Exercise, Nutrition, and Your Teeth

Exercise and a healthy diet are the cornerstones of a healthy lifestyle. But being healthy is about much more than simply looking slim and fit. Many very athletic adults and teenagers believe that their boosted metabolisms allow them to eat pretty much anything they want to so long as they continue to look slim and fit. But the consequences of a poorly constructed diet on the internal systems of your body, on your teeth, and even on your athletic performance, are the same regardless of how much you weigh or how healthy you may appear on the outside.

A diet filled with excessive amounts of highly refined sugar and grains, as well as foods and beverages that are high in acid, can have equally negative effects on the teeth and bodies of extremely active people as they do on sedentary individuals over time. And when it comes specifically to the teeth, very active individuals may actually be at a higher risk of tooth decay when consuming sugary or acidic foods and beverages during workouts in order to stay fueled and hydrated.

A quick burst of energy from a gel, sports beverage, or even a candy bar, may be exactly what you need to push you through the last leg of your athletic performance or training session, but that quick energy generally comes from a highly-concentrated combination of simple sugars and caffeine. Citric acid, and other acidic flavor enhancers, are often in the mix as well. Sugar and acid in the mouth create the perfect environment for cavity-causing bacteria to multiply and thrive. And introducing these elements into the mouth during intense exercise, when the saliva flow is often compromised, leaves your teeth even more vulnerable to these bacteria and accelerated tooth decay.

Certainly, there are many preventive measures that we can all take before, during, and after exercise to help protect our teeth and our bodies from the negative effects of the concentrated forms of sugar and acid we might consume during a workout. Our newest resource article, entitled Oral Health for Athletes, outlines several adjustments you can make the way you care for you teeth and fuel your body during a workout or race in order to better protect your teeth from accelerated decay.

For everyone, regardless of your level of athleticism, the first and best preventive measure you can take in protecting the health of your teeth and your body is to eat a well-balanced diet low in sugar and refined carbohydrates, and filled with plenty of whole fruits and vegetables, lean sources of protein, some whole grains, and moderate amounts of healthy fats. A strong metabolism should never be an excuse to regularly offer your body inferior sources of nutrition. No matter how athletic any of us may aspire to be, we should all be practicing healthy dietary choices every day and teaching our children that eating well isn’t just about protecting our health today or fueling an athletic performance next week – it’s about building and maintaining a healthy foundation for a vibrant and active lifestyle for years to come.

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What Your Child’s Sleeping Habits May Be Telling You

It’s easy to misinterpret certain types of sleep behavior in children as simple signs of deep sleep or dreaming. A little snoring or minor limb movement on occasion are certainly nothing to worry about, but when your child begins to snore chronically, breathe irregularly, or thrash physically during sleep, it may be time to consider whether or not he or she might have some form of sleep disordered breathing.

Obstructive Sleep Apnea (OSA) is one of the most common forms of sleep disordered breathing in adults, but children can also suffer from it – especially when there are other contributing factors present like excessive weight, chronic allergies, or specific jaw and bite alignment issues. Unfortunately all of these conditions can be intricately interrelated, sometimes making it difficult for a parent and a medical provider to successfully treat the OSA completely without addressing multiple factors at once.

What makes OSA so serious for both children and adults is that in its most severe form, it can be fatal. Thankfully, those cases are still extremely rare. However, medical research is now demonstrating that OSA and other types of sleep disorders in children and adults can manifest daytime symptoms that mimic mild to moderate forms of ADD and ADHD. Mistreating these cases with ADHD medication (typically stimulants) is dangerous on two levels: Your child could potentially be taking medication he or she does not need; and he or she could still have an underlying sleep disorder that remains unaddressed and potentially even exacerbated by the medication. 1

This month, I’ve added a new resource to The Airway Series that expands and explains these important issues in discovering and treating breathing and airway development issues in children. It is my hope that eventually all children will be screened for the underlying conditions that can lead to OSA, and that preventive measures like functional orthodontic treatment, healthy eating, and plenty of exercise are pursued before the pathological conditions related to OSA ever have a chance to develop.

As always, I encourage you to share this material as much as possible with your friends and family, and to bring any questions you may have about your own children with you to your next regularly scheduled appointment.

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The Truth About Kids, Cavities, and Fluoride

This year Portland, Oregon made national headlines when the majority of voters rejected a measure to add fluoride to the city’s public water system. The debate was heated, and as a whole, the final decision was criticized by many as ill-informed and not in the best interests of our children. As a dentist, it may surprise you to know that I do not believe Portland was wrong in their decision, but my reasons have little to do with the fluoride itself.

Certainly, I am fully aware of the dental benefits that topical fluoride can provide to children and adults under the right circumstances. The scientific evidence is clear that fluoride does contribute to stronger enamel development and thus helps prevent cavities. In our modern society, however, tooth decay simply does not happen because we lack fluoride. It happens because of what we eat and how we take care of our teeth. Fluoride can be a helpful aid in the battle against decay, but it is not the cause or the ultimate solution to the problem.

Tooth decay is caused by pathogenic bacteria that live in our mouths. Everyone has this bacteria and there is no way to remove it completely without also removing beneficial forms of bacteria that live in the mouth as well. Preventing the development of tooth decay is all about controlling the numbers of these pathogenic bacteria through diet and home care (brushing and flossing).

The bacteria responsible for tooth decay thrive on sugar, refined flour, and acid. Diets high in sugar, high-fructose corn syrup, white flour, and acid are the quickest way to multiply the number of pathogenic bacterial colonies in the mouth. Sugar-sweetened beverages are especially attractive to these bacteria because they often contain high amounts of both sugar and acid.

The most common chronic condition in Oregon children is tooth decay. In 2011, the Oregon Public Health Division reported that in Oregon, more than 177 million gallons of sugar sweetened beverages are consumed each year (read report here). That amounts to approximately one gallon per week for every man, woman, and child in the state. The same report quoted a survey of Oregon mothers indicating that about half of the 2 year olds in Oregon drink sugar-sweetened beverages at least once per week.

What troubles me most about these statistics is that they do not include all the other food sources of sugar and acid in a child’s diet that also contribute to tooth decay (and childhood obesity). Fruit juice, for example, may not be sweetened with sugar but can still have the same effects on the teeth and the body. Fructose is a naturally occurring form of sugar found in all fruit and bacteria feed on it just as easily – especially when all the fiber of the fruit itself is removed during the juicing process. And certainly, when a child is drinking a sugary beverage, the likelihood that he or she is also eating a meal or treat that is high in sugar, acid and/or refined white flour is fairly high.

In the battle against tooth decay, every little bit counts, and when tooth decay in children reaches epidemic proportions, water fluoridation as a stop-gap is an option we all need to consider. But consider this as well: If a child’s diet is filled with sugars, highly-refined flours, and acid, fluoridated water is simply not enough. And if that same child also does not brush and floss his or her teeth – or they do not know how to do it correctly – then nothing (including fluoridated water) will be able to prevent tooth decay from developing.

Information is perhaps the most powerful tool there is in preventive medicine. In my continuing effort to provide relevant information on how to care for your teeth and prevent decay no matter where you live or what kind of water you drink, I have created several informational resources that I hope you will take the time to review for your own health and the health of your children.

Kids and Cavities
How to Brush and Floss Your Teeth
A Parent’s Guide to Oral Health for Kids and Teens
Drinks That Eat Teeth
A Guide to Added Sweeteners

As always, I encourage you to read and learn as much as you can from as many reputable sources as possible in order to make the best decisions possible for yourself and your family.

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Sugar Has No Place in Your Diet

It’s not popular to say that sugar and refined carbohydrates should be eliminated from everyone’s diet. So many of our holiday and cultural traditions revolve around sugar, and for many people a sugary treat is often used as a reward or a temporary escape from stress. But the hard truth is that sugar and refined carbohydrates have absolutely no nutritive value. Even the USDA has removed sweets & refined sugar from its dietary recommendations because fruits, vegetables, whole grains, and lean proteins contain all the necessary nutrients a body needs to thrive – no added sugar necessary. In fact, the days when we could consider a sweet tooth as an innocent indulgence are over. More and more scientific evidence is building to suggest that even slightly elevated levels of blood sugar still within the normal range can have drastic consequences for our health.

As a dentist, I’ve been advocating for low- and no-sugar diets my entire career. Tooth decay has obviously been my primary concern, but as we all know, everything in the body is connected. If simple carbs and refined sugar create an environment in the mouth where pathogenic bacteria can thrive, what is happening in the rest of the body when that sugar enters the bloodstream as an excess of glucose? Obesity, insulin resistance, diabetes, cardiovascular disease, behavioral issues, and even cancer and mental deterioration have all been linked to high blood sugar in recent years.

In the January 2013 issue of Alternatives For the Health Conscious Individual, Dr. David Williams reviews several blood sugar studies performed in the last decade. The most compelling of these suggest that subjects demonstrating even slightly elevated blood sugar levels still considered within the “normal” range are showing drastic increases in the incidences of cancer and Alzheimer’s as compared to similar subjects with lower overall blood sugar levels.

We’ve all begun to understand the disastrous effects that high blood sugar can have on the endocrine system in the form of type II diabetes, and the cause-effect relationship is very clear in that case. It is not at all clear that elevated blood sugar levels cause cancer, but we do know that even slightly elevated levels don’t help. And there is growing evidence to suggest a strong enough relationship between Alzheimer’s and blood sugar that many researchers are starting to refer to Alzheimer’s as type III diabetes.

But diets high in sugar and refined carbohydrates don’t just contribute to blood sugar disorders and the risk factors that go with them – they also have another very serious complication: weight gain. Carrying additional weight, especially in the midsection of the body, is a tremendous strain on the cardiovascular system as well as the joints and muscles. Overweight individuals automatically carry a higher risk factor for insulin resistance, diabetes, heart disease, high blood pressure, and even depression. HBO recently released an excellent series on weight and diet that is available for free online here. If you have not yet watched this important series on obesity in America, I strongly urge you to do so for your own health and the health of your family.

All of this information is simply too important to ignore. Every one of us needs to understand and make use of it in order to make the healthiest changes to the way we eat and to the way we feed our children. To help you get started, I have compiled a resource article on the subject entitled Sugar and Your Body. It is my hope that this article will provide you with a solid base of information and serve as a stepping stone to other valuable resources that will help you feed your body in the most healing and nutritive ways possible.

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Avoiding Dental Emergencies

While there are many ways that the mouth or teeth can be injured during an accident that might require immediate care, the fact is that most truly emergent dental conditions (abscesses and other forms of rampant bacterial infection) do not evolve overnight, and most are completely preventable.

Unfortunately, when it comes to health and dental care, we all succumb to the ‘if it ain’t broke, don’t fix it’ philosophy now and then. The problem with that analogy when it comes to our bodies is that we often cannot see the breakage that is already underway until it is too late. Bacterial changes in the mouth begin at a microscopic level, and cracked or weakened teeth are generally not visible to us in the bathroom mirror. These are the signs that an emergency situation is developing. We may not know exactly when the tooth will break or the abscess will occur, but we do know that it won’t get better by ignoring it.

Just as we would never wait for a bridge to fall into the river before we make a plan to fix it, we should never wait for a weakened tooth to break or a minor infection to develop into an abscess before we make a plan to treat it. Necessary dental treatment tends only to get more complicated and expensive the longer we wait to have it done. And if we wait too long, the severity of the infection or breakage may make it impossible to save a tooth at all.

When possible, regular dental care combined with a healthy diet and good oral healthcare habits at home are your best defense against a dental emergency. Your dentist and hygienist can help you identify the areas of your mouth that are susceptible to decay, infection, or breakage and help you make a plan to improve the overall health and stability of those areas before further damage occurs.

Of course, emergencies can still happen. Even with regular dental care, it can be a few months between visits and conditions can sometimes change in the mouth in a matter of weeks. Stress, changes in diet, accidents, increased clenching or grinding habits, and medications can all affect the delicate balance in the mouth. Whenever you notice a subtle change in your mouth that recurs or does not go away within a day or two, take notice and call your dental office for advice if the trend continues.

There are some situations where simply taking notice is not enough though, and for that we have created A Guide to Dental Emergencies. Here you will find an index of symptoms that can develop in the mouth, what they can mean, and how soon you should consider seeking dental or medical care. When in doubt, however, you should never hesitate to call your dentist to ask whether or not you should come in for an appointment. Communicating your symptoms and concerns to your dental team is the most important part of your partnership with your dentist in preventing future dental emergencies.

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