Watson Blog (3)

Braces, Oral Health, and Observing Children’s Dental Health Month

By Dr. Emily Watson

Children love soda.

They also love candy and other sweets.

You can’t blame them really. For most people, a package of Sour Patch gummies is much tastier than a side dish of broccoli. Beyond that, who doesn’t love that sugar rush we get – or at least think we get – from the candy bar we grabbed just as we were checking out at the supermarket? 

Unfortunately, as we all know, those delectable treats are the nemesis of healthy teeth, even if people do sometimes say they have a “sweet tooth.”

All of this comes to mind because February – most often associated with Valentine’s Day (and the candy that goes along with it) – is also Children’s Dental Health Month. This annual observance, sponsored by the American Dental Association, has the worthy goal of promoting the benefits of good oral health to children, parents, teachers, and anyone else who serves as caregivers or role models for children. 

Since this year is a Leap Year, we even have an extra bonus day to remind ourselves – and our children – of the importance of good oral health.


When Braces Get in the Way

The obvious starting point for those excellent oral health habits is regular brushing and flossing. Those two activities are the standard and can seem routine, yet they can be slightly more challenging for anyone with traditional braces or Invisalign.

Flossing, for example, is not an easy task for anyone who is wearing braces. With those wires and brackets to navigate, you simply can’t work the thread into all the areas you would like. One answer to this problem is to use a Waterpik so that you are flossing with a strong jet of water rather than with that dental-floss thread. The water flows easily into the areas around the braces, flushing out bacteria and food from between the teeth and under the gum, and heading off the problems those bacteria and bits of food could create down the road. 

In much the same way, we provide children who have braces with a toothbrush that is specially designed to get around those hard-to-reach areas, so that their brushing has the intended results and isn’t a largely futile effort.

As an orthodontist, I of course appreciate it whenever children take care of their brushing and flossing needs, and when parents help reinforce those habits.

But there also are other ways that I encourage my patients who wear braces or Invisalign to make sure they are doing the utmost to take care of their smiles.


Drinks and pH Level

One thing that always concerns me is what the children are drinking because there are so many sugary drinks out there that are not conducive to healthy teeth – sodas, energy drinks, and many types of teas, just to name a few. The sugar in those drinks mixes with bacteria in the mouth to form acid that attacks the teeth. For some drinks, such as sodas, that already have acid in them, this just compounds the problem.

I have a chart I share with patients that shows the pH levels for different drinks, giving them a good idea of what to avoid and what to seek out. The lower the pH level, the more erosive the drink is to teeth and the more likely the child will experience tooth decay. Over time, those drinks cause the enamel to weaken and they lead to white decalcification or scars on the teeth.

So, ideally, what pH level are we shooting for?

The neutral pH level in the mouth is 7.0. When the pH level begins to fall below 5.5 is when the trouble starts to brew. And when it comes to what children (and adults) drink, that trouble wastes little time getting started.

Many sodas are extremely erosive with pH levels below 3.0. Even the least erosive are usually between 4.0 to 5.0. Sports drinks such as Gatorade and Powerade, which also have sugar in them, also have pH levels below 3.0.

Good old-fashioned water remains the best bet.


Empowering Children to Make Decisions

In my efforts to help children develop better habits, I remain realistic, though. Even with that pH table that reveals to children just how problematic their favorite drinks are, and even with my suggestions, children are still drawn to sugary drinks.

So, I combat the problem in other ways as well.

One way is to promote a toothpaste that has a higher pH level, which can help reduce the acidity in the mouth. 

Another approach involves their diet. The goal is to limit the amount of sugar in the diet, and this is something I do with my own children. Children are only supposed to eat between 24 to 29 grams of sugar a day. As you might guess, it’s not that hard to go over the recommended amount.

So I think it’s a good idea to get them involved in weighing their cravings against what is best for them.

One good example happened recently with one of my daughters. She wanted a Chobani Flip that has little Oreos in it. The package will tell you that this one 5.3-ounce yogurt has 21 grams of sugar in it. This single snack would put her at nearly her entire sugar allotment for the day, and I pointed this out to her. 

“Would you rather eat this now, or enjoy the sweets you’re going to have at the birthday party later?” 

I left the decision up to her, though. Rather than flatly saying no, I think it’s good to bring the child into the decision, let them understand everything, and then say, “Do you want to do this? (In this case, eat that yogurt.) Or do you want to use your daily allotment in another way?”

All of us, of course, can make better oral health decisions when we have a better understanding of the ramifications of the choices we make. 

The more I can educate my patients about how their actions affect their treatment, and their overall oral health, the better the final results will be.