SPRING|SUMMER Cavities and kids - ODA · wash away food debris and this helps to control plaque as well.” “Your dentist can help you come up with a plan to treat both the symptoms

SPRING | SUMMER 2013

PLEASE DO NOT REMOVE FROM RECEPTION AREA. Visit us online www.youroralhealth.ca

Cavitiesand kidsQuestions and (sometimes surprising) answers

SWEET ANDSNEAKY SUGARIt’s everywhere – andit’s bad for your teeth

SENSITIVE TEETHTalk to your dentist

SLEEP APNEAWhat is it – and why

are you losing sleep?

DRUGS ANDYOUR DENTIST

The importance of keepingyour dentist informed

Your source foryour oral health.

Spring | Summer 2013 3

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Our Contributors

Welcome fromDr. Deborah Saunders, Editor-in-Chief

Julia Aitken writes about food andnutrition for many Canadianmagazines and newspapers suchas the Toronto Star, Food & Drink,Diabetes Dialogue and Expressions,and has authored three cookbooks,the latest being 125 BestEntertaining Recipes. Since sheeats for a living, Julia takes verygood care of her teeth, includingreligiously wearing a nightguard.

Cheryl Embrett is a Torontofreelancer writer/editor who haswritten for many national magazinesincluding Canadian Living, Today’sParent and Best Health. She is happyto report that her 12-year-olddaughter has never had a cavity.

Jennifer D. Foster is a freelancewriter, editor and fact-checker whoseclients include The Globe and Mail,Kids Can Press, the Art Gallery ofOntario and Ontario Dentist. She livesin Toronto with her husband, Greg,and their 10-year-old son, Darius, andthey all brush and floss daily!

Welcome to our Spring/Summer 2013issue of Your Oral Health.ca (YOH.ca)!

We asked you what you wanted to read about in this issue of YOH.ca. and here’swhat you told us — more oral health-care information for moms — both first-timers and vets like myself (I have three kids) — you had questions about whatto put in your baby’s bottle; whether you need to clean a baby’s gums and whatthe best toothbrush is for your toddler.

Plus, we have a very informative article on sugar — did you know there is sugar in almost everything and that it’sa major culprit when it comes to childhood cavities?

Finally, we have included an article on sleep apnea. This topic is a great example of where dentists and physicianscan play a dual role in helping to manage your health and well-being, so we wanted to explore it a bit for you andwe look forward to your feedback.

As always, our articles are vetted and reviewed by a number of ODA member dentists. As you read this in yourdentist’s reception area, if you have questions about the articles — or any oral health-care topic affecting you oryour family — we hope you’ll take a moment to talk to your dentist about it.

And please don’t forget to visit our public website — www.youroralhealth.ca — for more oral health-care articles,tips and quizzes.

We hope you enjoy this issue of our magazine — and thanks again for your interest in Your Oral Health.ca. If youhave feedback about YOH.ca, we’d love to hear it. Please email us at [email protected].

Did you know?

4 youroralhealth.ca

What’s InsideSPRING | SUMMER 2013

PublisherKari Cuss

Editor-in-ChiefDr. Deborah Saunders

Consulting EditorDr. Ian McConnachie

Art DirectorKimberley Strange

EditorJulia Kuipers

Policy EditorLynne Sweeney

ADVISORY BOARD

Dr. Arthur WorthODA PresidentThamesville, Ont.

Dr. Rick CaldwellODA President-ElectNew Liskeard, Ont.

Dr. Gerald SmithODA Vice-PresidentThunder Bay, Ont.

Dr. Harry HöedionoODA Past PresidentKitchener, Ont.

ADVERTISINGFor more information about advertising orsponsorship opportunities for Your Oral HealthBrought to You by the ODA, please contactJennifer DiIorio or Sarah Vassos at DovetailCommunications at 905-886-6640 [email protected] or [email protected].

DISCLAIMERThe publication of an article or advertisement shouldnot be construed as an endorsement of or approvalby the ODA. The opinions expressed in Your OralHealth Brought to You by the ODA are those of theauthors, and do not necessarily reflect the opinions ofthe ODA.

CONTACT USWe welcome your feedback!Please contact us at the ODA —[email protected] or 416-355-2276.

The ODA is the voluntary professional organizationwhich represents the dentists of Ontario, supports itsmembers, is dedicated to the provision of exemplaryoral health care and promotes the attainment ofoptimal health for the people of Ontario.

We have more information about many

oral health topics on youroralhealth.ca

– the ODA’s website.

And it’s all ODA-approved!

5

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All photos in this issue: iStockphoto.com | Cover photo: iStockphoto.com/4774344sean

www.youroralhealth.ca

5 Somebody Bring Me Some WaterXerostomia can leave you feeling parched.Cheryl Embrett

7 Sense and SensitivityTooth sensitivity is a pain– talk to your dentist about it.Julia Aitken

9 Brushing and Flossing and Rinsing.Oh my!What parents need to knowabout kids’ oral health care.Jennifer D. Foster

12 Expert Advice About Cavitiesand KidsAnswers to your questions.Cheryl Embrett

14 Sweet and SneakySugar – it’s everywhere and it’s bad for your teeth.Julia Aitken

16 Obstructive Sleep ApneaWhat is this – and why are so manylosing sleep over it?Cheryl Embrett

18 Drugs and Your DentistWhy you need to tell your dentistabout your medications.Cheryl Embrett

20 Kids’ ZoneQuizzes, puzzles, fun facts and more!

9


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By Cheryl Embrett

Xerostomia (or dry mouth as it is commonly referred to)

can leave your mouth feeling as parched as the Sahara

Somebody Bring Me Some Water

If your mouth often feels dryand uncomfortable, you may havexerostomia. That’s the clinical termfor dry mouth — a common condi-tion that occurs when the amount ofsaliva in your mouth, well, dries up. Areduced saliva flow may lead to allkinds of problems, including badbreath, cavities, oral trauma, gum dis-ease, mouth infections and difficultyswallowing, eating or talking.

Saliva has antibacterial, digestive,mineralizing and lubricating proper-ties that keep the mouth healthy, andboth the quantity and quality are im-portant, says Dr. Deborah Saunders,Medical Director of the DentalOncology Program at North EastCancer Centre in Sudbury, Ont.

6 youroralhealth.ca

Who gets dry mouth?While anyone can develop drymouth, it’s most common in older pa-tients who tend to be on more med-ications and are more likely to havehad a recent change in health, saysDr. Gillian Soskin, a full-time dentistat London Health Sciences Centre inLondon, Ont.

What causes it?Dry mouth can be caused by manyfactors, but medications are thebiggest culprit, especially medicationsfor anxiety, depression or hyperten-sion, says Dr. Saunders. And takingmultiple medications complicatesmatters, she adds. “One medicationmay cause a bit of dryness but whenyou add another one plus one plusone, you have four-fold dryness andthat may have a huge impact.” Med-ical conditions such as cancer, dia-betes and Sjögren’s syndrome are alsoassociated with xerostomia. (Sjögren’sis an auto-immune disorder that cancause dry, sandy eyes and a drymouth1, notes Dr. Saunders.)

“It’s important that people areaware of the medications they’re tak-ing and the medical conditions thatcan have an effect on the environ-ment in their mouth and talk to theirdentist about it,” says Dr. IanMcConnachie, an Ottawa pediatricdentist and Past President of theOntario Dental Association.

There are a number of dry mouth treatments that will help restore moisture tothe mouth. But the first step is always to discuss your symptoms and possibletreatment with your dentist. Says Dr. Saunders: “The best defence against drymouth is moisturizing the mouth to relieve dryness. As plaque is difficult to con-trol in a dry mouth, sugar-free foods are recommended. Saliva also serves towash away food debris and this helps to control plaque as well.”

“Your dentist can help you come up with a plan to treat both the symptomsand the side-effects, such as decay,” says Dr. Soskin. Your dentist may suggest oneor more of the following:

1 Mayo Clinic website: www.mayoclinic.com/health/sjogrens-syndrome/DS00147

2 Cancer Care Ontario website: www.cco.ca

Visit youroralhealth.ca

for more informationabout dry mouth.

Ways to decrease and treat dry mouth symptoms

• H2O. While there are many salivarysubstitutes on the market, somepeople don’t like the texture,” saysDr. Soskin. “A lot of my patientsprefer to take frequent sips of waterinstead.”

• Bland mouth rinse. Dr. Saundersrecommends a standard bland rinsefrom Cancer Care Ontario for any-one experiencing dry mouth. Mix1/2 teaspoon of baking soda and 1/2

teaspoon of salt in two cups (500mL) of water and rinse wheneveryour mouth is feeling dry. (Do notrefrigerate.2) “If you have a drymouth, your oral environmenttends to be acidic and the sodiumbicarbonate in baking soda helpsneutralize that acidity,” says Dr.Soskin.

• Xylitol lozenges. These can be pur-chased at the drugstore or throughyour dental office to help stimulatesaliva and keep your mouth free ofplaque, advises Dr. Saunders.

• Your dentist may also recommend topical fluoride application trays (to beused in the dental office under your dentist’s supervision). “These are a majorpart of treatment since the biggest problem for patients with dry mouth isrampant decay,” says Dr. Soskin. �


Sense Sensitivityand

Think having sensitive teethis just an inconvenience? Thinkagain. When ice cream or frostydrinks come with an “ouch” factor,it’s time to tell your dentist. “Toothsensitivity may be an initial markerfor something more serious,” explainsDr. Harry Höediono, Past President ofthe Ontario Dental Association and adentist in Kitchener, Ont.

Tooth sensitivity is a pain andyour dentist needs to know about it

Tooth sensitivity occurs when theprotective enamel on the tooth isdamaged or when receding gums orperiodontal disease exposes thedentin at the roots. Explains Dr.Höediono: “Dentin is the materialthat makes up the part of the toothbelow the gums, the tooth root, andis found under the tooth’s enamellayer. It is a much softer material

By Julia Aitken

�

Your dentist needs to know if yourteeth are sensitive because thecauses can include:

• tooth decay or damage• gum disease and recession• tooth grinding

Tooth Sensitivity 101

8 youroralhealth.ca

than enamel and contains tubules, tiny tubes that connectto the tooth’s pulp or nerve chamber. When this materialis exposed to the air, cold, acidic drinks or infected withdecay, the tooth may exhibit signs of discomfort.”

Once you’ve spoken with your dentist and the majorcauses have been treated and/or eliminated (see “ToothSensitivity 101”), there are several ways to relieve thediscomfort.

Brushing regularly with a desensitizing toothpaste helpsbecause it contains ingredients such as potassium nitratethat seal the tubules in the dentin, says Dr. Gillian Soskin,a dentist at London Health Sciences Centre in London,Ont. “It’s like putting a sweater on the tooth and insulatingit,” she explains.

(Please visit the Canadian Dental Association’s website —www.cda-adc.ca — and look on the CDA Seal ofRecognition page for a list of recommended desensitizingproducts.)

Using a fluoride rinse or gel may help to harden theenamel, protecting the teeth. Depending on their strength,these rinses or gels are available with or without a pre-scription. Talk to your dentist about whether this option issuitable for you — and how frequently it should be used.

Another option available that your dentist may recom-mend is a fluoride varnish, a thick paste with a highconcentration of fluoride that’s applied to sensitive teethevery two or three months.

Bonding is a more permanent fix where an insulatinglayer of tooth-coloured composite resin is applied toexposed, sensitive roots. According to Dr. Höediono, thiscan provide long-lasting protection from tooth sensitivityprovided you use a soft toothbrush, warm water and gen-tle brushing.

If grinding your teeth at night has caused tooth enamelto wear away, your dentist might suggest making you aclose-fitting, thermoplastic nightguard to protect yourteeth while you sleep. �

Dental 911

Here’s how to help prevent tooth sensitivity:

Keep your teeth clean: plaque forms bacteria thatirritates your gums and may make them recede.

Use a desensitizing toothpaste and fluoridateddental products.

Use a soft toothbrush that won’t scratch toothenamel or wear away gum tissue and brush gently

using a circular motion.

Use warm water when brushing your teeth tosoften your toothbrush’s bristles.

Avoid tobacco in any form. In addition to itscarcinogenic effects, smoking cigarettes orchewing tobacco may cause gums to recede.

Reduce your intake of acidic foods and sugarysnacks and drinks.

You should always tell your dentist if your teeth are sensitive to hot, coldor sweet, but Dr. Höediono says you should call your dentist at once if youexperience any of these symptoms:• Your teeth are also sensitive to pressure.• Your tooth sensitivity doesn’t decrease after using a desensitizingtoothpaste for a few weeks.

• The pain from tooth sensitivity lasts longer than one hour.• The gums around your sensitive teeth appear to be changing colour.

Fighting the

“Ouch”Factor


�

By Jennifer D. Foster

Brushingand Flossingand Rinsing.

What parents need to know aboutkids’ oral health care

It’s probably not news to any parent that regular toothbrushingand flossing, combined with routine dental visits, are key to healthy teeth andgums. But with an awe-inspiring array of dental products available on everydrugstore shelf, does it make a difference as to what kind of toothbrush or flossyou buy for the kids? And, what may be news to parents (especially those first-timers) is that “practising good oral hygiene habits need to start long before youbuy a toothbrush for that child,” says Dr. Rick Caldwell, ODA President-Elect,who maintains a busy dental practice in New Liskeard, Ont.

Newborns and infants: Some new moms and dads may think that noteeth equals no brushing. Not according to Dr. Jerry Smith of Thunder Bay, Ont.,and ODA Vice-President. “For babies without teeth, their gums should be wipedwith a clean, soft cloth moistened with water, after every feeding.” This accus-toms baby to having her mouth cleaned and sets the stage for toothbrushing —once the little one has teeth.

Oh my!

10 youroralhealth.ca

When to brush?As soon as baby’s first tooth appears,Mom or Dad can brush it carefullyusing a toothbrush with a very smallhead and soft, rounded bristles, ad-vises Dr. Smith. “Use plain water andno toothpaste, unless there is a levelof caries [decay] risk, as determined byyour dentist. In that case, an amountthe size of a small grain of rice may beused.” Once children are over the ageof three, “a fluoridated toothpaste canbe used twice daily by Mom or Dad tobrush their kids’ teeth, using anamount similar to the size of a smallgreen pea,” he says. “And ensure thechild is able to spit it out.”

How long a parent is the solebrusher of the child’s teeth varies.ODA President Dr. Arthur Worth, ofThamesville, Ont., says the ability of achild to brush unassisted depends onhis or her motor co-ordination skills.“Most children, regardless of their en-thusiasm for brushing, simply don’thave sufficient dexterity to allowthem to effectively clean all the toothsurfaces, until six to eight years ofage.” And that’s precisely why adultsupervision is crucial. According tothe Canadian Dental Association,your child is ready to do an effectivejob brushing when she or he canwrite (not print) his or her name.

So, manual or electric?Manual toothbrushes, in general,tend to have smaller brushing headsthan the electric spin-type brushes,accessing the harder-to-reach areasmore easily. But, for some children,“the novelty of a brush that spinsmay get them to brush longer and,thus, a better job is potentially done,”says Dr. Caldwell. And, he says “anelectric toothbrush could be recom-mended when there are dexterityissues (that is, an electric brush mightbe easier to hold) or when the devicewill help mitigate some behaviourissues.” But, warns Dr. Caldwell, “thepotential con of some electric brushesis that the child could actually dam-age teeth or tissue, if she presses toohard or long in one area.”

What about those electric brushesthat play music? “Part of the trainingthat goes with the musical brush isthat the child will learn how long ittakes to brush her teeth properly. Ifthat is learned, it’s a very inexpensivebut valuable lesson,” says Dr. Caldwell.Dr. Worth agrees, adding: “Anythingthat encourages good oral hygiene is agreat idea. Electric toothbrushes offerinitial greater uptake and usage, but,as with most items, there’s an initialpeak use and then familiarity willoften lessen interest, in the long run.”Over time, he says, “either brush typeis effective.”

Look for a toothbrush with a child-sized head and handle, and one withsoft, round bristles. As the childgrows, so, too, must the size of thebrush. When in doubt, smaller is usu-ally better. Overall, “just getting anytoothbrush, be it manual or electric,in the child’s mouth is helpful,”stresses Dr. Caldwell.

Regardless of whether a manual oran electric brush is used, childrenshould brush (with supervision) orhave their teeth brushed twice daily.And remember, stresses Dr. Smith, “alltoothbrushes need to be changed atleast every three to four months andimmediately after any sickness.”

How much?

A small rice-sized portion of toothpasteon the left — and a portion the size of

a small green pea on the right.

Source: Canadian Dental Association website:www.cda-adc.ca

7654321


Flossing 101Flossing should beginas soon as your child’steeth are touching.“These are areas whereplaque will accumu-late, and the bristles ofthe brush cannot reach; hence, com-mon areas for decay,” says Dr. Smith.Dr. Worth concurs: “Once a child’steeth start to fit closely together, usu-ally between the ages of two and six,parents should get their children inthe habit of flossing daily.”

But, because flossing requires moremanual dexterity than using a tooth-brush, younger children will need tohave their teeth flossed by a parent,states Dr. Caldwell. “You can teachchildren with good hand dexterityhow to floss using regular floss atvarying ages; for others, you can teachthem how to use aids, like floss picksand floss wands.” But are all flossescreated equal? The flavour doesn’tmatter; although, flavoured floss mayincrease the taste appeal. What doesmatter, says Dr. Caldwell, is what ma-terial the floss is made from. “Someflosses are a plain, twisted fibre thatcan shred in tight contacts; others arewaxed to help prevent shredding.And others are made from a morehigh-tech material that slides throughtight contacts, with no shredding andfew breakages.” Ultimately, “flossingis a valuable preventative dentalmeasure,” stresses Dr. Worth. “Justfloss the teeth you wish to keep!”

Mouth rinses andmouthwashes:What’s the difference?

As with toothbrushes andflosses, a wide variety of

mouthwashes and rinsesflood the oral hygieneshelves. But are they nec-essary? “Children, typi-cally, do not need to usea mouth rinse, unless thechild, through a caries

It’s no secret that getting kids to brushand floss regularly can be a struggle.Here are your best bets for getting yourchild into a daily dental hygiene routine:

1 Provide a good example for your child byhaving him see you brush and floss yourteeth twice a day.

2 Have your child brush earlier in theevening, when snacks are finished, in-stead of right before bed. Children aremore awake and tend to do a better job.

3 Instead of using a timer, have your childchoose her favourite song, then brush toget rid of the “sugar bugs” until the songis over.

4 Let your child pick out the toothbrush,toothpaste and dental floss, as long as allthree are age-appropriate.

5 Create a rewards chart. For example, aftertwo full weeks of regular brushing andflossing, decide on a treat (not food-related)such as an afternoon at the zoo, stayingup a little later on theweekend or watch-ing a new orfavourite movietogether.

[decay] risk assessment by hisor her dentist, is determined

to be of moderate to high riskof dental caries,” advises Dr. Smith.And “what we are talking about

here are fluoridated mouthrinses that do not contain al-

cohol and are used daily or weeklythat are very effective at reducing theincidence of dental decay, when usedcorrectly,” he adds. If the dentist de-cides that a fluoride rinse is a neces-sary part of your child’s oral hygieneregimen, your child must be able torinse for a period of time, then spitthe rinse out. “This is typically some-where around the age of six,” saysDr. Smith.

What about mouthwashes or rinsesthat contain alcohol for kids? Drs.Worth, Smith and Caldwell all agreethey’re an absolute no-no for children.

When it comes to home care, “thegoal is to limit materials used only tothose that are specific to the needs ofthe child,” says Dr. Ian McConnachie,a pediatric dentist in Ottawa andODA Past President. “This becomesmore relevant these days, as there aremore toothpastes and mouth rinseswith additional additives for differenttherapeutic purposes. This under-scores the need for open communica-tion between dentist and patient.”

And regardless of which brush,floss, toothpaste or rinse is used,“every child should visit a dentist byage one year or when the first teethappear,” says Dr. Smith. “Dental cariesis a disease that is, by and large, pre-ventable with regular home care,proper nutrition and regular visits tothe dentist.”

ToothpasteAre all toothpastes createdequal? Look for the Cana-dian Dental Association’sSeal of Recognition whenselecting a toothpaste,advises Dr. Smith. �

The best rewards, however, aren’t foundon a chart: fewer cavities, healthy teeth

and gums, and a beautiful smile!

Top 5 Tips

For Getting Your Child toBrush and Floss Every Day


My 12-year-old has never hada cavity. I’d like to take credit for thatby saying she brushes and flosses reg-ularly and never consumes sugaryjuices or candy. But the truth is herbrushing sometimes consists of aquick swipe and spit, and her favouritebeverage is mango juice. Still, for themost part, we’ve tried to do all theright things to ensure a clean bill ofhealth from our dentist. Here’s what

the experts say is impor-tant to know about

dental decay fromthe moment those

little teeth start mak-ing an appearance.

Questions and (sometimes surprising)answers

By Cheryl Embrett

Q:A: Tooth decay starts when the nor-mal bacteria (germs) in your mouthcombine with food and saliva to forma sticky substance called plaque thatattaches to the teeth. According tothe Canadian Dental Association,when your child consumes sugaryfood or drinks, the bacteria in thedental plaque mix with the sugars tomake a mild acid. This acid attacksthe hard outer layer of the tooth,called the enamel. If the dentalplaque is not removed every day bybrushing and flossing, over time, theenamel gets soft and a cavity forms.

Q:A: “Sucrose is the No. 1 bad guy,”says Dr. Ian McConnachie, a pediatricdentist in Ottawa, and an ODA PastPresident. Sucrose is the technicalname for table sugar, cane sugar orwhite sugar and is found in numerousprocessed foods. Limiting how muchand how often your child consumesfoods and beverages that containsugar will help prevent cavities. Sugarin fruit, says Dr. McConnachie, is notas destructive to our teeth, except if itis found in dried fruit or fruit prod-ucts, which may linger or “stick” tothe teeth. Fruit in general is consid-ered to be very tooth-friendly.

Cavities and KidsExpert Advice About

What exactly is toothdecay, anyway?

How does sugaraffect teeth?


Q:A:

Q:

A: They may be nutritious, says Dr.McConnachie, but they’re not greatfoods for growing teeth since they arehigh in sugar and stick to the teeth fora long time. If you give them to yourchild as a treat, make sure he brusheswell afterward. Even better, choosetooth-friendly snacks like cheesecubes and raw fruits and veggies themajority of the time.

Q:A: Any colour change on any teeth.Also, any tooth that is sensitive tohot, cold, sweetness or pressure. Ifyour child is experiencing any ofthese symptoms, talk to your dentist.

Q:

A: “If baby teeth aren’t cared forcarefully, they can decay, cause painand infection, and that can affect thespacing of permanent teeth,” says Dr.McConnachie.

Q:

A: Nowadays, dentists put more em-phasis on assessing the various riskfactors in a child’s mouth that putshim or her at a low, moderate or highrisk for decay, says Dr. McConnachie.“And then we want to alter those riskfactors through dietary changes, orhygiene adjustments or possiblyadding in fluoride.” The goal is tostop the process before the cavity isformed.

1 For more information about preventing cavities, visit the ADA’s website: www.mouthhealthy.org

Q:A: Chew gum. We’re not kidding.For the high-risk patient, gum thatcontains xylitol may actually lowerthe bacteria that causes decay andmay reverse early cavities, says Dr.McConnachie. The American DentalAssociation (ADA) agrees; it has stud-ies that show chewing sugarless gumfor 20 minutes promotes the flow ofsaliva, which helps wash away foodand other debris.1 But, cautions theADA, it’s obviously not a substitutefor brushing and flossing.

And, finally, don’t share utensilswith your child or lick off a dirty paci-fier and put it back in her mouth (yes,some parents do this). The bacteriathat starts cavities can be passed fromparent or caregiver to child (moreoften from the mother, says Dr.McConnachie) and may cause toothdecay. �

What contributes tocausing cavities?

• Too little fluoride. Thisnatural compound makesteeth more resistant to decayand can prevent or even re-verse tooth decay that hasstarted. It’s added to the watersupply in many communities,as well as to toothpastes. Anddentists sometimes apply it toteeth as part of a child’s nor-mal checkup.

“Some children who comefrom non-fluoridated areascertainly have more decaythan those from fluoridatedareas,” says Dr. Rick Caldwell,a dentist with a busy practicein New Liskeard, Ont., andPresident-Elect of the ODA.

• Medications. There aremany medications that canalter or reduce the saliva inyour child’s mouth and putshim or her at a much higherrisk of developing tooth decay,says Dr. McConnachie.

• Poor oral hygiene. Brush,floss and see that your childvisits your dentist regularly forexams and professional clean-ings. “Kids who have good,healthy diets, brush their teethwell a few times a day andfloss regularly wouldn’t be ex-pected to have a huge decayissue,” says Dr. Caldwell.

• Bedtime bottles and sippycups. Don’t let your child fallasleep with a bottle or sippycup filled with juice or milk.Those sugary liquids (yes, evenmilk contains some sugar) canpool in her mouth and causebaby bottle tooth decay. Ifyour baby is thirsty, it’s a goodidea to only offer water afterthe evening toothbrushing,advises Dr. McConnachie.

Is it OK to give my childhealthy snacks such asgranola bars and raisins?

What are the warningsigns of tooth decay?

Why all the fuss abouttaking care of baby teethwhen they’re just goingto fall out?

Is there anything new inthe treatment of dentaldecay?

Any other tips forpreventing cavities?

Visit youroralhealth.ca

for brushing andflossing tips.


Chow down on somethingsweet and the sugar provides food foryour mouth’s bacteria which thenproduce acids to attack your teeth. Nowonder dentists want us to reduce thesugar in our diets!

Perhaps you have cut back oncandy and pop but there are lots ofother sources of sugar. Manyprocessed foods contain it (see“Sneaky Sugar”) and in its 2004 Cana-dian Community Health Survey, Statis-tics Canada estimated that theaverage Canadian ingests about 30pounds of sugar each year from man-ufactured products. A recent article inThe Globe and Mail1 quoted StatisticsCanada as stating that Canadian chil-dren, ranging in age from one to 13,get more than 25 percent of theirdaily calories from sugar — more thanany other age group.

It’s in cereal, milk shakes,pasta sauce and even potatochips: sugar’s everywhere,and it’s bad for your teeth!

By Julia Aitken

Cutting down on processed foodshelps, but there are other natural-sounding sources of sugar that maysurprise you. Dr. Deborah Saunders, adentist practising in Sudbury, Ont.,suggests limiting our intake of driedfruit as it is concentrated and reten-tive in nature. The “stickiness” ofsome foods plays a key role, she ex-plains. Anything that is high in car-bohydrates can be broken down byplaque bacteria. The byproduct ofthat bacteria is acid, which deminer-alizes your teeth, leading to tooth sen-sitivity and cavities. “Would you eattwo cups of fresh grapes?” she asks.“Probably not, but that’s equivalentin sugar to eating less than one-quartercup of raisins.”

But, does avoiding sweet thingsmean fresh fruit is off-limits? Ab-solutely not, says ODA President-ElectDr. Rick Caldwell, a general-practicedentist in New Liskeard, Ont. “Thekey to snacking on naturally sweetfoods, such as fruit, is to eat it over ashort period of time to reduce theamount of time your teeth are ex-posed to acid,” he explains.

For advice on a balanced diet, reachfor the Canada Food Guide, saysDr. Arthur Worth, President of theOntario Dental Association and a gen-eral practitioner in Thamesville, Ont.“You do need fruit in your diet,” hesays, “but don’t eat it in excess. Tan-gerines are fine but having five or sixin one day might harm your teeth.”

1 The Globe and Mail – “Junk is the new normal.” March 25, 2013


If you can’t resist a sugary treat, Dr. Ian McConnachie, apediatric dentist in Ottawa, has some advice. “Eat it with ameal rather than on its own, because the higher saliva flowthat occurs during a meal will neutralize the acids that de-velop when you have sugar.”

Always brush after eating any snack or rinse your mouthwith water. In a pinch, says Dr. McConnachie, chew onsugarless gum, such as one sweetened with xylitol, a natu-ral sugar substitute which may help to remineralize toothenamel. Sweet!

Do the (Scary) Math!Dr. Don Dempsey, President of the New Brunswick DentalSociety, who has a general dental practice in Bathurst, N.B.,suggests this easy way to figure out how much sugar a prod-uct contains:

One teaspoonful of granulated sugar weighs four grams.If a product’s label tells you that an item contains, say, 20grams of sugar per portion, divide the number of grams byfour to find out the number of teaspoonfuls. In this case, itwould be five teaspoonfuls of sugar per portion!

It’s surprising how many prepared products in yoursupermarket might contain sugar. Here are just a few:

• baked beans• barbecue sauce• bread• breakfast cereal• cookies• crackers• dried fruit• frozen dinners• fruit juice• fruit spreads• fruit yogurt• granola and other multigrain cereals• granola bars• iced tea• instant oatmeal• ketchup• muffins and muffin mixes• pasta sauce• peanut butter• potato chips• protein drinks• some reduced-fat products(see “The Low-Fat Trap”)

• salad dressings• sports drinks

Berry Muffin 340 calories 11 g fat 25 g sugar (6.25 tsp)

Low-Fat 290 calories 2.5 g fat 30 g sugar (7.5 tsp)Berry Muffin

Honey Dip 210 calories 8 g fat 11 g sugar (2.75 tsp)Donut

What’s in a Name?

• barley malt• cane juice• corn syrup• dextrose

For the best dental health, buy products with the leastamount of sugar (it will be included toward the end of theingredient list). When checking labels, you might not alwayssee the word “sugar,” but these are all a form of it:

• fructose• glucose• sucrose

• honey• maltodextrin• maple syrup• molasses

The Low-Fat TrapThe fat in food makes it taste good so some manufacturersadd flavour to low-fat products by bumping up the sugar.Choosing a low-fat muffin over a donut at our favouritecoffee shop is a given for most of us. But take a look at thenutritional information for the following: (The low-fatmuffin is probably still a good choice, butwho would have thought it containedthat much sugar?)

Sneaky Sugar


Does your bed partnercomplain about your snoring? Areyou unusually sleepy during the dayand don’t know why? These are twoof the most common symptoms ofobstructive sleep apnea (OSA), a sleep-related breathing disorder that cancause you to stop breathing dozens oreven hundreds of times each night.1

According to The Canadian LungAssociation, these breathing episodesusually last for 10 to 30 seconds —

Obstructive Sleep Apnea

You’ve seen those commercials on TV andthe Internet — What is sleep apnea and whyare so many losing sleep over it?

By Cheryl Embrett

not long enough to fully wake you upbut enough to prevent you from en-joying the restful sleep your bodyneeds to recharge its batteries and stayhealthy.

A Canadian Community HealthSurvey conducted in 2009 by the Pub-lic Health Agency of Canada foundthat an estimated 858,900 Canadianadults, 18 years and older, reportedbeing told by a health professionalthat they have sleep apnea.2


1 The Canadian Lung Association: www.lung.ca.

2 2009 Canadian Community Health Survey – “Sleep Apnea Rapid Response”: Public Health Agency of Canada

3 The Canadian Lung Association: www.lung.ca

4 Goodday, R.H.B. et al. “Obstructive Sleep Apnea Syndrome: Diagnosis and Management” Journal of the Canadian DentalAssociation, 2001.



“Only a physician can diagnoseobstructive sleep apnea,” says Dr.Deborah Saunders, a dentist practis-ing in Sudbury, Ont. Dentists do notdiagnose OSA. However, a dentistmay see patients who they suspectmay be at risk and will refer them totheir family physicians for further di-agnostic followup.

As they do with discussing tobaccointervention or oral cancer with pa-tients, dentists have advantages overother health-care professionals inidentifying patients at risk of OSA,because dentists generally see theirpatients on a more frequent andconsistent basis. As well, because thejaws and related structures may influ-ence OSA, dentists play an importantrole in identifying patients whoshould be assessed [by a physician]and helping to institute treatment inselected cases.4

Treatment optionsThe most effective treatment for mildor moderate sleep apnea, says TheCanadian Lung Association, is con-tinuous positive airway pressure(CPAP). With CPAP you wear a specialmask attached to a CPAP machine. Asteady stream of air is blown thoughthe mask, into your nose and downyour throat. The pressure helps keepyour airways open so you can breatheproperly all night. Other treatmentsfor mild sleep apnea include lifestyle

changes such as losing weight, avoid-ing alcohol and sedatives and sleep-ing on your side, not your back.5

Your doctor may also recommendthat you use a dental (or an oral ap-pliance) that fits over your teeth andprevents your tongue and jaw fromblocking your airway. In comparisonto CPAP devices, these appliances aresometimes regarded as a convenient,silent and more bed partner-friendlychoice, says Dr. Alan Lowe, Professorand Chair of the Division ofOrthodontics, University of BritishColumbia’s Faculty of Dentistry.There are more than 80 different oralappliances currently available.6 Theseshould only be prescribed by yourfamily physician, who may referyou directly to your dentist, saysDr. Saunders.

A cautionary note from Dr.Saunders: some patients who havebeen diagnosed with sleep apnea maybe curious about ordering prefabri-cated devices over the Internet.“Think twice,” she says. “You mayend up with jaw pain or other prob-lems. That could be significant andserious.”

For more information on sleepapnea — including a quiz to helpidentify the main symptom of sleepapnea, daytime sleepiness — visit TheCanadian Lung Association’s websiteat www.lung.ca. �

Do you think you havesleep apnea?

Other signs and symptoms of sleepapnea may include:

• high blood pressure

• irritability

• gasping or choking duringsleep

• depression

• problems concentrating

• morning headaches

• memory problems/memoryloss3

If you have any of these symptomsand think you may have sleep apnea,you might want to discuss them withyour family doctor.


You know it’s important toupdate your doctor on your healthand medication status, but whatabout your dentist? Good communi-cation with your dentist about youroverall health is vital, says Dr. LynnTomkins, a clinical instructor inthe Department of Oral Diagnosisand Medicine at the University ofToronto’s Faculty of Dentistry and aPast President of the ODA. “Whathappens in your mouth affects yourbody, and what happens in your bodyaffects your mouth.”

Your medical history tells the storyof your health, adds Dr. Arthur Worth,President of the ODA and a dentist

Why you need to tellyour dentist aboutyour medications

By Cheryl Embrett

with a general practice in Thamesville,Ont. It gives your dentist with im-portant information needed to pro-vide the best care possible.

With so many different medicationsavailable, both over-the-counter andprescription, making sure your dentistis aware of everything you are takingensures that any possible negative in-teractions can be avoided and appro-priate precautions may be taken beforebeginning routine dental procedures.

Your dentist may also wish to com-municate with your family physicianto co-ordinate your oral health carewith your medical condition, advisesDr. Worth.

If you’ve had a hip or knee replace-ment or have a heart murmur, forexample, you may need antibioticsbefore any dental work in order to re-duce the risk of infection. You want tobe sure that the antibiotics your den-tist prescribes won’t interfere with anymedications you’re already taking.Your dentist is also in a good positionto notice any changes in your mouththat may signal potential health prob-lems. Bleeding gums, for example,may indicate the beginning of gumdisease, which could also be related todiabetes if your gums have otherwisebeen healthy. Or they may indicatethe use of blood thinner medications(see “Blood Thinner Alert!”)

Drugs and Your Dentist


Make sure you update and review your medical history every time you seeyour dentist, advises Dr. Worth. Here’s a checklist of what your dentist willneed to know to provide you with the best possible care.

� All medications that you take, both prescriptionand over-the-counter.

� Vitamins.

� Naturopathic or herbal supplements.

� Anymedical conditions being treated by your physician. For example,chronic diseases such as diabetes, thyroid problems, heart conditions,autoimmune diseases and respiratory conditions such as asthma.

� Antidepressants – they may cause xerostomia or dry mouth, whichcan have significant effects on the teeth and gums. (See page 5,“Somebody Bring Me Some Water”, for more information aboutxerostomia.)

� Any surgeries you’ve had, especially those involving the heart or joints(artificial knee or hip replacement, for example) or head and neckareas. Antibiotics may be required to prevent infection associated withcertain dental procedures.

� Your family history – for example, if you have or had cardiovasculardisease, cancer and diabetes, and any dental history of periodontaldisease.

� Whether you smoke or consume alcohol frequently. If so, you maybe at greater risk for certain types of oral cancer.

� If you’re pregnant. Your dentist may suggest that you postpone certaintreatments for the duration of your pregnancy.

Also, don’t forget about allergies to specific drugs, cautions Dr. Worth.Your dentist and dental team wear latex gloves, so an allergy to latex isdefinitely the first thing you should tell your dentist.

During your first visit, your dentistwill ask for a thorough medical his-tory, including lifestyle information(whether or not you smoke, for ex-ample). This history, along with theresults of your initial examination,will help your dentist determine thebest treatment approach. Mentioneverything about your health, advisesDr. Worth, even if you don’t think it’simportant.

Don’t forget about those medica-tions only taken occasionally as well,adds Dr. Tomkins. For example, youmay use a puffer only at certain timesof the year when your asthma flaresup, but you need to tell your dentistabout that as well. �

Blood Thinner Alert!

If you are on blood thinner medications,it is important that your dentist bemade aware of the type anddosage you are taking, saysDr. Worth. These medications act toreduce the body’s natural clottingmechanisms. Since it is not uncommonfor minor amounts of bleeding to occurduring even simple dental procedures,such as tooth cleaning and scaling, it isvery important to let your dentist knowat least several days PRIOR to anytreatment that you are taking bloodthinner medications. Your dentist maywish to consult with your family doctorabout the advisability of discontinuingthis particular medication for a day orso prior to your dental appointment.

Tell Your Dentist About...


What activities will you do this summer?Remember your mouthguard when playing sports!colour it in !

Draw a pictureof whatyou’ll be doingthis summer!

�


Pam: “Why did the tree go to the dentist?”Dan: “I don’t know. Why?”

Pam: “To get a ROOT canal!”

No two people have thesame set of teeth — your teeth are

as unique as your fingerprints !

Did you know?

ToothFun FactSharks neverrun out of teeth!If one is lost, anotherspins forward fromthe rows and rowsof backup teeth.

Visit youroralhealth.caClick on Kids’ Zone

for more games and puzzles!

Q: What’s soft and furry andshaped like a tooth?

A: A molar bear!

elmis__________________

romla ________________

gouten ________________

rebcas ________________

hurbs ________________

ehtet ________________

Unscramble the lettersto find the word!

ANSWERS:smile;molar;tongue;braces;brush;teeth


1 2

3

4 5

6

7

8

9

CrosswordPuzzle

© 2013


Across1. These help straighten teeth. (6)4. Use this to help clean your teeth. (10)7. This type of tooth is in the back of your mouth. (5)8. This person helps keeps your smile healthy. (7)9. You should have one every six months. (7)

Down2. Too much of this sweet stuff isn’t good for your teeth. (5)3. You open this up to show the dentist your teeth. (5)4. After brushing your teeth, give this a brush too! (6)5. After you brush your teeth, use water to do this. (5)6. This cleans between your teeth, where brushing can’t get. (6)8. If you don’t look after your teeth, they will start to do this. (5)

Answers:

Across:1.braces4.toothbrush 7. molar 8. dentist 9. checkupDown:2.sugar 3. mouth 4. tongue 5. rinse 6. floss8.decay


LMRAO

VCITYA

LEMSI

SFOSL

SBUHR

TTSIDNE

PKCUHEC

EHETT

14 16 8

15 7

9 13

6

2 17

5 12

3 10

111 4

Visiting the dentist helps you

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Word ScrambleUnscramble each of the words on the left side of this page, then copy the letters from the

numbered boxes to the boxes below to find the hidden phrase!

© 2013


NOT EVERYBODYCAN SEE IT, BUT

YOUR DENTIST CAN.BOOK AN EXAM TODAY.

PROVIDED BY THE ONTARIO DENTAL ASSOCIATION

Documents

SPRING|SUMMER Cavities and kids - ODA · wash away food debris and this helps to control plaque as well.” “Your dentist can help you come up with a plan to treat both the symptoms