Tag Archives: children’s dental health

Oral Health & School Performance – Yes, There’s a Connection

The same day that the Pew Chartiable Trust’s latest report on children’s dental health made the news, I happened upon a news item about a heated budget battle in North Carolina.

Since 1967, Guilford County has had a dental hygienist working in its schools. Now the county Health Director has proposed axing that position to save $25,000 per year – a miniscule amount in a budget that runs in the hundreds of millions. One Commissioner – Paul Gibson – passionately argued against the cut, calling the proposal “short-sighted.”

Gibson said having a dental worker in the schools examining kids’ mouths – and drawing parental attention to problems through a letter home – clearly made sense.

“It’s a great service,” Gibson said. “For $25,000, I think it’s well worth having that person stay where she is and go look into people’s mouths.”

Gibson said most of the commissioners were no doubt familiar with the fact that, not long ago, a young boy in Maryland died because he didn’t get care for an abscessed tooth. Gibson said he didn’t want to see something like that happen in Guilford County.

You can read about the Maryland boy, Deamonte Driver, here.

“Short-sighted.” Gibson’s comment brought to mind a study I happened across earlier this year in the American Journal of Public Health, “Impact of Poor Oral Health on Children’s School Attendance and Performance.” Analyzing data on more than 2000 students, the research team found that not only were those with poor oral health three times more likely to miss school because of dental pain, they also did worse academically. Those who missed school to get their teeth cleaned and examined, however, showed no drop in performance.

Missing school wasn’t the key. Dental problems were. Thus, the authors concluded,

These findings suggest that improving children’s oral health status may be a vehicle to enhancing their educational experience.

In this light, $25,000 for a school-based hygienist seems a totally reasonable investment.

As for the Pew report? California rated a C, ranking in the bottom half of the nation, as might be expected for a state in which more than half of all kindergarteners have a history of tooth decay (71% of third graders) and one in 5 kids under 12 has never even seen a dentist. While a biological dentist might question some of the measures used in the Pew study – for instance, sealant use and fluoridation – it is clear that we can and need to do better when it comes to kids’ oral health.

Image by B Tal, via Flickr

Note: I’ll be taking a short break from blogging – back to the regular schedule on June 17. – Dr. E

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Secondhand Smoke Hurts Kids’ Teeth & Gums

When we think about the health effects of smoking, the first things that come to mind are usually diseases such as cancer and emphysema. But smoking does a number on a person’s dental health, too – and far beyond simple bad breath and stained teeth. For instance, smokers are four times more likely than non-smokers to develop periodontal disease, even if their home hygiene is exemplary. Gum health deteriorates, often leading to bone and tooth loss. Some periodontists – dentists who specialize in treating the gums – refuse reparative treatments to smokers if they continue to use, such is the ongoing damage.

More than half of all cases of periodontal disease can be attributed to smoking.




If you smoke, you might think, “Fine, but it’s my body. I can do what I want to it,” and that’s certainly your choice – though I would argue it’s far from the best you can make. But you’re not the only one exposed to the toxins in cigarette smoke. Just as secondhand smoke can cause cancer, emphysema and other diseases in non-smokers, so can it cause dental problems for a very vulnerable population: young children.

Two studies published over the past couple years have demonstrated that “passive smoking” (exposure to secondhand smoke) considerably raises young people’s risk of dental problems. The first, published in 2008 in the Archives of Oral Biology showed quite plainly that children exposed to cigarette smoke had more caries (cavities). They also showed higher counts of pathogenic oral bacteria, more acidic saliva and a lower rate of salivary flow – all factors contributing to the formation of caries.

The second study, published earlier this year in the Journal of Clinical Periodontology, found that children exposed to cigarette smoke also show deterioration of their gum tissues. Here, the researchers measured levels of continine – a primary metabolite of nicotine – in the children’s saliva, urine and gingival crevicular fluid (found in the small space between each tooth and the surrounding gum tissue), as well as conducted periodontal exams. Those children with higher continine levels showed lower clinical attachment levels (the attachment of gum tissues to the alveolar bone and tooth structure) – a marker of gum disease. Though it’s not clear why, this effect was more pronounced in children whose fathers smoked compared to those whose mothers smoked.

The moral of the story? If you choose to continue to smoke, avoid doing so around others, especially children. But best of all – for kids’ health as well as your own – is to quit tobacco use altogether. For those of you ready to take that step, here are some resources from the CDC and info on a few natural remedies to help you get started stopping.


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