or some, the arrival ofspring means breakingout of a winter slump and

getting back on track with healthand fitness. Improving your oralhealth may not be part of theseplans, but it should be. Poor oralhealth can contribute to generalhealth problems, so taking care ofyour mouth is an important partof maintaining a healthy body.

“Oral health and systemichealth are so intimately connect-ed,” says Dr. Tom Boran, dean ofthe faculty of dentistry at Dalhou-sie University in Halifax. “Moreand more, we’re recognizing thatif you maintain a high standard oforal health, chances are you willalso have good systemic health.”

The opposite is also true, hesays, with systemic disease oftenshowing up in the mouth beforesymptoms manifest in other areasof the body.

“It’s impossible to maintaingood overall health withoutmaintaining oral health,” says Dr.Peter Doig, a dentist in Dauphin,Man., and president-elect of theCanadian Dental Association.

Most dental diseases arepreventable and progressive, sothat with effective care, they canbe avoided or controlled. Butwithout proper care and treat-ment, Dr. Doig explains, dentaldiseases may result in hospital-ization and even in death due toinfection in rare cases. “They canaffect an individual’s ability to get

and maintain employment and,ultimately, to be self-supportingand a contributor to the economicsuccess of their community andthe country,” he notes.

In extreme situations, whenteeth are lost due to periodontaldisease or caries (cavities), thereis a significant impact on self-esteem, says Dr. Boran. “You mayshy away from social situations,because you’re uncomfortablewith the appearance of your teeth.You may stop smiling, and a smilecan make or break an interview,a conversation, even a relation-ship.”

A study published in thejournal Psychological Science lastNovember found that smilingeven helps alleviate depressionand results in faster physiologicalrecovery after stressful activities.

To keep a healthy smilethroughout life, even as themouth ages along with the restof the body, it’s important to visityour dentist regularly, Dr. Boranadvises. “Dental care is a col-laboration between the dentist, adental team that includes dentalassistants and hygienists, andthe patient. Together, we work toestablish a customized home-careregimen that evolves with thepatient’s needs over time.”

Regular dental visits also ensurethat diseases such as oral cancerare diagnosed early. “We still havea significant portion of the popu-lation that indulge in tobaccoproducts and excessive alcohol,which cause tissue changes inthe mouth that can lead to oralcancer,” says Dr. Boran. “In addi-tion, with systemic diseases suchas diabetes or celiac disease, thefirst symptoms often show up inthe mouth.”

Dental care has two primaryobjectives: prevention and inter-vention. “As dental professionals,we have stressed the preventiveaspect of oral health care formany decades, to minimize theamount of intervention required,”says Dr. Doig.

Prevention is especially criticalin the face of efforts by some

groups to ban community waterfluoridation, which has beenproven effective at reducingcavities over decades, especially invulnerable populations, he says.“A ban would have a detrimentaleffect on the long-term oral healthof Canadians.”

With community fluoridationand other advances in oral healthcare, Canada’s baby boomers arethe first generation to commonlyretain their natural teeth through-out old age. With the prevalenceof crowns, implants and bridges

among this demographic, indi-vidualized, active care is especiallycrucial. Longer lifespans are alsocontributing to a relatively newissue: erosion.

“You can have the best oral-hygiene care and eat the mostnutritious foods available, butin the wrong combination, youmay have acid erosion,” explainsDr. Boran. “When we meet withpatients, we’re able to look attheir habits as well as their teeth,and suggest preventative changesif required.”

SpecialOral health

M O N DAY, A P R I L 8 , 2 01 3 CDA 1

AN INFORMATION FEATURE

Dental care, preventioncritical for healthy teeth – and healthy lives

This report was produced by RandallAnthony Communications Inc. (www.randallanthony.com) in conjunction with the advertising department of The Globe and Mail. Richard Deacon, National Business Development Manager, rdeacon@globeandmail.com.

As part of a healthy lifestyle and to help reduce the riskof oral disease, follow these 5 steps to good oral health.Your whole body will thank you for it.

See your dentist regularly• Regular checkups and professional

cleanings are the best way to preventproblems or to stop small problems fromgetting worse.

• Your dentist will look for signs of oraldisease. Oral diseases, such as oral cancer,often go unnoticed and may lead to or be

a sign of serious health problems in other parts of the body.

Keep your mouth clean• Brush your teeth and tongue at least twice

a day with a soft-bristle toothbrushand fluoride toothpaste.

• Floss every day. Flossing reaches morethan a third of your tooth surface that isotherwise neglected with just brushing.

• Your dentist may also recommend thatyou use a fluoride or antimicrobial mouthrinse to help preventcavities or gum disease.

Eat, drink, but be wary• Healthy food is good for your general

health and oral health. The nutrients inhealthy foods help you to fight cavitiesand gum disease.

• Limit consumption of sugar – one of themain causes of dental problems.

• Limit consumption of highly acidic foodand drinks. The acid may contribute to dental erosion.

Look for warning signs and tellyour dentist• Look for warning signs of periodontal

disease (gum disease): red, shiny, puffy,sore or sensitive gums; bleeding whenyou brush or floss; or bad breath thatwon’t go away. Gum disease is one of themain reasons why adults lose their teeth.

• Look for warning signs of oral cancer: bleeding that you can’texplain, open sores that don’t heal within seven to 10 days, whiteor red patches, numbness or tingling, small lumps and thickeningon the sides or bottom of your tongue, the floor or roof of yourmouth, inside of your cheeks or on your gums. The three mostcommon sites for oral cancer are the sides and bottom of yourtongue and floor of your mouth.

• Look for warning signs of tooth decay: teeth that are sensitive tohot, cold, sweetness or pressure.

Avoid all tobacco products• Smoking can cause oral cancer, heart

disease and a variety of other cancers. Itcan also create stained teeth, tooth loss,infected gums and bad breath.

• All forms of tobacco are dangerous toyour oral health and your overall health,not just cigarettes. Smokeless tobacco,

such as chewing tobacco, snuff and snus can cause mouth, tongueand lip cancer, and can be as addictive as cigarettes.

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It is impossible tomaintain good overallhealth without optimaloral health, say experts.ISTOCKPHOTO.COM

ABOUT

APRIL IS NATIONAL ORAL HEALTH MONTH

The Canadian DentalAssociation is the nationalvoice for dentistry dedicatedto the advancement andleadership of a unifiedprofession and to thepromotion of optimaloral health, an essentialcomponent of general health.

“We still have a significantportion of the populationthat indulge in tobaccoproducts and excessivealcohol, which causetissue changes in themouth that can lead tooral cancer. In addition,with systemic diseasessuch as diabetes orceliac disease, the firstsymptoms often show upin the mouth.”

Dr. Tom Boranis dean of the faculty of dentistry atDalhousie University in Halifax

INSIDE

Filling the oral health care gap in Canada. Page CDA 2

Dental research promises to improve disease treatment. Page CDA 2

Dentists help Canadians overcome smoking addiction. Page CDA 4

omen who require hyster-ectomies to treat uterinefibroids can now choose

instead to have an outpatientprocedure that blocks blood flowto the tumours. The treatment,which dramatically lessens recov-ery time and missed work, as wellas reducing health care costs andrisk, is a remarkable advance in acondition that affects more than40 per cent of women aged 40 to60.

Also remarkable is the fact thata new material intended to makethe procedure safer and more ef-fective, which will be available inabout 18 months, is the result ofresearch conducted by the Depart-ment of Applied Oral Sciences atDalhousie University in Halifax.

Dental research that translatesinto groundbreaking advance-ments in treatment for otherareas of the body is surprisinglycommon, says Dr. MichaelGlogauer, an award-winning sci-entist at the University of Torontoand incoming president of theCanadian Association for DentalResearch. Dentistry is a field thathas traditionally excelled at pre-vention and minimally invasivetreatment, and Canadian dentalresearchers – though relativelyfew in number – have a particular-ly strong record of achievement,he notes.

Dr. Daniel Boyd is the bio-materials scientist at Dalhousiewhose research team developedthe uterine fibroid treatment.“Right now, we’re researching anew group of dental materialsthat can stabilize fractures in thespine, and using dental biomate-rials research to build materialsthat can block the blood supplyto tumours,” he says.

In the oral health realm, histeam is working with glass iono-mer cements (GICs) to developpainless, injection-free as well aslower-cost dental restorations.“We’re learning from developingcountries. In the West, we tendto use more expensive materi-als – we’re trying to demonstratethat GICs are often better for thejob. They work extremely well,don’t have any associated allergicresponses and, frequently, don’trequire injections,” Dr. Boyd says.

In the faculty of dentistryat the University of BritishColumbia, Dr. Joy Richman isinvestigating the causes of cleftlip and other facial deformities.Also at UBC, dentistry professorsDr. Lewei Zhang, Dr. CatherinePoh and Dr. Michele Williamspublished a study that identifieda group of molecular markersthat can help determine which

patients with low-grade oralpre-cancers are at higher risk forcancer development.

Dental research has providedmany compelling clues to thelinks between infections in themouth and the causes of systemicdisease in the rest of the body,says Dr. Glogauer. “There are anumber of possible links betweenperiodontal disease and otherdiseases, such as heart diseaseand strokes, diabetes, pre-termand low-birth-weight infants, andcancer,” he explains, noting thatextensive research is now under-way to better understand theselinks and associations.

Dr. Glogauer has achievedwidespread recognition for histeam’s work on new, non-invasivemethods to detect disease mark-ers in the mouth, including anoral rinse that makes it possibleto monitor susceptibility to infec-tion in patients undergoing bonemarrow transplants. “It is likelythat five or 10 years from now,we will diagnose oral infectionsusing mouth rinses, but we willalso use the mouth as a windowinto the body to detect diseases,or determine if a patient is moresusceptible to developing thosediseases,” he says.

The mouth is the entrywayinto the body in a world crawlingwith microorganisms, and theimmune system plays an integralrole in resisting harmful bacteria,he explains. “We focus on the im-mune system and the white bloodcells constantly pouring into themouth, to try to understand howthey’re fighting infection. It is anexcellent representative sampleof the way those cells work any-where else in the body.”

In some diseases, such asperiodontitis and rheumatoid ar-thritis, the immune system itselfcauses the damage. Studying themouth provides an opportunityto determine how the immunesystem may be altered, says Dr.Glogauer. “When we know whatis going wrong, we can beginto develop new treatments forsome of these conditions.”

Achievements in disease pre-vention brought about by dentalresearch are exemplified by theexcellent work done on com-munity water fluoride startingin the 1930s, and they continuetoday, he says.

As a result, investments indental research net a uniquelyhigh return, Dr. Glogauer adds.“It’s critical that dental research-ers receive the funding theyneed, because their researchtranslates into significant ben-efits to all Canadians.”

t h e g lo b e a n d m a i l • m o n daY, a p r i l 8 , 2 01 3CDA 2 • AN INFORMATION FEATURE

Given the connection between oral health and overall health and well-being, keeping our mouths healthy as weage is important. ISTOCKPHOTO.COM

Dental researchers at the University of Toronto study white blood cells in themouth to better understand how the immune system is altered in those withautoimmune diseases such as rheumatoid arthritis. ISTOCKPHOTO.COM

Canada’s aging population poseschallenges for oral health

Working together for Canadian’s oral health – filling theoral health care gap

OPINION

ORAL HEALTH

Dr. Robert Sutherland, President,Canadian Dental Association

here is good news forCanadians concern-ing their oral health.

According to the 2007-2009Canadian Health MeasuresSurvey – a national survey ofthe public conducted by HealthCanada and Statistics Canada– the oral health of Canadiansis very good, and most Canadi-ans visit a dentist on a regularbasis. Dental care in Canadais delivered to the majority ofCanadians in a private practicehealth care setting. Approxi-mately two-thirds of Canadianshave dental insurance, mostthrough employer-sponsoredbenefits plans, and 74 per centof Canadians visit the dentist

on a regular basis.Unfortunately, that’s not the

full story. There are gaps in ouroral health care system that needto be filled. There are segmentsof our society that experiencepoor oral health including somechildren and seniors, low-in-come populations, people withspecial needs and First Nationspeoples.

Access to dental care shouldnot be limited to those whowork full-time and have dentalbenefits. Access to dental careshould be available to all.

The Canadian Dental Associa-tion (CDA) believes it can playan integral role in helping to fillthese gaps. Finding solutions tothis complex problem will not beeasy, and no one group, agencyor community can be expectedto do it in isolation. CDA believesin the development of a nationalplan adopted in collaborationwith those who have the capac-ity to contribute. There is theneed for partnerships amongthe dental profession, other oral

health care providers and healthcare professional groups, federaland provincial governments,community agencies and others,and alternative models of care orfunding need to be explored.

As a first step, CDA has strucka national working groupwith the priorities of reducinghospital wait times for childrenbeing treated for early childhoodcaries, encouraging a first dentalvisit by age one and advocat-ing for standardized legislationin long-term care facilities toprovide daily oral health care forresidents and access to profes-sional care. The CDA is alsovery active in advocating forimproved access to care for FirstNations peoples.

But that is only the start.Where the ability to pay for den-tal care is a barrier, CDA believesthat increased public funding isappropriate using a needs-basedapproach. We support enhanceddental coverage for special needspatients, children, seniors andthe medically compromised, and

the inclusion of oral health careinformation in school programs,outreach programs and commu-nity health centres, in ways thatare culturally appropriate.

Research has shown that oraldisease shares the same risk fac-tors as diabetes, cardiovasculardisease and cancer. Prevention iskey. A health-care regime of dailybrushing and flossing is an es-sential part of good oral health.Access to profession dental careis equally important for preven-tion, diagnosis and treatment.

CDA believes that all Cana-dians have a right to good oralhealth, that oral health is anintegral part of overall health,that tooth decay is a preventabledisease and that a collaborativeapproach is needed.

As oral health care experts,dentists have a leadership roleto play in the implementationof any proposed oral health carerecommendations and initiatives– but we cannot do it alone.Together we can succeed, for thehealth of all Canadians.

nder the supervision ofpractising dentists andprofessors, students

from the faculty of dentistry atthe University of British Colum-bia are providing free dentalexams and treatment to elderlyresidents at two long-term carehomes in downtown Vancouver.

This unique program ismeeting a current need – pro-viding dental services that areall too rare in such facilities. Atthe same time, it is preparingstudents to meet the complexdemands of geriatric dentistry– knowledge that will be evenmore critical for dental profes-sionals in the years to come.

“Our profession needs toensure we have the expertiseand the resources to care for theaging Canadian population,”says Dr. Christopher Wyatt, a UBCprofessor and leader in geriatricdentistry who developed theAdopt a Long-Term Care Facilityinitiative. “This need will growdramatically over the next 15 to20 years, as the baby boomersage.”

Beyond their sheer numbers,Dr. Wyatt explains, boomers“have had better dental carethan any previous generation.They are maintaining more oftheir natural teeth and have alot of implants and bridgework,

which makes preserving theiroral health more complex.”

Dr. Alastair Nicoll, a CanadianDental Association board mem-ber who has a family dental prac-tice in Elkford, B.C., shares thisconcern. “A massive wave of frailelderly is on the horizon, andmost will have natural, heavilyrestored teeth requiring signifi-cant maintenance,” he says. “Iliken it to a perfect storm.”

Another major worry is the in-creased use of prescription medi-cations among this population,says Dr. Nicoll. “These drugs arekeeping more seniors active andhealthy, but a major side-effectof most of them is dry mouth.Because saliva is a key defenceagainst tooth decay, the potentialexists for seriously negative oral-health outcomes.”

Meanwhile, the gap betweenseniors’ oral-health needs andtheir access to care is already adaunting challenge. Many Cana-dians don’t have dental insur-ance; those who do usually losetheir benefits upon retirement.

Cost is a barrier to good oralcare for seniors living in thecommunity and in long-termcare, says Dr. Michael Wiseman,a Montreal dentist and assistantdentistry professor at McGill Uni-versity. Dr. Wiseman, who treatsveterans and other elderly pa-

tients in residential care, pointsto other challenges there.

“Nurses and nurses’ aides infacilities often lack knowledgeabout proper oral care for theelderly, particularly for residentswith serious physical and cogni-tive impairments,” he says. “Oneof my tasks is to work with themto develop oral-care plans.”

The Canadian Dental As-sociation and its provincialcounterparts are taking actionin the face of these challenges.They are advocating for manda-tory oral-health standards inlong-term care facilities, as wellas tax-based dental benefitsfor low-income seniors in suchfacilities.

Another key strategy is toincrease oral-health educationfor seniors and their families, es-pecially as many older Canadiansstop going to the dentist whentheir insurance ends. The profes-sionals say that preventive oralcare is an investment with highdividends.

“It’s important for seniorsto recognize they’re at the agewhere they are more prone todental problems,” adds Dr. Wise-man. “Given the link betweenoral health and overall healthand well-being, keeping ourmouths healthy as we age is allthe more critical.”

“Research has shownthat oral disease sharesthe same risk factors asdiabetes, cardiovasculardisease and cancer.Prevention is key.”

LOOK FOR THE CDA SEAL

From toothbrushes to toothpastes, mouth rinses to dental floss, look for the CDASeal of Recognition.

CDA’s Seal of Recognition Program is designed to help consumers makeinformed choices on dental products that are beneficial to their oral health.

These products are of value when used in a conscientiously applied pro-gram of good oral hygiene and regular professional care.

For more information on CDA’s Seal of Recognition Program,visit www.cda-adc.ca/Seal.

SENIORS

PROGRESS

Dental researchers break newground in medical treatment,disease prevention

ORAL HEALTH

AN INFORMATION FEATURE • CDA 3the globe and ma il • mondaY, apr i l 8 , 201 3

Regular dental visits important for healthy teeth – and moreEXPERT ADVICE

ost people wouldn’t putthe dentist’s office on theirlist of favourite destina-

tions. But it’s definitely a tripeveryone should take – regularly.

“If you want to have nice,healthy teeth that last a lifetime,then you need to make sure you'relooking after them now,” says Dr.Gary MacDonald, a dentist in Mt.Pearl, N.L., and vice-president ofthe Canadian Dental Association(CDA). “This means not only prac-tising good oral hygiene at home,but also visiting your dentist on aregular basis.”

Visiting the dentist office everysix to 12 months ensures good,preventive oral care and makes iteasier to identify problems early,before the patient can see or evenfeel them. Dr. MacDonald notesthat there are those who see theirdentist only when they thinkthere's something wrong with theirteeth or mouth. Some stay away foras long as they can, because theyview dental visits as unpleasant.

Such procrastination is defi-nitely not good practice, especiallyas early intervention makes repairmuch easier and less expensive,says Dr. MacDonald. Understand-ing what actually takes placeduring an appointment can helpease any discomfort a patient mayhave when visiting their dentist,he adds.

“It’s critical that the patientknows what to expect during avisit and understands what is beingdone,” says Dr. MacDonald. “Evenduring a routine visit, the patientshould be well informed aboutwhat is happening. I can’t empha-size enough the importance ofgood communication between thepatient and the dentist.”

An initial visit with a dentisttypically starts with the dentistexamining the patient and havingX-rays taken. Based on a thoroughassessment, the dentist then cre-ates a treatment plan, includingscheduling dental cleanings.

After an appointment for clean-ing by a dental hygienist, patientsshould expect their dentist tocome take a look inside theirmouth.

“Some people think we’re justlooking to see if the teeth werecleaned properly, but in fact we’redoing a meticulous dental exami-nation,” says Dr. Randall Croutze,an Edmonton dentist and memberof the CDA board of directors. “Inaddition to checking for cavitiesand gum disease, we’re checkingsoft tissues, muscles and glands,and looking for lumps and bumpsthat shouldn’t be there.”

Dentists examining youngchildren also check to see if theirpatients have met certain mile-stones – such as the growth ofcertain teeth – and make sure theirbite, tongue and jaws are well posi-tioned and working properly, saysDr. Croutze.

Sometimes, an exam by a dentistcan flag a serious condition, suchas oral cancer, says Dr. Michael H.Brown, a dentist in Moncton, N.B.,and CDA director.

“We’ve all had training in oralpathology,” he says, “So we knowwhat doesn’t look right.”

While they are oral health ex-perts, general dentists themselvesdon’t always treat everything to dowith the mouth and teeth, says Dr.Brown. They’ll often refer a patientto a specialist, such as an oral sur-geon, for wisdom tooth extraction,a dental implant placement or toinvestigate possible oral cancer. Forsevere gum disease, gum recessionor dental implant placement, thepatient may be sent to a periodon-tist.

Dr. MacDonald says patientsshould never hesitate to ask theirdentist any questions about theirdental health or treatment. Com-munication is key, and patients areencouraged to be active partici-pants in their oral health.

“Patients should expect a treat-ment plan that is based on theiroral health needs, and it may differfrom what is offered by their dentalplan,” says Dr. MacDonald. “It isimportant to remember that adental plan is not a treatment planand that your dentist is treating,you, the patient, and not your plan.You should always expect yourdentist to do what is best for youroral health.”

Most people visit a general dentist regularly for theirdental and oral health care needs. General dentistsprovide services to the old and young, treating

healthy and not-so-healthy mouths. However, there are some situations for which your dentist may refer youto a specialist. Dental specialists have the advanced knowledge and skills that can be essential to maintain andrestore oral health under certain circumstances. There are 9 nationally recognized dental specialties in Canada.

Dental Public HealthDental public healthspecialists focus on

improving the dental health ofpopulations rather than individu-als. They principally serve thecommunity through research,health promotion, education andgroup dental care programs. Tolearn more about dental publichealth, visit the Canadian Asso-ciation of Public Health Dentistrywebsite at www.caphd.ca.

EndodonticsRoot canal therapyis the most common

procedure performed by endo-dontists. But that’s not all theydo. Their specialty encompassesthe diagnosis, prevention andtreatment of nerve and tissuediseases and injuries. To learnmore about endodontics, visit theCanadian Academy of Endodon-tics website at www.caendo.ca.

Oral and MaxillofacialSurgeryOral and maxillofacial

surgeons diagnose and surgicallytreat disorders, diseases, inju-ries and defects impacting thefunctional and esthetic aspectsof the mouth, head and neck. Forexample, they can extract wis-dom teeth or broken teeth, treattemporomandibular joint disor-ders, or place dental implants andbone grafts. To learn more aboutoral and maxillofacial surgery,visit the Canadian Association ofOral and Maxillofacial Surgeonswebsite at www.caoms.com.

Oral Medicine andPathologyOral medicine and

pathology specialists focuson the diagnosis, nature andprimarily non-surgical manage-ment of oral, maxillofacial andtemporomandibular diseasesand disorders, including thedental management of patientswith medical complications.These specialists rely on clini-cal, radiographic, microscopicand biochemical examina-tions to establish a diagnosis,including assessment of tissuespecimens.

Oral andMaxillofacialRadiology

Oral and maxillofacial radiolo-gists help diagnose and treatdiseases and disorders of thecraniofacial complex throughthe use of imaging technologiessuch as X-rays, CT scans andMRIs.

Orthodontics andDentofacialOrthopedics

Orthodontists are trained todiagnose, prevent and treatdental and facial irregularities,for both functional and estheticreasons. Treatment options in-clude the use of dental braces,retainers, spacers and otherdevices. To learn more aboutorthodontics and dentofacialorthopedics, visit the CanadianAssociation of Orthodontistswebsite at www. cao-aco.org.

Pediatric DentistryPediatric dentistsare specially trained

to care for the oral health anddevelopment of children andadolescents, including thosewith disabilities. They providepreventative and comprehensivecare including management ofchildhood dental anxiety. Formore information on pediatricdentistry, visit the CanadianAcademy of Pediatric Dentistrywebsite at www.capd-acdp.org.

PeriodonticsPeriodontists focus onthe diagnosis, preven-

tion and treatment of diseasesand conditions that affect thebones and gums or that lead toloose or lost teeth. They helpmaintain the health, functionand esthetics of these structuresand tissues. Periodontists alsoplace dental implants. To learnmore about periodontics,visit the Canadian Academy ofPeriodontology website atwww.cap-acp.ca.

ProsthodonticsProsthodontists aretrained to diagnose,

restore and ensure oral func-tion, comfort, appearance andhealth by the restoration of thenatural teeth or the replacementof missing teeth (e.g., bridges,dentures, implants). To learnmore about prosthodontics,visit the Association of Prosth-odontists of Canada website atwww.prosthodontics.ca.

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The Dental Specialties

For more information, visit www.cda-adc.ca or www.cdsa-acsd.ca.

MAKEYOURDENTIST’S JOBEASYWITHTHIS SIMPLE ROUTINE.

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t’s an infectious diseasethat affects more youngchildren than any other.

It can cause acute and chronicpain as well as nutritionalproblems, and require hospital-ization.

But early childhood caries(ECC) is also almost entirely pre-ventable. “We go to great lengthsto try to give our kids the beststart,” says Dr. Mitch Taillon,a dentist in Assiniboia, Sask.,and chair of the Access to CareWorking Group of the CanadianDental Association (CDA). Inorder to do that most effectively,he says, “we’d like to see them

within six months of gettingtheir first tooth, or by one yearof age. By starting at that veryyoung age, we can help get themon the right path to lifelong oralhealth.”

Even after many years ofadvocacy by the CDA and otherorganizations, the prevalence ofECC continues to climb. “Whenyou look at hospital wait-lists forchildren, treatment for dentaldecay is always at the top of thelist,” says Dr. Taillon. “In a mod-ern country like Canada, that’s areal concern.”

A healthy mouth is critical forearly childhood development.

“Oral disease affects everythingfrom proper nutrition to speechdevelopment and buildingself-esteem,” says Dr. MichalGoralski, a pediatric dentist inBarrie, Ont., and president of theCanadian Academy of PediatricDentistry. “We’re encouragingage-one visits as a proactive, pre-ventative approach. We can sitdown face-to-face with parentsand go over a few basic strate-gies that will help the child gofrom age one to age three or fourwithout any dental disease.”

Parents tend to think aboutcavities in “baby teeth” as beingless important than in perma-nent teeth. Research shows,however, that children withcavities early in life often havethem into their teen years andadulthood, while those withhealthy mouths continue thatway as well.

For many families, “the firstvisit is also the first step inestablishing a ‘dental home,’”says Dr. Goralski. “Your dentistis then there to provide informa-tion, care and emergency care,should something happen. Youhave someone you can trust andrelate to.”

Contrary to the general per-ception, ECC is not the result ofpoor habits or eating too muchsugar, although those may becontributing factors. “This is aninfection caused by a specificbacteria, mostly streptococcusmutans. Without this bacteria,your child will never have acavity, but your child’s habitsgreatly affect the likelihood heor she will be colonized andthereby have the disease ornot. Unless you think of it as aninfection, it’s difficult to treat,”says Dr. Goralski.

Infection is transmitted to thechild, usually by parents. “Often-times a child drops their pacifier,the mother puts it in her mouthand sticks it back into the baby’smouth,” explains Dr. Goralski,

noting that “the child would bebetter off with a little bit of dirt.”

Frequent sugar intake – suchas regularly sipping juice orchocolate milk – and a lack offluoride help create an environ-ment in the mouth that is morelikely to be colonized, he says.

While it is present at everysocioeconomic level, ECC hitshardest among the most vulner-able. Along with provincial den-tal associations, the CanadianDental Association is workingto support and improve publi-cally funded children’s dentalprograms for socioeconomicallyor geographically disadvantagedfamilies.

“In some locations, we willwork collaboratively with otherhealth professionals, such asphysicians, nurses, communityhealth workers, dental hygien-ists and assistants, and govern-ments and non-governmentalagencies that serve these high-risk groups,” says Dr. Taillon.

the globe and mail • mondaY, apr i l 8 , 201 3CDA 4 • AN INFORMATION FEATURE

ORAL HEALTH

By thenumbers

4,000estimated newcases of oralcancer arediagnosed eachyear*

19.9%Canadians aged12 and olderwho smokedeither daily oroccasionally in2011**

Sources:

* Canadian Cancer Society** Statistics Canada

Early start gets kids on the path tolifelong oral health

Oral health care at homeDr. Dana Coles, a family dentist in Prince Edward Island who hasworked with children for more than 15 years, offers parents tips formaintaining kids’ oral health.

• Brush at least two times and floss onceeach day. Start as soon as teeth appear.If your toddler isn’t co-operative at thesink, have him or her lie down on a bedto keep the head stable, while you do thebrushing and flossing.

• Visit your dentist and dental hygienistregularly.

• Ensure that your child eats a healthy diet; limit sugar. Regularlysipping sugary drinks, even unsweetened fruit juice, can bedamaging.

• Toothpaste with fluoride helps prevent tooth decay. (Use only a“rice kernel” amount of toothpaste if your child cannot yet spitit out.)

• Talk to your dentist about using sealants to help reduce the risk ofdecay.

• When playing sports such as hockey orsoccer, use a mouth guard.

• Limit pop, energy drinks and sportsbeverages.

• Avoid tobacco products of all kinds.• Be aware that tongue and lip piercings

can damage teeth as well as causeinfection.

For more information, visit www.cda-adc.ca.

Allchildren

Olderchildren &

teens

Dentists take action to fighttobacco use

ould you ask your dentistfor advice on how to quitsmoking?

That might have been anunusual question 15 to 20 yearsago, but not today, says StevenPatterson, associate chair (aca-demic) in the School of Dentistryat the University of Alberta inEdmonton.

“In recent years, our profes-sion has more fully embracedour role in the area of smok-ing cessation,” he says. “We’vecertainly seen a change in dentaleducation; students are nowlearning how they can moreactively support patients in theirefforts to quit tobacco.”

Given that many Canadiansmay see their dentist more regu-larly than their family physician,this role as a quit smoking advis-er is all the more important. Insome provinces, your dentist canalso prescribe needed smoking-cessation medications.

“Dentistry has long recognizedthe serious – sometimes devas-tating – effects of tobacco use onoral health. Both smokers andusers of smokeless (chewing)tobacco face an increased risk ofconditions including periodon-tal or gum disease, tooth decay,tooth loss, mouth lesions and de-layed healing after dental work,”says Dr. Jim Tennant, a practicingdentist from Hay River, NWT, anda member of the Canadian Den-tal Association board of directors.

Smokeless tobacco is oftenviewed as less harmful as thereis no effects due to smoke, butit must be noted that it is notharmless, contributing to bothoral disease and damage andsome general health effects.

The most serious risk fromboth forms of tobacco is oralcancer. The Canadian CancerSociety estimates that 4,000new cases of oral cancer wereidentified and 1,150 deaths oc-curred last year as a result of thedisease.

“Around 75 per cent of oralcancer is estimated to be causedby tobacco use, which meanswe could go a long way towardseradicating it if people didn’t usetobacco,” explains Dr. Patterson.“The earlier you find this typeof cancer, the better the progno-sis, which is why regular dentalscreening is so critical. Yourdentist can conduct a thoroughclinical examination of all the tis-sues in the mouth and the visiblethroat area, and detect even verysmall changes.”

The dental profession is notlimiting its anti-tobacco initia-tives to supporting, monitoringand treating individual patientsin their offices. The CanadianDental Association (CDA) isactive in education campaignsand promotes policies aimed atreducing and eventually elimi-nating tobacco use.

“The CDA is working to edu-cate Canadians on tobacco risksand the importance of regularscreening for oral disease,” saysTom Raddall, a dentist in Liver-pool, N.S., and chair of the CDA’sadvocacy committee. The orga-nization is part of the CanadianCoalition for Action on Tobacco,which advocates in such areas assmoking-cessation funding, plainpackaging and bans on the saleof flavoured tobacco products.

“We are very concerned aboutflavoured smokeless tobacco,for example, which is designedto make those products moreattractive to young people,”adds Dr. Raddall. “We know thatchewing tobacco is growing inpopularity among teenagers.Given the clear oral-health risks,we must do all we can to reversethis trend.”

“So, for those Canadians whosmoke or use any form of to-bacco, find ways to stop. And forthose who are thinking of start-ing, be health smart and don’tstart. Your mouth and body willthank you,” advises Dr. Tennant.

ADDICTION

CHILDHOOD CARIES

A first dental visit before age one ensures that parents have the basicstrategies they need to help their child avoid dental disease. ISTOCKPHOTO.COM

“We’re encouraging age-one visits as a proactive,preventative approach.We can sit down face-to-face with parents and goover a few basic strate-gies that will help thechild go from age one toage three or four with-out any dental disease.”

Dr. Michal Goralskiis a pediatric dentist in Barrie,Ont., and president of theCanadian Academy of PediatricDentistry