New Perinatal And Infant Oral Health Guidelines

New Perinatal And Infant Oral Health Guidelines

New Perinatal And Infant Oral Health GuidelinesThe 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

Fluoridated Water: Questions & Answers

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).

Dry Mouth (Xerostomia) : Symptoms, Causes, Tips

Dry MouthWhat do I need to know about dry mouth?

Dry mouth is the feeling that there is not enough saliva in the mouth. Everyone has a dry mouth once in a while — if they are nervous, upset or under stress. But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to serious health problems. It can also be a sign of certain diseases and conditions. The technical term for dry mouth is xerostomia. Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking, can increase your chance of developing dental decay and other infections in the mouth, can be caused by certain medications or medical treatments. Dry mouth is not a normal part of aging. So if you think you have dry mouth, see your dentist or physician–there are things you can do to get relief.

Symptoms include:

  • a sticky, dry feeling in the mouth
  • trouble chewing, swallowing, tasting, or speaking
  • a burning feeling in the mouth
  • a dry feeling in the throat
  • cracked lips
  • a dry, rough tongue
  • mouth sores
  • an infection in the mouth

Why is saliva so important?

Saliva does more than keep the mouth wet.

  • It helps digest food
  • It protects teeth from decay
  • It prevents infection by controlling bacteria and fungi in the mouth
  • It makes it possible for you to chew and swallow

Without enough saliva you can develop tooth decay or other infections in the mouth. You also might not get the nutrients you need if you cannot chew and swallow certain foods. Some people feel they have a dry mouth even if their salivary glands are working correctly. People with certain disorders, like Alzheimer’s disease or those who have suffered a stroke, may not be able to feel wetness in their mouth and may think their mouth is dry even though it is not.

What causes dry mouth?

People get dry mouth when the glands in the mouth that make saliva are not working properly. Because of this, there might not be enough saliva to keep your mouth wet. There are several reasons why these glands (called salivary glands) might not work right.

  • Side effects of some medicines. More than 400 medicines can cause the salivary glands to make less saliva. Medicines for high blood pressure and depression often cause dry mouth.
  • Disease. Some diseases affect the salivary glands. Sjögren’s Syndrome, HIV/AIDS, diabetes, and Parkinson’s disease can all cause dry mouth.
  • Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.
  • Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
  • Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

What can be done about dry mouth?

Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can try to determine what is causing your dry mouth.

  • If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage.
  • If your salivary glands are not working right but can still produce some saliva, your physician or dentist might give you a medicine that helps the glands work better.
  • Your physician or dentist might suggest that you use artificial saliva to keep your mouth wet.

What can I do?

  • Sip water or sugarless drinks often.
  • Avoid drinks with caffeine, such as coffee, tea, and some sodas. Caffeine can dry out the mouth.
  • Sip water or a sugarless drink during meals. This will make chewing and swallowing easier. It may also improve the taste of food.
  • Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow; citrus, cinnamon or mint-flavored candies are good choices.
  • Don’t use tobacco or alcohol. They dry out the mouth.
  • Be aware that spicy or salty foods may cause pain in a dry mouth.
  • Use a humidifier at night.

Tips for keeping your teeth healthy

Remember, if you have dry mouth, you need to be extra careful to keep your teeth healthy. Make sure you:

  • Gently brush your teeth at least twice a day.
  • Floss your teeth every day.
  • Use toothpaste with fluoride in it. Most toothpastes sold at grocery and drug stores have fluoride in them.
  • Avoid sticky, sugary foods. If you do eat them, brush immediately afterwards.

Visit your dentist in ny midtown for a check-up at least twice a year. Your dentist might give you a special fluoride solution that you can rinse with to help keep your teeth healthy. We provide General Dentistry and Cosmetic Dentistry, Bleaching/Whitening, Orthodontics, Implants, and Reconstructive Dentistry with Cosmetic Dentists and Specialists all in our spacious and new mid-town Manhattan office.

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

The Effects of Periodontal Disease on the Body

     pain-body My patients know that I am a huge advocate of preventative dentistry, emphasizing proper oral hygiene through brushing and flossing and timely treatment of problems.  Preventative dentistry techniques keep the mouth healthy.  A healthy mouth provides a bright and beautiful smile, fresh breath, and prevents other medical problems throughout the body.  When proper oral hygiene is ignored, bacteria tends to build up around the teeth and gums.  This bacteria is the cause of periodontal disease. 

      An astounding 75 percent of adults over the age of 35 have some degree of periodontal disease.  Left unchecked, periodontal disease can cause serious damage to bone and tissues in the mouth and affect conditions elsewhere in the body.  In fact, there is ongoing research linking periodontal disease with very serious medical problems.  Some of these potential ailments include:

 Increase in the risk of Cardiovascular Disease

  • Increase in the risk for strokes
  • Respiratory problems
  • Problem pregnancies
  • Diabetes
  • Osteoporosis
     

    Bacteria stored in the plaque in your mouth can very easily enter the bloodstream, which has been know to trigger an increase in certain protective materials which attach to vessels in the heart.  This build up of plaque and fatty proteins thickens coronary arteries, a condition known as atherosclerosis.  This inflammation is the major cause of the development of cardiovascular disease and increases the risk of having a stroke.

      Researchers have found that a person with a large amount of bacteria, due to improper oral hygiene, will inhale these germs into the respiratory tracts.  An increase in bacteria in the respiratory system causes infections and worsens existing respiratory conditions, such as pneumonia.

      Current research has found a link between periodontal disease and pre-term births.  Mothers with periodontal disease have been found to be much more likely to give birth to a pre-mature or low birth weight baby.  While this research is new, periodontal disease seems to increase certain biological fluids which induce labor, leading to pre-term births.

      Periodontal disease has been known to be more prevalent in those who suffer from diabetes.  New research is now finding that periodontal disease may, in fact, play a role in the development of diabetes.  While victims of diabetes have a hard time fighting the infections caused by the bacteria associated with periodontal disease, conversely, these infections can bring about reactionary processes that lead to the onset of type 2 diabetes in healthy individuals.

      While periodontal disease is found in a large majority of adults, it is important for people of all ages to be aware of the damage this disease can cause to the mouth and the rest of the body.  It is imperative that proper oral hygiene is practiced at home and regular trips to your dentist’s office are scheduled throughout the year. 

 Daniell Mishaan, D.M.D. is a dentist in the Garment District in midtown Manhattan.  He serves patients from all over New York City.

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