children have visited a dental office.

A dental health screening consists of three parts. The screener first inquires about the child’s dental health history. This is followed by a brief physical examination of the child’s mouth. Finally, the screener will offer a referral to a dentist for preventive care and treatment.

Common problems spotted during a dental health screening include

  • baby bottle tooth decay
  • cavities—28% of children age five and under have one or more cavities
  • missing or damaged teeth
  • sore, swollen or infected gums

In order for these problems not to worsen and compromise your child’s health and performance in school, they should be treated by their pediatric dentist. We will screen your child in our office or accept referrals from other screeners.

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Stick to It: The Benefits of Chewing Sugarless Gum

Let’s pop one myth: it’s not cracking, popping or blowing bubbles with gum that can make it something of a health boost to your kids. Simply chewing it, though, actually can help prevent cavities.

Here’s how it works: The gum, to start, has to be sugarless. The only chewing gums endorsed by the American Dental Association shown to prevent cavities are those that contain the sugar substitute xylitol. Studies show that when children as young as five and six chew xylitol-sweetened gum after meals, the cavity-prevention benefits can last for years, even after the habit has been discontinued.

Next, your child has to chew the gum for a good solid while, approximately 10 to 20 minutes after a meal. The goal is to increase saliva flow, which will happen as your child chews.

This added saliva has numerous benefits. First, it physically helps to wash away small particles of food left on the teeth. Less food means less sugar for cavity-causing bacteria to feed upon. Too, compounds in the saliva can neutralize acids in the mouth—produced by those pesky bacteria—that can otherwise cause tooth enamel to deteriorate. The saliva also transports to the teeth some general antibacterial compounds, as well as tooth strengtheners like calcium and phosphate.

Is there a downside to gum-chewing (besides the possible audible annoyances)? You and your children should avoid fruit-flavored sugarless gum, because the acids in the flavorings can contribute to decay, instead of helping to prevent it.

It’s crucial, in the end, that your whole family remember this: Chewing sugarless gum absolutely does not substitute for brushing at least twice a day and flossing once daily. It is only an additional tool to help prevent cavities.

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Children’s Oral Health Linked to Mom’s Well-being

Teaching children to brush and floss may not be all that’s needed to ensure their dental health. A 2012 study suggests that oral health at age 14 is directly related to a primary caregiver’s emotional health, knowledge and education level.

Researchers at Case Western Reserve University’s School of Dental Health followed a group of 224 children, born with both normal and low birth weights. They tracked the children throughout the years, examining the amount of tooth decay and missing teeth they had by age 14. They also gave the children’s mothers (the primary caregiver in all cases) surveys to track dental visits and access to dental care and insurance, sealants, fluoride treatments and sugar consumption. According to the study, published in the Journal of Dental Research, regardless of all these factors (which obviously appear likely to affect dental health), having healthy teeth had less to do with the dental care and more to do with the mother’s overall emotional state and knowledge about nutrition and health.

It is important to remember that this is one small study and that it simply suggests a link, not an explanation. Since three factors (emotional health, educational level and knowledge) played into the findings, it’s hard to know which one really confers the most benefit. What we can take away from this research is that oral health, and most likely health in general, is affected by a child’s environment.

What can parents do with this knowledge? There is no point in dwelling on the past, and there is certainly no reason to blame yourself if your child has had dental problems. But perhaps adults can learn that staying positive and conscientious about taking care of ourselves has a direct impact on our offspring.

Many parents worry so much about their children that they forget to pay attention to their own well-being. This research could be used to justify putting your own happiness and health at the top of your priority list to set a good example for your children—and perhaps give them an extra edge in protecting their oral health in the future.

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Healthy Mouth, Healthy Body

Over the past 10 years, researchers have uncovered links between oral health and systemic diseases. Many of these connections begin in childhood but become apparent only in adults. Others directly affect children.

Appearing to be the common thread between mouth and body health, inflammation is the result of bacterial infections. For instance, infection of the gums, called periodontitis, can develop in both children and adults. When the gums become infected, chemical signals attract cells of the immune system to the infected site. As the immune system fights the infection, the gums become swollen, painful and bleed easily. The pain and soreness, just like pain from a cavity, can cause children to lose sleep, become distracted at school, eat poorly and develop low self-esteem—all conditions that interfere with school performance. If left untreated, periodontitis also can damage the jawbone, resulting in loose or lost teeth.

Untreated inflammation in the mouth is also thought to stimulate inflammation in the blood vessels. This increases blood pressure and the risk of heart disease and heart attack later in life. The reason for this connection remains under investigation.

Researchers have also found a strong correlation between periodontal disease and type 2 diabetes. Diabetes is a disease in which the body’s ability to convert sugar to energy is impaired. The level of sugar in the blood rises, leading to a myriad of serious health problems. Although diabetes is most often an adult problem, the rate of type 2 diabetes in children has increased substantially, in tandem with the increased rate of childhood obesity.

Researchers are not sure just how periodontitis relates to diabetes. The direction of the causation has not been determined. People with diabetes may be more likely to develop gum infections and vice versa. Preventing and treating periodontal disease is one small way to help people control their diabetes.

Good dental habits, such as eating healthy foods, avoiding excess sugar, brushing and flossing daily, having regular dental visits, and treating tooth decay and gum disease early, help keep the mouth—and the body—healthy.

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Mouthguards: Necessary Athletic Equipment

Do your children play basketball, football, soccer or softball? Do they wrestle or box, play rugby or lacrosse, skateboard, or participate in martial arts? According to the Academy of General Dentistry, all children should wear a properly fitted mouthguard when participating in these or any other contact sport. A mouthguard will help protect their teeth and reduce the likelihood of lip, cheek, tongue and jaw injuries.

Mouthguards are flexible appliances that protect teeth from both direct and indirect trauma. Most mouthguards cover only the upper teeth. However, we may recommend a mouthguard for the lower teeth if your child wears braces on these teeth.

Mouthguards come in three styles and price ranges:

  • Stock mouthguards are off-the-shelf devices. They are inexpensive but offer the least protection because they require the lower jaw to remain closed to keep them in place. Dental professionals consider the protection offered by stock mouthguards to be inadequate.
  • “Boil and bite” mouthguards are made of a thermoplastic material that, when heated and inserted into the mouth, conforms to the shape of the teeth. They provide better protection than do stock mouthguards
  • Custom-made mouthguards are the most expensive but provide the best level of protection and comfort. These are made from a mold of the teeth taken in our office.

The National Youth Sports Safety Foundation projects that more than 3 million teeth will be knocked out each year in youth sports events. Children who do not wear mouthguards are 60 times more likely to experience tooth damage. Despite this, a survey commissioned by the American Academy of Orthodontists found that 84% of children playing organized sports do not wear mouthguards.

So, buy helmets, pads and other protective equipment to keep your children safe, but also put a high-quality mouthguard on your shopping list. And if your child is using a mouthguard, bring it along to his or her next dental appointment and let us check the fit.

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