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Does an Apple a Day Keep the Dentist Away?

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Can an apple a day keep the dentist away?  March is National Nutrition Month and today we will discuss the importance of a balanced diet to not only overall health but speifically oral health.  Will will also discuss the importance of March 20th around the world and give you an update on the opioid epidemic in Ohio.  Join us today for Talkin' Teeth.

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A smile says it all. If your teeth could talk, what would they say? Find out today on Talkin' Teeth with Dr. Kyle Bogan.

Hello, and welcome. This is Talkin' Teeth. My name is Kyle Bogan, and today's show is jam-packed with useful information, both for your teeth, and honestly, we're talking about whole-body health today. Do you remember that old saying, that an apple a day keeps the doctor away? Did you know that the same could be said about the dentist? March is National Nutrition Month, so I thought it was the perfect time to talk about the relationship between nutrition and your oral health.

Let's start with the basics. First off, when we are meeting people and talking to people, we really consider our mouth, and our teeth, and even our gum tissue kind of part of our greeting. It's our smile. But it's really so much more than a pretty smile.

We need our teeth for chewing and swallowing, which are the very first steps of the digestive process. The mouth is the initial point of contact for everything that we eat, and what we put in our mouth also impacts our teeth and gums.

So, if your nutrition is poor, actually the first signs of a bad diet or poor nutrition oftentimes will appear in your mouth. This can be shown as staining of the teeth, tooth decay, gingivitis, periodontitis, we can even see chipping and breaking of teeth. So many different things, and many other issues that we can see based on our nutrition, and they all start with our teeth.

As far as our diet goes, and its correlation to our oral health, it seems it's easy to say, but not so easy to put into practice, but the healthier your diet is, the healthier your mouth will be. Simple, right? Not so much. The form of the food, whether it's liquid, it's a solid, sticky, slow to dissolve, crunchy, all of that can make a difference. Obviously, solids and liquids leave the mouth quickly, so things like water, even soda, if you're drinking it fast, kind of comes and goes. Whereas, sticky or slowly dissolving foods tend to hang around longer and cause problems for your teeth and gums.

The amount of time or how often you eat sugary goods and beverages and how often you drink or eat acidic foods and beverages also affects your oral health. For instance, I like to use this analogy a lot with my patients. Everyone is always concerned about drinking things like coffee for staining, like regular soda for all the sugar and everything, and I often say "I would rather have somebody ..." Everyone is concerned about the quantity. How much is too much?

And it's really about the frequency of sugar contacts with your teeth as far as cavities and various things go. And so, I often say, "I would rather see somebody drink three cans of pop and drink them all within a minute's time, than have somebody drink one can of pop who sips it all day long." 'Cause every time that sugary drink touches your teeth, there's a certain period of time where the acidic nature of the drink can degrade your enamel. The sugar is present on your teeth for bacteria to metabolize and turn into a cavity. And so, really, it's about contact time and not amount. And so, if you're drinking sugary beverages, I would recommend that you drink them over a shorter amount of time and not sip them throughout the day, as that will increase your chance for cavities.

Obviously, when we're talking about diet and nutrition, you can kind of break it down generically into the good and the bad. The good is that you can control what you eat, and every day you can make smart and healthy decisions to keep your smile at 100%. There's plenty of delicious foods that are also very, very beneficial to your oral health. And not just in a nutrition sense, but honestly, some of these foods can actually help to cleanse your oral cavity as you eat them.

For instance, things like carrots, celery, apples, things that kind of have that crunchy nature to them, can actually help clean your teeth during the day as you eat them. Plain nuts, yogurt, and cheese, these snacks are high in calcium, which is great for having that mineral in your mouth to help repair tooth enamel. In addition, protein-rich food like meat, poultry, fish, milk, eggs, these are the best sources of phosphorus. Again, all of these minerals can help to protect your enamel. Things such as leafy greens like spinach and kale, they're very high in vitamins and minerals, as well as calcium, and again, all this can help strengthen your teeth and lead to healthy enamel.

Other fruits and vegetables are a great choice for a healthy smile since they're high in water and fiber. They balance out the sugars they contain to help clean the teeth.

These foods are also great in helping to stimulate saliva production. It's funny, we don't really think of saliva as we go at our day-to-day business, but saliva actually contains enzymes and various components that actually help fight bacteria. They keep our oral cavity washed and clean. They rinse our teeth when we're done eating. So anything we can do to help stimulate saliva production while we're eating is a great thing. Saliva can, actually, also, help to neutralize the pH in our mouth, and so when we eat acidic foods and beverages that can cause the mineral to leach out of our enamel, our saliva actually helps to balance that pH back to a kind of a more neutral situation.

A lot of these fruits and vegetables also contain Vitamin C and Vitamin A, and a lot of these are very important for oral health.

We talked about kind of the good foods and their kind of role, now let's talk about some of not-so-good choices. There are, obviously, some empty calorie foods out there. Candy is a big one. Hard, sticky candies like lollipops, mints, taffy, and caramel. Sweets like cookies, cakes, muffins, and snack foods like chips are all a cause for dental concern. Because not only do they not have any nutritional value, necessarily, but the amount and type of sugar that they contain can adhere to the teeth.

Now, obviously, I'm not the person out here that's saying you can never eat any of this stuff. 'Cause funny enough, if you were to come to a dental office, a lot of the biggest sweet-tooth containing people happen to work in the dental industry and the dental profession. And so, if you go to our break room, a lot of times there's sugary, salty snacks back there.

And so, it's not about you can't do it, but it's just about moderation and making the right choices within some of these kind of empty calorie treat-type foods. Obviously, if you're going the candy route, less sticky type candies are often best. For my kids, I try to limit the number of gummy bears and things like that. Things that stick to the teeth, that sugar sticks around a lot more than candies that aren't sticky in nature.

Sugar containing drinks, I talked a little bit about this earlier, kind of the analogy of, it's all about contact time and not necessarily amount. But things like soda, lemonade, juice, sweetened coffee or tea, they're all particularly harmful because sipping them, like I said, causes a significant sugar bath over the teeth, which can promote decay. Just having that sugar available to the bacteria, that's what bacteria love to metabolize, and that's what causes cavities.

There are some nutritious acidic foods that can also harm the enamel if eaten in too big of quantities or too often. Tomatoes and citrus fruits can have acidic effects on tooth enamel. Eating them as a part of a meal is great, but again, snacking on them throughout the day multiple times can often have deterious effects on our enamel.

Dried fruits like raisins are also great choices for a healthy diet, but they are sticky. They have some natural sugar in them. They adhere to the teeth, and so, they can stick around and give bacteria in our mouth that food that they love to degrade and to cause cavities. So, I'd opt for some fresh fruit instead.

Talking about sugar, one trip to the grocery store looking at a couple labels, and sugar can kind of hide itself. And so, sugar is what's called a soluble carbohydrate. Carbohydrates act like food for oral bacteria. So, when you consume sugar, you're giving oral bacteria what it needs to not only thrive, but it metabolizes that, and the byproducts are what's available to cause cavities. So, cutting back on your sugar and other sources of simple carbohydrates that are easily fermentable reduces your risk to get a cavity.

You can also limit added sugars in your diet by reading food labels to determine the amount of added sugar in a food. Since the ingredients are listed on the label in order of weight from most to least, anything listed in the first few ingredients, it's a good bet that that food is high in sugar.

The problem is a lot of times sugar isn't what's listed. There's a lot of ways to name sugar, and sometimes they can get hidden in the details. Some of the aliases that sugar goes by on some of the labels, I'll give you a few of them just so you can be on the lookout: sugar, brown sugar, cane sugar, confectioner's or powdered sugar, turbinado sugar, raw sugar. Those all say "sugar" in them somewhere, so they'll all fairly easy to find. But corn sweeteners, corn syrup, crystallized cane sugar, maltose, fructose, sucrose, glucose, dextran, evaporated cane juice, fruit juice concentrate, honey, high fructose corn syrup, invert sugar, syrup, malt syrup, maple syrup, molasses, these are all names that sugar can go by. A lot of times, if you're just taking a quick glance, you look for the word "sugar", and if you don't see it, like, "Oh, that's not too bad." Just kind of look for those hidden words.

Hopefully, you've learned something about how nutrition and oral health kind of go hand-in-hand. A lot of times it's not as ... We don't really think of that connection when we're thinking about it. But maybe you can make some healthy changes to your diet, and help keep your smile beautiful even longer. After all, another saying is, you are what you eat, and the same goes for teeth, so try to make those healthy choices, and we'll keep our teeth healthy for many years to come.

March is really all about health. We just talked about how March is National Nutrition Month, but also, March 20 is a very special day in dentistry, because it is World Oral Health Day. World Oral Health Day is celebrated globally every year on March 20. It's organized by the FDI World Dental Federation, and is the largest global awareness campaign on oral health. The World Oral Health Day spreads messages about good oral hygiene practices to both adults and children alike, and demonstrates the importance of optimal oral health in maintaining general health and well being.

We kind of just talked about kind of nutrition and how good nutrition not only helps our whole body, but really in our oral cavity, as well. Now we're going to kind of take that a step further and talk about the importance of maintaining optimal oral health and how that connects to our general well being.

First off, why March 20? Why did the FDI pick World Oral Health Day as being on March 20? It's kind of funny, there is a couple of different meanings behind it. First, seniors must have a total of 20 natural teeth at the end of their life to be considered healthy. And so, there's where one of places where the number 20 comes from. Children also possess 20 baby teeth. Healthy adults must have a total of 32 teeth and zero dental cavities to be considered having a healthy oral cavity. Expressed on a numerical basis, this is translated to 320, so they got March 20. So, all dental reasons the reason that they picked World Oral Health Day to be March 20.

Let's first talk about good oral healthcare for children. Obviously, World Oral Health Day concentrates on children and adults, so we'll start and talk about the kids. Oral diseases like tooth decay and gum disease are widespread and preventable through proper self-care, regular dental checkups, and managing risk factors, good oral health and general health can be secured.

I get the question all the time for new moms and dads asking, "When should we start oral healthcare for our babies?" We should really start it within the first few days after birth. It's not with the toothbrush, it's really by just wiping the gums with a clean, moist gauze pad or washcloth at least twice a day. You wipe their gums, especially after feedings and before bedtime. This kind of gets them, as they're growing up and getting older, not only does it remove that from their gums and tissue, but it also kind of gets them used to the process of oral cleansing, using a washcloth to start. We can progressively move that into kind of a baby toothbrush, a toddler toothbrush, and a kid's toothbrush as they get older. It just gets them used to that where it's kind of a normal part of the day.

You also want to avoid letting your baby sleep with a feeding bottle in their mouth, and start to clean your baby's teeth as soon as the first tooth pushes through. So in the beginning, we're just kind of wiping the gum tissue. Once the teeth start to come in, we're switching to more of a baby brush, and brushing the plaque, and everything, and the food away from their teeth. As far as sleeping, or allowing their baby to sleep with a feeding bottle in their mouth, it's the same thing we talked about earlier with soda drinks, is that allowing that milk to constantly bathe the teeth over and over and over all day long, you hear the term "baby bottle decay" sometimes, and it just creates rampant caries in the mouth, or rampant cavities in the mouth. Really, just keeping that bottle to feeding times and trying to do water in between and things like that.

Your child should brush their teeth using a fluoride toothpaste. You want to check the packaging before you buy it just to make sure that it contains the amount of fluoride recommended. Everything here has the ADA Seal of Approval that contains fluoride. What you want to do is, you want to use a size of toothpaste on the brush that's about the size of a grain of rice. That way if they happen to ingest some of it, it's not going to be harmful to them.

The other thing is, my kids especially, once you put that toothpaste, it's just sitting on the bristles, and you give them the brush, the first thing they do, is they eat the toothpaste off the brush. And so, what I do is, I put that grain of rice size of toothpaste on the bristles, and then I push it down in the brush, and so that way it's deep in the brush. They can't just eat the toothpaste off right away, and it allows that brushing motion to happen, and allows the toothpaste to stay in the brush while they're cleaning their teeth, or while you're cleaning their teeth.

Just as an adult, children should brush their teeth for two minutes, twice a day, to help reduce their risk of tooth decay and gum disease. They should not rinse their mouth with water straight after brushing. Instead, they should just spit out any remaining toothpaste and leave the rest kind of just sitting on the teeth, especially at bedtime. The best thing to do when we're brushing before bed, kids and adults alike, is to brush our teeth, spit out the extra paste, and go to sleep, and don't eat or drink anything else. 'Cause what happens is, the beneficial fluoride in that toothpaste, you've spit out the extra, but you still have kind of a coating left on your teeth. What that coating will do is overnight, it will sit on your teeth and help strengthen your enamel. Obviously, there are some people out there that just hate that paste feeling. If you absolutely have to, you can rinse it. You're just not getting the added benefit of that fluoride being on there for a long period of time.

As always, kids and adults alike, we should replace our toothbrushes every three months, or when the bristles are splayed out. A lot of the toothbrushes these days have those kind of blue bristles on them. You can kind of see when the blue is starting to wear off.

A big thing that a lot of parents kind of don't think about when we're ... is sports safety. When we're buying our equipment for baseball, or football, or various contact sports, just remember that a professionally made mouth guard is always recommended for any sport that involves physical contact, or moving objects, or falls, or things like that. A mouth guard is a rubber-like cover that fits exactly over the teeth and gums, cushioning and protecting them from fracture, displacement, or loss. There's also some evidence that they can actually help prevent concussions, as well. At our office, we make professionally fitted ones. You can buy them over the counter that are boil and bites. Just making sure that it's properly fitted, no matter what method you go really helps to prevent injuries in sports.

For kids, you want to limit their intake of sugars to about three teaspoons daily. Making sure they don't consume excessive amounts of sugars and snacks, and processed foods and drinks, in order to help prevent dental caries or tooth decay.

You want to take your kid to the dentist after their first tooth has pushed through their gums, and no later than their first birthday. At our office, we see kids of all ages, and we really like to see them early. Not saying that we put them through a full cleaning, and full appointment, and everything. A lot of times we're just talking to them, talking to the parents about oral health. We're taking a look at the teeth if they're up for us to get in there and clean them that first time, great, if not, then we introduce that the second time. We're getting the professional fluoride application on there to help fight decay. It's just so beneficial that within six months of that first tooth pushing through the gums, that kids get to see the dentist.

Now let's talk about adults. Oral diseases like tooth decay and gum disease, again, for adults, just like kids, they're widespread, and they're preventable. For adults, like we talked about for kids, we want to brush two minutes, twice a day, with a fluoride toothpaste. We want to make sure that toothpaste has the proper amount of fluoride. And again, it's that ADA Seal of Acceptance will tell you that it has the proper amount of fluoride. You want to apply that toothpaste on your toothbrush, making sure you've got a full length of toothpaste on the toothbrush. You want to rinse with a fluoride mouthwash after you're done brushing, especially right before bed you're getting that extra application.

The one thing that we don't think a lot of is chewing sugar-free gum after a meal. We talked earlier about saliva and how beneficial saliva is in kind of restoring our mouth to the healthy conditions. It helps balance out our pH. It helps cleanse our teeth. If you use a sugar-free gum, or gums that contain sugar alcohols like xylitol, that is actually very, very healthy for your teeth, especially after meals that stimulate saliva and all the benefits of that are amplified. There is actually research that will show sugar alcohols are actually anti-caries that will help prevent cavities. That is something, if you can't brush your that when you're at work, and you just finished lunch, throwing in some sugar-free gum is a great way to help prevent cavities.

Along with brushing twice a day, we also want to floss at least once a day. Again, our brush, as we brush, doesn't reach in between our teeth where they touch, and so a lot of cavities will start to form at that contact area where the floss clicks, or just below. And so, we want to make sure that we're getting in there daily with the floss to clean out our interdental areas.

Adults, we recommend you see the dentist every six months. Again, we're taking x-rays, we're checking for cavities. We're talking about any changes we see in the oral health, any possible habits. Grinding, clenching, things like that can be detrimental to our enamel, as well.

We also want to talk about limiting tobacco use and alcohol consumption. Tobacco and alcohol put your mouth at increased risk for gum disease and oral cancer. Along with that, tobacco can cause teeth staining, bad breath, premature tooth loss, and loss of taste and smell. And then, the combination of tobacco products and alcohol over the long term can actually cause an increased risk and the possibilities that you could get oral cancer.

And so, with March 20 being World Oral Health Day, sponsored by the FDI, I just wanted to take a few minutes to kind of talk about some of the basic oral health considerations for both kids and adults. Hopefully, that will kind of help us continue to kick the year off right going into April and making sure we make good choices both for our oral health and overall health.

Dentistry in the news.

Some of you may remember I was recently on News Radio 610 WTVN show What Matters with Mindy and Mikaela. We were really talking about an issue that's had widespread notoriety throughout the country, really, but especially right here in Ohio, talking about the opioid epidemic and kind of discussing the role of medicine and dentistry, and just really healthcare in general in being kind of one of the first places that some people who can become addicted to these medications actually become exposed to it for the first time.

If you remember, I kind of detailed some of the kind of major steps that, especially dentistry in Ohio, has taken to really help curb the number of prescriptions that are out there. 'Cause, obviously, one way that teenagers can be exposed to opioids is through a prescription at the time they get their wisdom teeth out. Sometimes us as adults have medication in our medicine cabinets, and sometimes kids can get exposed to it through that avenue. And so really, one of the ways to kind of limit exposure to our kids of these types of medications really just simply comes down to not having them in the house.

One of the ways that we can prevent people from having them available is decreasing the number of prescriptions that are written for them. Using alternative pain control methods. We talked about that a lot, whether it's Tylenol and ibuprofen, and really how effective they are at controlling, especially oral pain, whether that's various pain control methods at the time of the procedure, whether you're having a root canal or a tooth extracted.

Are we using longer lasting anesthetics to kind of get you through that first bit of pain right after the procedure? Are we using some steroids to help decrease pain inflammation, swelling, that sort of stuff? Are we using ice and that sort of stuff, again, to help with pain and swelling?

There's various methods, but I wanted to kind of come back today and talk a little bit about that, just because on March 12 there was a story on 10TV here in Ohio that talked, kind of revisited this, and kind of gave an update on where we are here in the state of Ohio. The state's prescription reporting system shows that the number of prescription opioids, meaning Vicodin, that sort of stuff, dispensed to Ohioans declined for the sixth consecutive year in 2018. The Ohio State Board of Pharmacy's automated prescription reporting system shows that the total number of opioids dispensed to Ohio patients decreased by 325 million doses, or 41%, from 2012 to 2018. That's huge. A 41% decrease in the total number of opioids dispensed, and the total opioid prescriptions issued to Ohioans for that same period, 2012 to 2018, decreased by 4.6 million. There were 4.6 million fewer opioid prescriptions written when you compared 2012 and 2018. Huge. There's that many fewer prescription opioids out there to be potentially used incorrectly.

The report also found that prescribers and pharmacists use the prescription reporting system at record levels. Healthcare providers are requesting that information to help make sure that opioids, when prescribed, are prescribed in a responsible manner. And actually, Governor Mike DeWine said in a statement that, "The downward trend in opioid prescription demonstrates Ohio's prescribers are making significant progress in their efforts to prevent addiction." If you remember, when I talked about that on the Mindy and Mikaela show, I said that, "Organized dentistry in Ohio is making huge strides working with the state to help do this, and I feel like medicine across the board is doing the same thing. We're all trying to do our part to help curb the opioid crisis here in Ohio."

And so, great to see that report come out. It's great to see that some of the things that are happening here in Ohio are making progress in that manner. So, I just wanted to stop back today and give you an update on that, 'cause I know I talked about it in an earlier episode, and I really just feel like we're making progress and doing good things.

I hope you've enjoyed listening to Talkin' Teeth today. Our next episode will air next month, and as always, we would love to answer any questions that you have regarding teeth, dentistry, community events, anything like that. Please email us at info, I-N-F-O, @northorangefamilydentistry.com, and we'll be happy to answer them on our next show.

Finally, if you're looking for a dental home, we'd be happy to welcome you in to our North Orange Family Dentistry home. Please give us a call at 740-548-1800, or visit us online and schedule your appointment online at northorangefamilydentistry.com. Thanks again for listening. Have a wonderful day, and we'll talk to you next time.

Thanks for listening to Talkin' Teeth with Dr. Kyle Bogan. Be sure to visit northorangefamilydentistry.com to join the conversation, access the show notes, and discover our fantastic bonus content. Please remember this podcast is for educational purposes only. It is not intended or implied to be professional medical or dental advice, or a substitute for professional care by a dentist or other qualified medical professional. Guests who speak in this podcast express their own opinions, experience, and conclusions, and North Orange Family Dentistry and Dr. Kyle Bogan do not endorse or oppose any particular treatment option.

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