Fast-paced Lifestyle Eroding Teens' Teeth

As quick meals in the form of "nutrition" bars and carbonated beverages help keep teens alert and on schedule between school, extracurricular activities and part-time jobs, today's fast-paced lifestyle threatens to leave a generation with permanent damage to oral and overall health.

"Premature loss of tooth enamel and weakening of overall tooth structure are two devastating oral effects of teens' poor diet that cannot be reversed later in life," explains Jane Soxman, DDS, author of a study that appears in the January/February 2003 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).

Adolescence is the time of peak bone growth, a time when more nutrient-packed calories are essential to fuel growing bodies and strengthen teeth and bones, however adolescence is the same time when soda and sugary, high-carbohydrate foods are rapidly displacing healthy foods such as milk, fruits and vegetables.

"The easy access of sugary beverages and foods from home to school and everywhere in between has compromised the health of teens' teeth and helped fuel the national obesity epidemic," says AGD spokesperson Julie Barna, DMD, MAGD.

Dr. Soxman's report shows drinking carbonated beverages seems to be one of the most significant causes of increased cavities and obesity for today's teens. Fifteen percent of American adolescents ages 6 to 19 are overweight. This number is expected to increase. Why? Ten percent of overweight preschool-age children ages 2 to 5 are becoming addicted to caffeine and sugar, which makes it harder for them to stop unhealthy habits such as drinking soda throughout the day.

The phosphoric, citric, tartaric and carbonic acids in soda are linked to the breakdown of tooth enamel around dental sealants and restorations, further compromising teens' teeth and leading to more extensive dental treatment to prevent total tooth loss.

Soft drinks and bone density

The phosphoric acid in most regular and diet cola drinks limits calcium absorption and has a direct influence on bone density. By age 16, girls have accumulated 90 to 97 percent of their bone mass, making adequate calcium intake vital. However, national statistics show only 19 percent of girls ages 9 to 19 are getting the recommended 1,300 milligrams of calcium a day.

Research also confirms a direct link between soft drink consumption and bone fractures in teenage girls.

"These girls are at an extreme risk for developing osteoporosis, already exhibiting symptoms of this disease in their teen years," says Dr. Soxman. "Early education on the importance of calcium consumption is key to reversing this trend."

Start the School Year Off With a Smile

Every child wants to look their best as they head back to school this fall. Parents help by scheduling haircuts and buying new outfits, but most overlook the simple steps to helping their child maintain one of their most visible features – their smile.

Studies show that one of the first things people notice about someone is their smile and that a good smile creates a positive self-image…something all parents wish for their children. "Back-to-school time is the perfect time to incorporate good oral health habits into a child's daily routine," says Academy of General Dentistry spokesperson Cindy Flanagan, DDS, FAGD. "The sooner you make them a priority, the sooner your child will benefit."

Schedule a back-to-school dental visit

Seeing a dentist twice a year during the school-age years is vital because this is a time of great change in the mouth, with kids losing baby teeth and getting in their permanent teeth. Tooth decay is still the most common chronic childhood disease and, left untreated, it can impair a child's ability to eat, speak, sleep and learn. However, studies show more than 60 percent of school-age children do not see a dentist annually. "Simple preventive checkups twice a year can head off childhood decay and help you and your child learn how to protect their teeth throughout the year," says Dr. Flanagan. To locate a dentist in your area, call 1.877.2X.A.YEAR (1.877.292.9327).

Establish daily brushing habits with your children

Children should brush at least twice a day. To encourage children to brush after every meal, let them pick out their own travel toothbrush and toothpaste to take to school. "There are many child-friendly products that help encourage younger children to brush," says Dr. Flanagan, "Make sure your child's toothpaste contains fluoride and the toothbrush is soft-bristled."

Make good nutrition a top priority

National studies show that only one in five school-age children eats the recommended five daily servings of fruits and vegetables – greatly increasing their risk of cavities. In addition, only one in five children meets even the minimum standards for calcium consumption. Take charge of your child's health this school year by packing healthy lunches.

"Don't forget after-school snacks," says Dr. Flanagan. "Many school children go straight to sporting practices after school and turn to sugary foods and drinks from a vending machine when they don't have any other option, which are disastrous to children's oral health." Bite-sized carrots, fruits, nuts and bottled water are much better after-school snack options and give children the fuel they need to excel in physical activity.

Teens: Want a Brighter Smile? Visit the Dentist, not the Shopping Mall

Although teeth whitening may be one of the safest, non-invasive and cost-efficient ways for teens to immediately boost their appearance, parents should learn about the best whitening options for their adolescent, reports the Academy of General Dentistry (AGD), an organization of general dentists dedicated to continuing education.

Teeth whitening is a multi-million dollar industry that is partly fueled by image-conscious teens heading to the mall to pick up instant, do-it-yourself teeth whitening kits, many of which are heavily marketed and are not dentist-supervised.

"Teens should visit their dentist instead of the mall for a healthy, white smile," says AGD spokesperson Manuel Cordero, DDS, MAGD, who has seen a steady increase in his teen patients' requests for this procedure.

Proper whitening depends upon the use of a custom-made bleaching tray, which only a dentist can properly fit. Some Internet companies sell the materials that allow consumers to make their own whitening tray. But only dentists can assure the proper use of these materials. Without supervision and expertise, these materials can cause damage to existing dental work. As with any dental procedure, whitening should always be done under the supervision of a dentist.

Tips for teens and their parents on tooth whitening:

• According to Dr. Cordero, teens should wait for whitening procedures until at least the age of 14. At this time, the tooth's pulp is fully formed, which means the teen will experience less sensitivity.
• Drink soda and coffee through a straw to prevent discoloration of the upper, front teeth.
• Wearing braces? Brush and clean teeth meticulously because food and their bi-products can discolor teeth as well as create cavities.

To Pierce or not to Pierce

Have you thought about chipped teeth, drooling, gum damage, nerve damage, taste loss, tooth loss or infection? The problems that can arise from an oral piercing might surprise you.

Fractured teeth are a common problem for people with tongue piercings. People chip teeth on tongue piercings while eating, sleeping, talking and chewing on the jewelry. The fracture can be confined to the enamel of your tooth and require a filling, or it may go deep into the tooth; in which case, a root canal or tooth extraction may be necessary.

"Every time you swallow, the barbell hits the teeth, causing constant irritation that can result in mouth ulcers," says Academy of General Dentistry spokesperson Manuel A. Cordero DDS, FAGD.

Infections are also common. Dentists are learning that oral infections can be linked to other infections. "The tongue is covered with bacteria," Dr. Cordero said. "The moment the tongue is punctured, bacteria are introduced into the blood. When that happens, bacteria can travel to the heart and cause a variety of serious problems."

If you decide to pierce your tongue, take care of it. Once the tongue has been pierced, it takes four to six weeks to heal. Barring complications, the jewelry can be removed for short periods of time without the hole closing. Always remove the jewelry every time you eat or sleep.

To avoid serious infections such as HIV or hepatitis, make sure the piercer sterilizes everything in an autoclave, which uses extreme heat to sanitize surgical instruments. Ask the piercer questions about after-care, cleanliness, equipment and other concerns.

Clean your piercing with an antiseptic mouthwash after every meal and brush the jewelry the same as your teeth to remove plaque.

So You Want to Pierce Your Tongue?

Oral piercing can cause pain, swelling, infection, drooling, taste loss, scarring, chipped teeth and tooth loss. Most dentists discourage oral piercing because of these risks.

Regulations vary in each state, so be careful if you decide to get any kind of piercing. Make sure that you ask the person performing the piercing about care after the piercing, possible side effects, cleanliness and anything that may concern you. If they are not prepared to answer your questions in a clear, professional manner, go somewhere else.

Chipped teeth

Fractured teeth are a common problem for people with oral piercings. People chip teeth on tongue piercings while eating, sleeping, talking and simply chewing on the jewelry. The fracture can be confined to the enamel of your tooth or may go deep into your tooth, which may require a root canal or extraction.

Swelling

It is not unusual for the tongue to swell after being punctured, but in some cases the tongue swells so much that it can cut off your breathing. In rare cases, doctors may pass a breathing tube through a patient's nose until the swelling subsides.

Infection

The tongue is covered with bacteria, so any infection can be serious. See your dentist at the first sign of a problem. Dentists are learning that oral infections can lead to infections in other parts of the body. Your mouth has high levels of bacteria. When you puncture any part of the oral cavity, these bacteria may find its way into your bloodstream. Bacteria can reach your heart and cause a variety of health problems.

There is also a risk of contracting blood-borne infections such as human immunodeficiency virus (HIV) and hepatitis. Ask the person performing the piercing what they do to prevent the spread of these serious infections. Does the piercer use a fresh needle for every piercing? Some may reuse needles to keep down the cost of the piercing. Make sure they completely sterilize all needles and instruments in an autoclave, which uses extreme heat to sanitize instruments.

Allergic reactions

Make sure that the piercer uses the right kind of metal, such as surgical-grade stainless steel. Some people have allergic reactions to certain metals, which can lead to further complications.

How do I maintain my piercing?

Once your tongue has been pierced, it will take four to six weeks to heal. The piercer will place a larger, starter 'barbell' in your tongue to give it enough room to heal when your tongue swells. If you decide to keep the piercing, make sure to get a smaller barbell after the swelling goes down, which will be less likely to get in the way of your teeth and more difficult for you to chew on.

Barring complications, you will be able to remove the jewelry for short periods of time without the hole closing. Some suggest that you remove the jewelry to protect your teeth every time you eat or sleep. Some parlors sell plugs that you can place in the hole, which should allow you to remove the jewelry for as long as necessary.

Keep it clean

Keep your piercing clean. Use an antiseptic mouthwash after every meal and brush the jewelry the same as you would your teeth. After the tongue has healed, take the piercing out every night and brush it as you would your teeth to remove any unseen plaque. Consider removing the piercing before eating, sleeping or strenuous activity.

Dentists Tell Athletes Keep the Mouthguard, Take Out the Barbell

Perhaps more than most people, athletes view their bodies as their temples. Seeking to emulate their professional heroes, a growing number of high school and younger athletes are adorning those temples through oral piercings.

But oral piercing and tongue jewelry place athletes at risk for serious medical and dental consequences, according to the Academy of General Dentistry (AGD), an organization of general dentists dedicated to continuing dental education.

"For years, we have been urging athletes to wear mouthguards when they are playing," says AGD spokesperson Bruce DeGinder, DDS, MAGD. "Now we have to tell them to take the barbell out of their tongues."

According to an article in the March/April 2002 issue of General Dentistry, the Academy's peer-reviewed, clinical journal, one out of every five oral piercings results in infection from contaminated puncture wounds. Athletes are more likely than most people to develop infections because the increased blood flow and breathing rate involved in vigorous exercise, as well as the increased chance of bleeding from a contact injury, can spread infection more quickly.

And the dangers don't stop with infection. In a survey, 24 percent of pediatric dentists reported that they had treated patients with complications resulting from oral piercing. Common problems include bleeding, airway restriction and chemical burns from the use of postpiercing care products. After the piercing is healed, damage to teeth and gums is common.

Suzann P. McGeary, DDS, lead author of the report, says the risks are even higher for athletes. "The athlete who participates in contact sports may be particularly susceptible to airway restriction because an impact may dislodge the tongue jewelry, which could be inhaled. It also could be swallowed, which could cause injury to the gastrointestinal tract."

Damage to teeth by tongue jewelry is another danger intensified by participating in contact sports. "We have seen so many cracks and fractures in teeth caused by clicking, tapping or rubbing the jewelry on them that it has gotten its own name – the wrecking ball fracture," says Dr. DeGinder. "The danger of this is much higher on the playing field." According to Dr. McGeary, the jewelry can also injure the gums and other soft tissue, as well as interfere with proper salivary functioning, conditions that decrease the body's defenses against infection and disease.

Dr. DeGinder's first suggestion regarding oral piercing is, "Don't do it."

Mixing tongue jewelry and a mouthguard is a particularly bad combination, says Dr. McGeary. "The jewelry may interfere with the mouthguard and cause increased salivary flow and gagging or inhibit breathing or speech."

"Remove the tongue jewelry – not the mouthguard," says Dr. McGeary.

A Fatal Fad? Tongue Studs Cause More Problems Than Chipped Teeth

Wearing a tongue stud puts people at risk for chipped teeth, recessed gums and nerve damage. However, most people don't realize that getting an oral piercing also places them at risk for developing a fatal infection, such as Ludwig's angina or endocarditis, according to a report in the May/June 2004 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

Ludwig's angina, a bacterial infection of the floor of the mouth, occurs after a tooth infection, mouth injury, oral surgery or oral piercing. After getting an oral piercing, the mouth has an open wound that allows bacteria to travel through the bloodstream. Bacteria can cause the floor of the mouth to rapidly swell, which can block the airway or prevent the swallowing of saliva.

Endocarditis occurs when bacteria travels into the bloodstream through the piercing hole and infects the heart. People with a history of heart defects are at risk for endocarditis. At the dentist's office, a medical history is taken that helps the dentist determine who is at risk, and those patients are given antibiotics prior to certain dental procedures in order to avoid this potentially fatal problem.

"Some body piercers are unlicensed, and most are not members of the medical profession," says William J. Dunn, DDS, MAGD, ABGD, author of the study. "Because of this, health histories are not recorded or reviewed, emergency medical kits are not available, antibiotics are not prescribed and postoperative care is not available."

Postoperative care can also help identify these serious infections before they become fatal. "People are told to expect some swelling from a tongue piercing, but if they don't receive follow-up care, they may not be aware of abnormal swelling," says AGD spokesperson Melvin K. Pierson, DDS.

Unclean piercing equipment can cause other infections, such as hepatitis. Also, if a patient is not instructed to avoid touching the piercing, they might spread infections with their own fingers.

"I don't recommend piercing," says Dr. Pierson. "Because of the risks associated with this unregulated procedure, if someone is considering an oral piercing, they should discuss it with their medical or dental professional."

Students: Hitting the Books May Hurt Your Teeth

Behavior changes induced by academic stress may cause gum inflammation, temporomandibular disorder (TMD) symptoms and bruxism for some college students.

During exam weeks, students often pull all-nighters, sleep less, increase caffeine and nicotine intake, neglect healthy eating habits and experience high stress levels, which reduces saliva flow. "The emotional and physical factors involved in studying for exams often force students to abandon their healthy oral hygiene habits," says Academy of General Dentistry spokesperson J. Nick Russo, DDS, FAGD.

Also, the academic pressures students place on themselves will subconsciously surface, explains Dr. Russo, who treats many students for stress-related facial pain. "Sometimes, your roommate may be the first person to identify your bruxism problem because your tooth grinding keeps them up at night."

In a study investigating academic stress and its effect on gum health, participants' gums were assessed four weeks before final exams and on the last day of the exams. Researchers found 23 percent of students developed severe gingivitis (gum inflammation) in relation to at least one formerly healthy tooth throughout the examination period. Researchers also noted that within one day, students were able to remove nearly all plaque accumulated during the 21-day experiment.

Luckily, cramming for exams and ignoring oral hygiene habits is not a long-term behavior. "Academic stress shouldn't take a toll on your oral health," says Dr. Russo. Find ways to relax during stressful periods and pamper your teeth after your exams, suggests Dr. Russo. Return to a normal oral hygiene regimen and schedule a dental cleaning and checkup.

Is stress taking a toll on your mouth? If you have one or more of these symptoms, you may be have a temporomandibular disorder:

• Sore jaw, especially in the morning
• Clicking sound or difficulty when opening and closing mouth
• Locked or stiff jaw when talking, eating or yawning
• Sensitive teeth
• Ear pain