Dental Sealants Prevent Cavities and More Kids Need Them, CDC Says

There's a quick and easy way to prevent 80 percent of cavities, but most kids don't get it, federal health officials said Tuesday. The treatment, dental sealants, works well, but only 60 percent of kids who need sealants get them, the Centers for Disease Control and Prevention says.

                       

    

Dentist inspecting boys mouth before treatment. Universal Images Group / UIG via Getty Images

One good solution: doing it at school. But states often lack the funding to pay for such programs, and often bureaucratic requirements about having dentists on site can hold them up, also, the CDC said.

"Many children with untreated cavities will have difficulty eating, speaking, and learning," said CDC director Dr. Tom Frieden.

"Dental sealants can be an effective and inexpensive way to prevent cavities, yet only one in three low-income children currently receive them. School-based sealant programs are an effective way to get sealants to children."
The CDC says that 20 percent of kids and teenagers have untreated dental decay by the time they are 19. Kids with constant toothaches cannot eat properly and have trouble paying attention at school.

Related: Do Kids Need Dental Sealants?

Even though they are endorsed by the CDC and the American Dental Association, only 43 percent of 6- to 11-year-old children have a dental sealant, federal surveys show.

"Low-income children were 20 percent less likely to have sealants than higher-income children," the CDC's Susan Griffin and colleagues wrote in a report released Tuesday.                    

"School-age children without sealants have almost three times more cavities than children with sealants," the CDC added.

"Applying sealants in school-based programs to the nearly 7 million low-income children who don't have them could save up to $300 million in dental treatment costs."

That's because a filling costs more. In addition, once a tooth has been drilled to put in a filling, it's never as stable again.
But many states struggle to pay for such programs, the CDC team found.

"Federal funding of state oral health programs is largely com­petitive and varies widely by state," they wrote. "Many state and local school-based sealant programs cover part of their expenses by Medicaid billing."

And Medicaid, the joint state-federal health insurance plan for children and low-income people, is already badly stretched in most states.
One big expense is paying a dentist to oversee the program, the CDC found. One solution: Allow lower-paid professionals to administer sealant programs. At least one state has already done so.

"For example, in South Carolina, school-based sealant programs managed and staffed by dental hygienists deliver sealants in approximately 40 percent of high-need schools," Griffin and colleagues wrote.

"CDC currently provides funding to 21 state public health departments to coordinate and implement school-based and school-linked sealant programs that target low-income children and those who live in rural settings," the agency added.

It said the federal government plans to do more. It will classify pediatric dental services as an essential health benefit to be covered by dental insurance as part of the Affordable Care Act, for instance, and match state Medicaid and CHIP costs for sealants.
The sealants are plastic-based coatings that get into the cracks and crannies of molar teeth, stopping food and bacteria from starting the chemical reaction that leads to cavities.
 Studies show they are safe and stop tooth decay, even when they are layered over an existing pre-cavity.

"Studies on sealant effectiveness indicate that sealants delivered in clinical or school settings prevent about 81 percent of decay at two years after placement, 50 percent at four years, and can continue to be effective for up to nine years through adolescence," the CDC said.

"Sealants delivered in clinical or school settings prevent about 81 percent of decay at two years after placement."

 The American Dental Association (ADA) agrees, and says many people don't know that dental insurance often pays for them.

"Dental sealants are one-third the cost of a filling, so their use can save patients, families, and states money," the Pew Charitable Trusts, an independent, public service-oriented nonprofit, says in a statement. "Sealant programs based in schools are an optimal way to reach children — especially low-income children who have trouble accessing dental care."
 One worry that parents may have is about BPA, a chemical found in the sealants that is increasingly linked with health risks. The ADA says the benefits of sealants far outweigh any perceived risk.

"The potential amount of BPA patients could be exposed to when receiving sealants is minuscule, and it's less than the amount a person receives from breathing air or handling a receipt," the ADA says.

By: Maggie Fox, NBC News
http://www.nbcnews.com/health/kids-health/dental-sealants-prevent-cavities-more-kids-need-them-cdc-says-n668266

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

12 Things Your Dentist Knows About You Just By Looking In Your Mouth

While cavities and plaque build-up may be what's on your mind before a teeth cleaning, your dentist is looking for a whole lot more. "The mouth is the window to the body," says David Silverstrom, DDS, of The Silverstone Group in Livingston, NJ. "Often, diseases like cancer, anemia and diabetes will first be identified by the dentist in a regular examination, and this saves lives." And it's not just diseases- dentist can discover everything from your bad habits to your favorite beverages simply by asking you to say, "Ahh!"


1. You flossed right before your appointment—and that's the only time.
Sorry, but you can't fool your dentist into thinking you floss daily by doing so the night before or morning of your visit. "The gums of people who only floss right before a visit are bleeding or look damaged," says Timothy Stirneman, DDS, of All Smiles Dental in Algonquin, IL, "whereas, healthy gums are nice and tight and pink," he says. Kenneth Wong, DDS, of Santa Monica adds, "When patients floss right before coming for a cleaning, I can see the slices where the floss cut at the gum because they were overzealous."
2. You're pregnant.
"Nearly 40% of women will develop gingivitis during their pregnancy," says Glen Stephenson, DMD, of Prevention Dental in Boise, ID. "This is caused by increased progesterone, which facilitates the growth of bacteria, causing gingivitis. Some women will develop a deep red lump on their gums called a pregnancy tumor or pyogenic granuloma." (This type of tumor is completely benign and will go away after the pregnancy is over.) Stirneman adds that most women are typically pretty far along before their gums start bleeding, so it's not as though a dentist will magically "discover" that a patient is pregnant.

3. You bite your nails.
Without looking at your hands, a dentist may be able to detect this habit. "Signs include chips and cracking of the teeth, plus wear and tear on the teeth from the constant stress on them," says Keith Arbeitman, DDS, of Arbeitman & Shein in New York City. "This can cause your teeth to become uneven and lead to jaw pain and discomfort." Kyle Stanley, DDS, of Helm, Nejad, Stanley in Beverly Hills adds, "Patients that bite their nails using their front teeth usually have leveled off, flat front teeth. The nails themselves are not what cause the damage, but rather the contact that occurs between the top and bottom teeth," he says.
4. You used to suck your thumb.
"Most children that suck their thumbs or a finger have no long-term effects from the habit," says Stephenson. "However, those who did so past the age of seven or eight may show significant changes to their bite or the position of their teeth. Much of that can be corrected through orthodontic treatment, but some telltale signs can remain." Alice Lee, DDS, of Montefiore Medical Center in Bronx, NY, adds, "We can sometimes see protruding front teeth, and this can impact how kids' jaws are coming together and growing and can also impact their speech."
5. Your bad breath may mean something.
"General bad breath can be categorized as halitosis," says Arbeitman. But dentists are also trained to identify "fruity" smells and "fishy" smells, which can mean numerous things. " 'Fruity' breath could indicate uncontrolled diabetes or a dietary fast that has gone too far, while 'fishy' breath could be a sign of kidney or liver failure," he explains. If the smell is "very foul," says Arbeitman, it could be anything from gastroesophageal reflux (GERD) to an underlying lung abscess and bronchitis to a tonsil stone. Timothy Chase, DMD, of SmilesNY in New York City, adds, "The first thing the dentist should do is rule out the odor coming from the teeth and gums. After that, he should recommend that the patient see an ENT to rule out sinus issues, and a GI doc to rule out reflux issues."
6. You may have an eating disorder.
"Many patients are surprised that their dentist is the first one to ask about eating disorders," says Chase, "but bulimia exhibits a very distinct pattern of tooth wear that your dentist can easily identify." Stephenson notes that, "This erosion happens almost exclusively on the tongue-side of the front teeth and can contribute to increased cavities." But Silverstrom is quick to point out that acid erosion on the back of a patient's teeth does not always indicate an eating disorder. He says other possibilities include acid reflux and the use of antidepressants or mood-elevating drugs, both of which reduce the amount of saliva in the mouth, thereby upping the odds of acid damage.
7. You have a sinus infection.
"Often patients will call saying that they need a root canal," explains Ira Handschuh, DDS, of The Dental Design Center in NY, "when in fact it's actually a sinus infection and not a tooth problem at all." The reason, he explains, is because the roots of the top teeth are positioned in the same area as the floor of the sinuses. And both sinus infections and toothaches can show symptoms of pressure. "A simple home test is to have a patient bend over to touch their toes. If the pressure or pain increases just by doing this, the pain is most likely not tooth-related and he should see his ENT or primary care physician before coming to the dentist," he advises.

8. You have a vitamin deficiency. "A deficiency of vitamins and minerals can cause many oral conditions, like burning tongue syndrome, tissue sloughing off, increased infections, delayed healing, bone infections, and easy-to-bleed gums," explains John P. Dougherty, DDS, MAGD, of Artistic Dental at the Biltmore in Phoenix, AZ. Stephenson adds, "Surprisingly, iron deficiencies show up in many ways in your mouth. It can give some patients severe sores in the corners of their mouth while others have changes in their tongues. Some may experience a painful burning sensation, or all the small papillae fall off their tongue leaving it glossy and smooth. Getting more iron will solve these problems.
9. You have diabetes. "Many times, imbalances in sugar will show a rapid change in the health of your gums, including increased swelling, bleeding, and sensitivity," says Handschuh. "In conjunction, the consistency of saliva may change, and there may be increased decay. These may all be signs of sugar levels that are out of control, so dentists can alert patients to see their doctor to check for diabetes."

10. You have a drinking problem. "Alcoholic patients are cavity-prone because alcohol tends to dry the mouth out," says David Tarica, DMD, of 34th Street Dental in New York City. "A dry mouth will lead to cavities, because saliva neutralizes the damage-causing acid in our mouths. In addition, alcoholics have 'chipmunk red cheeks,' and the smell alone is usually a giveaway."
11. You have oral cancer. "The first signs of oral cancer can be seen from the following: unexplained bleeding in the mouth, white, red, or speckled patches in the mouth, a change in the way your teeth fit together, swellings, thickenings, lumps or bumps or eroded areas on the lips, gums, or other areas inside the mouth," explains Michael Apa, DDS, of Rosenthal Apa Group in New York City. "An oral surgeon should be consulted for a biopsy of any suspicious tissue."
12. You love Gatorade. You may know why you chipped your tooth, but Hugh Flax, DDS, of Flax Dental in Atlanta says that even though the cause may be apparent, "there could be underlying factors that weakened the tooth and made it susceptible to being chipped in the first place." He explains that teeth can be softened by sodas and other sugary beverages over time, which may make a tooth more susceptible to chipping. Energy drinks, which tend to be even more acidic than soft drinks, may cause even more damage to tooth enamel, he says.


By: Elizabeth Jenkins, Prevention
http://www.prevention.com/health/what-your-dentist-knows-about-your-health

 

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Sensitive Teeth

Teeth can become sensitive for many reasons. Sometimes, the sensitivity is an indication of a potentially serious problem. Other times, the dentally related problem may be small but the effects (the sensitivity) are extremely aggravating. 

What do we mean when we say "sensitive teeth?"
Twinges of pain or discomfort in our teeth in certain situations such as drinking or eating cold things, drinking or eating hot things, eating sweets, and touching the teeth with other teeth or the tongue. Your symptoms will involve reactions to temperature or pressure. Sensitivity to cold drinks or foods is the most common symptom. 

Two types of sensitivity:

1. Dentinal sensitivity
When the dentin (middle layer) of a tooth is exposed. Normally, dentin is covered by enamel. Dentin becomes exposed when the outer protective layers of enamel wear away. Dentin contains tiny openings called tubules. Inside each tubule lies a nerve branch that comes from the tooth's pulp (the nerve center of the tooth). When the dentin is exposed, cold or hot temperature or pressure can affect these nerve branches, causing sensitivity.

Causes:

• Inadvertent notching of the tooth surface and/or recession of the gum tissue (exposing the root surface of the tooth) caused by improper brushing: either brushing too hard, brushing with a toothbrush that is too hard, or using an improper brushing technique, which will wear away the enamel layer. This sensitivity can range from mild to extreme; the degree of sensitivity does not appear to be related to the size of the root exposure or notch.
• Poor oral hygiene, allowing tartar to build up at the gum line
• Untreated cavities
• An old filling with a crack or leak
• Receding gums that expose the tooth's roots, often caused by periodontal disease
• Gum surgery that exposes the tooth's roots
• Tooth whitening in people who have tooth roots that already are exposed
• Frequently eating acidic foods or drinking acidic liquids 
• Purposeful repositioning of the gum tissue during gum surgery can also lead to tooth sensitivity. While recession from brushing is slow, gum recession following gum repositioning occurs very quickly. The portion of the tooth once covered with gum and bone may now be exposed.  Root sensitivity in these instances can be quite severe and immediate. It can sometimes last four months or years if not treated.

2. Pulpal sensitivity
The reaction of the tooth's pulp. The pulp is a mass of blood vessels and nerves in the center of each tooth. Pulpal sensitivity affects only a single tooth.
Causes:

• Decay or infection. When a tooth is decayed, temperature changes and sweets will make it sensitive. The solution can be as simple as removing the decay and placing an appropriate restoration.
• A recent filling. A tooth may be sensitive to cold for several weeks after you get a filling. The metals in amalgam (silver) conduct the cold very well, transmitting it to the pulp. Bonded (tooth-colored) fillings require etching the tooth with acid before the filling is placed. In some cases, this etching removes enough enamel to make the tooth sensitive. If a filling is defective or failing, leakage around the filling may cause the tooth to become sensitive. The solution can be as simple as removing the defective filling and placing an appropriate restoration.
• Excessive pressure from clenching or grinding
• A cracked or broken tooth. If the tooth is fractured, you may be sensitive to temperature changes or when chewing food. This fracture condition may be hard to diagnose. If you think you might have this type of sensitivity, read our blog post on "cracked tooth syndrome."
• A tooth can become sensitive after it has been prepared (drilled) for a restoration (filling). You may have been anesthetized during the procedure, so you did not feel any discomfort when the nerve in the tooth reacted to the heat generated by the drill. The closer the drill comes to the nerve, the more likely it is to cause a sensitivity problem. The high-speed rotation of the bur in the drill generates heat, and the response of the nerve to heat is inflammation. This inflammation is felt by you as a "sensitivity."  If the decay, fracture, or drilling was not too deep, this sensitivity will decrease over time. A week to a month or two is not an unusual length of time for the sensitivity to disappear. A good sign is the continued decrease of sensitivity.  However, if the occlusion (bite) is off after the restoration has been placed, the tooth may either become sensitive or may stay sensitive. Once the bite is adjusted, though, the sensitivity should disappear.
• A dying nerve. This can be the result of a deep cavity. Commonly, the sensitive tooth holds an old large filling. The nerve may be damaged during drilling and the nerve has been dying gradually ever since. If this is the problem, the tooth will need endodontic treatment (root canal treatment).

See this post about the 10 biggest causes of tooth sensitivity.

How will the doctor diagnose sensitivity?
Your dentist will look at your dental history and will examine your mouth. You also will need x-rays to show if there is decay or a problem with the nerve. The dentist will ask about your oral habits. Grinding or clenching your teeth can contribute to sensitivity. Your dentist also will look for decay, deep fillings, and exposed root surfaces. During the consultation, your dentist uses an instrument called a spray gun to dispense air across every area of each tooth in order to locate the sensitivity. He or she may use an explorer - a metal instrument with a sharp point - to test teeth for sensitivity.
 
How will it be treated?

• Your dentist or dental hygienist will clean your teeth. If your teeth are too sensitive to be cleaned, your dentist may use a local anesthetic or nitrous oxide before the cleaning. 
• If there is a notch in the tooth or the shape of the defect is appropriate, the defect is restored (filled in) with a bonded material. This can give immediate relief -- sometimes partially, sometimes fully. 
• When there is no defect to be restored, the exposed and sensitive root surfaces are covered with a dentin-bonding or other material. This material is invisible and has very little thickness, so you do not notice any change in the appearance of the tooth; but it works. It may have to be reapplied after several months because the bonding material has worn away by tooth-brushing.
• If you have pulpal sensitivity and the tooth's nerve is damaged or dying, you will need a root canal. Your dentist will remove the nerve and place a non-reactive substance in the space where the nerve was. The tooth will no longer have a continuous barrier of enamel to protect it. Therefore, it will be restored with either a composite filling or a crown.
• Your dentist may apply a fluoride varnish to protect your teeth. This temporarily reduces sensitivity and strengthens your teeth.
• Using fluoride toothpastes and fluoride mouth rinses are home will help to reduce sensitivity. You can also buy toothpastes just for sensitive teeth. You should choose a fluoride mouth rinse that uses neutral sodium fluoride.

How can I prevent it?

• Brush twice a day and floss daily
•  Use a soft or ultrasoft toothbrush 
• Brush gently up and down, rather than side to side 
• Use a fluoride toothpaste and mouth rinse 
• Use a toothpaste that protects against sensitivity 
• Get treatment for grinding or clenching your teeth (bruxism), like a mouthguard

If you have any questions about tooth sensitivity, please feel free to call our office for a consultation at (512) 250 - 5012.