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New Perinatal And Infant Oral Health Guidelines

Posted on 20 June 2009 by admin

mother-with-baby1New Perinatal And Infant Oral Health Guidelines

The American Academy of Pediatric Dentistry (AAPD), the recognized leader in pediatric oral health, announced new oral health guidelines for expectant mothers and infants. The guidelines call for all pregnant women to receive counseling and oral healthcare during pregnancy, and also that infants receive an oral health risk assessment and oral care by their first birthday. These steps will contribute to optimal oral health for both mom and baby.

“There is evidence associating periodontal disease and increased risk of preterm birth and low-birth weight,” said AAPD’s Immediate Past-President Dr. Beverly Largent. A recently published study found significant differences between women treated for periodontal disease and those who were not treated. The findings suggest that incorporating periodontal care may result in improved pregnancy outcomes.

“Because premature births have become the number one obstetric problem in the United States, we felt the need to provide more guidance about necessary oral care for expectant moms, in addition to promoting oral health as a key part of pregnant women’s overall health,” said Dr. Largent.

The guidelines are based on studies that suggest that proper dental care during the perinatal period may help prevent preterm and low-birth weight babies and is an important aspect of overall health for pregnant women - allowing them to enter delivery in optimal health. Many women, however, are unaware of the implications poor oral health can have on themselves and their babies and often don’t seek oral care during pregnancy.

Additionally, mothers with poor oral health may be at greater risk of infecting their children with the bacteria that causes cavities, increasing their children’s caries risk at an early age. Because cavities in infants are preventable, determining which mothers are at the highest risk improves opportunities for preventive intervention.

“Every expectant mother should receive a comprehensive oral health evaluation and risk assessment,” said Dr. Largent. “Dental treatment is safe throughout pregnancy, and this is a time when expectant mothers need to be screened for oral risks, counseled on proper oral hygiene and receive necessary dental treatment.”

The updated guidelines also address proper oral care for infants and toddlers, the age group most susceptible to early childhood caries (ECC), which is an infectious but preventable disease that causes tooth decay and potentially more serious health issues. When left untreated, ECC can affect speech and communication, eating and dietary nutrition, sleeping, learning, playing, and quality of life - even into adulthood. The guidelines outline how simple changes in a mother’s oral hygiene, diet, use of topical fluoride and sharing of eating utensils can significantly reduce a child’s risk for ECC.

Overview of the new AAPD Oral Health Guidelines for expectant mothers and infants:

  • Oral Hygiene: Tooth brushing and flossing on a daily basis are important for the parent to reduce bacterial plaque, which research has linked to preterm, low-birth weight babies.
  • Diet: Dietary education for the parents, including the potential effect of foods and beverages on their oral health, helps maintain good dental care.
  • Fluoride: Using a fluoridated toothpaste approved by the American Dental Association and rinsing every night with an alcohol-free, over-the-counter mouth rinse containing 0.05% sodium fluoride have been suggested to help reduce plaque levels.
  • Caries removal: Routine professional dental care for the parents can help keep their oral health in optimal condition.
  • Delay of colonization: Education of the parents, especially mothers, on sharing utensils, food and cups can help prevent the transmission of cavity-causing bacteria.
  • Xylitol gum: Recent evidence suggests the use of xylitol chewing gum (four pieces per day by the mother) can decrease a child’s caries rate.

Dr. Daniell Mishaan, D.M.D.
MIDTOWN DENTAL GROUP
www.midtowndentalgroup.com

241 West 37th Street
New York, NY 10018
Phone: 212 730 4440
Fax: 212 764 7122

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Fluoridated Water: Questions & Answers

Posted on 30 May 2009 by admin

fluoride-tutorial1. What is fluoride?

Fluoride is the name given to a group of compounds that are composed of the naturally occurring element fluorine and one or more other elements. Fluorides are present naturally in waterand soil.

2. What is fluoridated water?

Virtually all water contains some amount of fluoride. Water fluoridation is the process of adding fluoride to the water supply so that the level reaches approximately 1 part fluoride per million parts water (ppm) or 1 milligram fluoride per liter of water (mg/L); this is the optimal level for preventing tooth decay (1).

3. Why fluoridate water?

In the early 1940s, scientists discovered that people who lived where drinking water supplies had naturally occurring fluoride levels of approximately 1.0 ppm had fewer dental caries (cavities). Many more recent studies have supported this finding. Fluoride can prevent and even reverse tooth decay by enhancing remineralization, the process by which fluoride “rebuilds” tooth enamel that is beginning to decay.

4. When did water fluoridation begin in the U.S.?

In 1945, Grand Rapids, Michigan, adjusted the fluoride content of its water supply to 1.0 ppm and thus became the first city to implement community water fluoridation. By 1992, more than 60 percent of the U.S. population served by public water systems had access to water fluoridated at approximately 1.0 ppm, the optimal level to prevent tooth decay. The Centers for Disease Control and Prevention (CDC) considers fluoridation of water one of the greatest achievements in public health in the 20th century.

5. Can fluoridated water cause cancer?

The possible relationship between fluoridated water and cancer has been debated at length. The debate resurfaced in 1990 when a study by the National Toxicology Program, part of the National Institute of Environmental Health Sciences, showed an increased number of osteosarcomas (bone tumors) in male rats given water high in fluoride for 2 years. However, other studies in humans and in animals have not shown an association between fluoridated water and cancer. In a February 1991 Public Health Service (PHS) report, the agency said it found no evidence of an association between fluoride and cancer in humans. The report, based on a review of more than 50 human epidemiological (population) studies produced over the past 40 years, concluded that optimal fluoridation of drinking water “does not pose a detectable cancer risk to humans” as evidenced by extensive human epidemiological data reported to date. In one of the studies reviewed for the PHS report, scientists at the National Cancer Institute evaluated the relationship between the fluoridation of drinking water and the number of deaths due to cancer in the United States during a 36-year period, and the relationship between water fluoridation and number of new cases of cancer during a 15-year period. After examining more than 2.2 million cancer death records and 125,000 cancer case records in counties using fluoridated water, the researchers found no indication of increased cancer risk associated with fluoridated drinking water. In 1993, the Subcommittee on Health Effects of Ingested Fluoride of the National Research Council, part of the National Academy of Sciences, conducted an extensive literature review concerning the association between fluoridated drinking water and increased cancer risk. The review included data from more than 50 human epidemiological studies and six animal studies. The Subcommittee concluded that none of the data demonstrated an association between fluoridated drinking water and cancer. A 1999 report by the CDC supported these findings. The report concluded that studies to date have produced “no credible evidence” of an association between fluoridated drinking water and an increased risk for cancer.

6. Where can people find additional information on fluoridated water?

The Centers for Disease Control and Prevention (CDC) site has information on standards for a fluoridated water supplies in the United States. Visit  and search for “fluoridation.”

The Environmental Protection Agency (EPA) Web site has more information about drinking water and health. It includes information about drinking water quality and standards. This Web site is located at on the Internet.

7. Key Points

  • Fluoride prevents and can even reverse tooth decay (see Question 3).
  • More than 60 percent of the U.S. population on public water supply systems has access to water fluoridated at approximately 1 part fluoride per million parts water—the optimal level for preventing tooth decay (see Question 4).
  • Many studies, in both humans and animals, have shown no association between fluoridated water and risk for cancer (see Question 5).

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