Nutrition and Dental Health-Can We Make a Difference?
by Harry W Bickel, Jr., D.M.D., MP.H., Region IV TASC, Bowling Green, Kentucky
One day I was performing classroom dental examinations in an elementary school in the middle of a housing project. I examined the children in one classroom and, to my surprise, referred fourteen of them for treatment - twice the number I would normally refer. I asked the teacher if these children were getting a lot of sugar somewhere. She pointed out the window to a large, green, laundry-sized truck, one of several just like it that cruised the neighborhood all day long, every day, peddling candy, ice cream, and other treats to children and their parents.
In our effort to provide dental screenings, examinations, and follow-up treatment for Head Start children, we often overlook one of the most important factors in the promotion of dental health-Diet. Diet and dental health can be summed up easily in one word-Sugar. Other factors are involved, but the one that Head Start programs can have the most impact on is this one.
Almost everything we eat contains sugar. I have read that the average person in this country consumes about 150 pounds of sugar a year. As children, when we behaved, we got candy or cake or ice cream. Most of us carry this into adulthood and, in turn, reward our children the same way. This is a cycle that we may never break, but we can have a significant impact on our children's dental health if we are willing to alter the cycle slightly.
The relationship between tooth decay and sugar is simple. Our teeth are covered with millions of bacteria (also known as plaque), some of which cannot be brushed off. Like all living things, these bacteria must eat to survive. The bacteria that causes tooth decay eats the sugar in our food. When they eat this sugar they produce acid. This acid can slowly dissolve away the surface of a tooth, creating a hole or cavity. Thus we have tooth decay. The more sugar, the more acid. The more acid, the more decay. Without sugar, there is no decay.
Frequency of sugar intake is much more important than total consumption. When we eat sugar, the bacteria on our teeth begin producing acid. Once the source of sugar is gone, however, they stop producing it in a relatively short period of time. They do not begin again until we eat more sugar. Therefore, if we reduce the number of times a day we eat sugar, we reduce the length of time the tooth is exposed to acid.
When a child arises, he/she usually eats breakfast. Since almost all breakfast foods contain sugar, the bacteria on the child's teeth begin producing acid. About thirty minutes after breakfast the acid production stops and does not resume again until lunch. Suppose, however, that thirty minutes after breakfast the child begins sipping on a soft drink. If it takes thirty minutes to finish the soft drink, and thirty more minutes
for the mouth to return to normal, the child's teeth have been bathed in acid for an additional hour. It is now about mid-morning and the child is hungry, so he/she eats a cookie or candy bar. The whole process begins again. By the time the mouth is back to normal, it should be about time for lunch. And the same scenario is repeated in the afternoon. As a result, the child's teeth are being dissolved by acid all day long. When we find children with excessive amounts of decay, this is almost always the case. The most important thing parents can do for their children's teeth is "confine sugar intake to meal times."
In Head Start, when we celebrate a child's birthday with cake or ice cream, serve it with lunch to reduce the amount of time teeth are exposed to acid. Let the children have their cake and ice cream but do so as part of a meal.
None of this, however, will work unless we get these ideas across to our parents. They are the key to our children's futures. Remember, the foundations that we lay in Head Start will follow these children and their families for the rest of their lives.
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