Halloween candy hikes risk of cavities, not just from more sugar, but from more frequent eating of it; here are tooth-friendly tips

Photo from EnviroDad.com

Halloween candy can rot your teeth.

At Halloween, the issue is not just sugar, it's how often you eat it. Often, kids bring enough candy home from trick-or-treating to last a lifetime, but then eat the candy in a few days.

Every time we eat or drink something that contains sugar or starches, bacteria in our mouth use the sugar and starch to produce acids. These acids eat away at tooth enamel and cause cavities.

With Halloween candy, the problem is twofold, according to the National Institute of Dental and Craniofacial Research. Not only do kids increase the amount of sugar consumed, they also increase the frequency at which they eat it. hat increases the exposure of their teeth to sugar, which increases acid exposure, which can cause cavities.

The University of Louisville School of Dentistry has worked for the past decade to inform the students in the Jefferson County Public Schools of the increased risk of cavities during the Halloween season. Over the years, the school's program has provided more than 25,000 students with free education about oral health and general health. This year, the dentistry freshmen continued the tradition and went to more than 70 classrooms and spoke to 3,300 students about the importance of oral health, especially during the Halloween season. The focus of their discussion was to teach the students about candy and the decay process.

The Dental and Craniofacial Research Institute offers these tooth-friendly tips to decrease the chance of tooth decay, especially important during the months after Halloween, when children (and even some adults!) see increases in both volume and frequency of sugar:

Limit between-meal snacks.

Save candy, cookies, soda and other sugary drinks for special occasions.

Limit fruit juice.

Don't eat or drink anything with sugar in after bedtime tooth brushing.

Brush your teeth.

Use fluoride toothpaste, especially if you have well water or only drink bottled water.

Does gum disease indicate future joint problems? Study links gum-disease bacterium to collagen-caused rheumatoid arthritis

Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases - periodontal disease and rheumatoid arthritis - the microbiological links have been unclear; a new study suggests this link is causative and that the bacteria responsible for gum disease leads to a faster progression of rheumatoid arthritis.

In a recent article published in PLoS Pathogens by University of Louisville School of Dentistry researchers say, "The bacterium responsible for periodontal disease, Porphyromonas gingivalis, worsens rheumatoid athritis by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction," according to a U of L news release.

The study says the bacterium produces an enzyme that worsens collagen-induced arthritis, a form of arthritis similar to rheumatoid arthritis produced in the laboratory.

The study was led by Oral Health and Systemic Diseases Group researcher Dr. Jan Potempa and a team that also studied another oral bacterium for the same effect, and found it did not affect collagen-induced arthritis or suggest a link to rheumatoid arthritis.

“This ground-breaking conclusion will need to be verified with further research,” said Potempa. Although the specific cause for the disease remains unknown, Potempa said he hopes these findings will shed new light on the treatment and prevention of rheumatoid arthritis.

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, says 2010 data from the Center for Disease Control and Prevention; this represents approximately 1 in every 250 children in the U.S. An estimated 1.5 million adults had rheumatoid arthritis in 2007. Click here for more information from the CDC.

Effort for kids' dental health in Clark, started by volunteers and continued by health department with tax, earns national award

"A community effort to fight tooth decay in children in Clark County has been named a model for the nation," veteran journalist Al Smith reports in an op-ed for the Lexington Herald-Leader. The Clark County Dental Health Initiative received the award for model practice last month at the annual conference of the National Association of City and County Health Officials, and the county health board recently raised taxes to pay for it.

"Its five-year campaign for change by volunteer dentists, hygienists and engaged citizens should inspire all Kentuckians in a state further scandalized by its own Diane Sawyer in her '20/20' program on ABC in 2009 when she showed 11 million viewers shocking scenes of Appalachian kids with disfigured teeth called Mountain Dew Mouth," writes Smith, former federal co-chair of the Appalachian Regional Commission and co-founder of the University of Kentucky's Institute for Rural Journalism and Community Issues, which publishes Kentucky Health News.

The Clark County program was inspired by Winchester dentist Rankin Skinner, after he and his wife, Ruthi, had started a preventive program for poor children in Ecuador, Smith writes: "He developed a similar plan for Clark County, became its unpaid director and persuaded all 16 other Winchester dentists and 116 volunteers to apply dental fluoride varnish to children in preschool through fifth grade. Every Winchester dentist donated service and staff to take the initiative inside the schools.

Five years later the decay rate in sixth graders has dropped to 11 percent, a decline of 78 percent since 2008 when Kentucky's decay rate for children was reported in national media to be a shameful 50 percent, the country's worst."

Smith notes that the effort was boosted by "a local banker who raised money with help from the Clark County Community Foundation and First Lady Jane Beshear, who urged Gov. Steve Beshear to use the Clark initiative as an example in organizing treatment for underserved children in Eastern Kentucky." The Beshears' permanent home is in Clark County.

Volunteerism only lasts so long, but the Clark County Health Department is now funding the program with a tax increase that will let it hire the state's first public-health dental hygienist. "With continued help from the local dentists and citizen volunteers, [it hopes to] eventually extend the program to students through high school," Smith reports.

The Clark County Board of Health voted this month to raise its tax rate to 4.6 cents per $100 of assessed property value from last year's 4 cents, to generate about $150,000 in additional revenue for the program. Public Health Director Scott Lockard "estimated that funding the program would take $127,531 per year, but the board wanted a cushion in the budget to help pay for dental care for students not covered by Medicaid, KCHIP or private insurance," Rachel Gilliam reports for The Winchester Sun. Lockard told the board, “I can think of nothing better to invest in other than our children.”

Foundation breaks down poll by region to show differences among Kentuckians' views on health topics and issues

The Foundation for a Healthy Kentucky has released regional breakdowns of the Kentucky Health Issues Poll, conducted for it and the Health Foundation of Greater Cincinnati last fall. Each breakdown outlines respondents’ answers to various KHIP questions and then compares regional responses to statewide findings.

Statewide KHIP results showed that most Kentucky adults do not have dental insurance, view health-care costs as a financial burden, favor a statewide smoke-free law, support integration of mental-health and medical services, and say they need more information about how the Patient Protection and Affordable Care Act will impact them personally. The Foundation for a Healthy Kentucky offered these snippets from the regional breakdowns, available by clicking each link:

Western Kentucky: Residents were less likely to have dental insurance and less likely to know someone who had experienced problems as a result of abusing prescription pain relievers.

Greater Louisville: Adults were more likely to have dental insurance, support the legalization of marijuana under any circumstance and be concerned with air quality.

Greater Lexington: Adults were less likely to have been prescribed a pain reliever that could not be purchased over the counter and less likely to change or limit their activities when they hear of an air quality alert being issued.

Northern Kentucky: Adults were less likely to have visited a dentist in the past year and less likely to have a favorable view of the Patient and Affordable Care Act.

Eastern Kentucky: Adults were more likely to rely on home remedies or over the counter drugs instead of going to the doctor and recognize that drug poisonings/overdoses were the leading cause of unintentional death in Kentucky.

“Local health issue data can be extremely useful for policymakers and health officials, especially those working on local initiatives to improve the health of their community,” said Susan Zepeda, president and CEO of the foundation.

The poll was conducted Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati.  A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones.  The poll has a margin of error of plus or 5.3 percentage points. The poll is available online, under the “Data and Reports” tab on the foundation's website.

Sick of all the bad facts about Kentucky's health? Here's encouraging news about oral health and drug treatment

Despite the plethora of bad news about Kentucky's poor health status, there are many positive initiatives for Kentucky's oral health and substance abuse treatment, which were stories buried under health news headlines about Medicaid expansion and low health rankings.

The Kentucky Board of Dentistry recently established the position of public heath dental hygienist, permitting hygienists to go into Kentucky schools to assess teeth on the front lines, which will provide basic preventive dental care to underserved kids with tooth problems through local health departments, Al Smith, left, reports in an opinion piece for the Lexington-Herald Leader.

"These hygienists will be able to do school fluoride varnish programs, place sealants, refer kids in pain, and promote dental health programs (like brushing and better nutrition) in the schools without being supervised by a dentist," Dr. Rankin Skinner, director of the Clark County Dental Health Initiative, told Smith. "I think this is a major step in developing dental health program like ours across the state and moving our kids towards better health in general."

The initiative, comprising 17 dentists and 127 volunteers, was selected as a national model by a national association of all the health departments. "It isn't often that a private volunteer program in Kentucky sets a national standard," Skinner told Smith.

Meanwhile, in Florence, Kentucky's first lady, Jane Beshear, a Democrat, joined her Republican co-chair of Recovery Kentucky, Lexington homebuilder Don Ball, to celebrate the Brighton Recovery Center's fifth birthday and nearly 800 graduates.

Brighton is one of the 10 new homes for Recovery Kentucky, a program that is also becoming a national model, Smith writes. Since its inception during the Fletcher administration, the program has provided supportive housing and addiction recovery programs to over 10,000 men and women, writes Smith.

Beshear said the next steps are for her and Ball to create more drug-free housing and jobs for graduates of the program, Smith reports. This goal creates hope for other successful initiatives and shines a ray of light at the end of a dark and dreary tunnel.

Oral health care for the poor in Kentucky suffers under managed care as dentists leave Medicaid; how about your county?

Kentucky's serious oral-health problems are getting worse because fewer dentists are participating in the Medicaid program -- a result of "new paperwork issues compounding Medicaid's reputation" for low payments to providers, Laura Ungar reports for The Courier-Journal.

Ungar's source for that is Dr. Raynor Mullins of the College of Dentistry at the University of Kentucky, who told her that only 700 to 800 of the state's nearly 2,500 dentists, about 30 percent, accept Medicaid patients.

That makes now seem like a good time for journalists to ask their local dentists if they accept Medicaid -- and if not, why not; and if so, whether they are considering dropping it.

Ungar notes that 28 of Kentucky's 120 counties are deemed not to have enough dentists to serve the local population. Most if not all of them are rural. You can find out which counties are under-served by physical, dental or mental health providers at this federal Health Resources and Services Administration website.

Poll shows more than half of Ky. adults have no dental insurance and many go without essential dental care

Routine dental care is essential to overall health, but a new poll shows 1.7 million Kentucky adults do not have dental insurance. That is more than times the number of people who will be at Churchill Downs for the Kentucky Derby, notes the Foundation for a Healthy Kentucky, which co-sponsored the poll.

The poll also showed that many Kentucky adults are going without the dental care they need. While the poll found that few owe money for dental bills, only 61 percent said they visited a dentist or dental clinic within the past year. The national figure is 70 percent.

“Oral health is essential to overall health,” said Dr. Susan Zepeda, president and CEO of the foundation. “Yet, our research indicates a majority of Kentuckians do not have dental coverage, so it is not surprising that a large number of adults do not have a personal dentist or oral health provider.”

Poor oral health or oral pain can lead to poor nutrition and can reduce someone's quality of life by making it difficult to sleep, work or interact with others, and having dental insurance is an important factor in determining whether someone is getting the dental care they need.  More than 50 percent of poll respondents indicated not having dental insurance of any kind, and almost half of that group said they skipped getting dental care or check-ups in the past year due to its cost.

Whether or not someone has a normal source of care is also an important factor in determining health care outcomes because those with a personal dentist or doctor are more likely to seek care. Almost 40 percent of poll respondents, however, said they do not have a personal dentist or oral health provider, and almost 80 percent of those respondents said its been more than five years since they last visited a dentist or dental clinic.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati. The poll was conducted last year from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones, and the poll has a margin of error of plus or minus 2.5 points.

U of L dean says $50 billion in annual health costs could be saved if Americans just walked more

Small changes in health behavior can have a huge impact on the public's overall health and well-being, and during National Public Health Week discussions last week, Dr. Craig Blakely, the new dean of the University of Louisville School of Public Health and Information Sciences, talked about the important role played by public health in promoting healthy behavior, preventing disease and saving both lives and money.

Blakely pointed to obesity as an example of an emerging health-related crisis, which can be addressed with behavioral changes that make a significant difference like adding more physical activity to your day, according to a U of L release.

“If we all took exercise seriously by just walking, we could save $50 billion in cardiovascular disease-related costs,” Blakely said. “A 10 percent weight loss equals a $5,000 savings in health-related complications. A typical desk worker could lose a pound a month by standing two hours a day.”

Blakely also addressed smoking bans, which are becoming popular in Kentucky, even though the state has the highest share of smokers (29 percent) of any state, leads the nation in high-school smokers (24 percent) and spends only a minuscule portion of its tobacco revenues to fight tobacco use, according to the Centers for Disease Control and Prevention.

If every state adopted comprehensive smoke-free policies, said Blakely, $2 billion would be saved in smoking-related deaths, lung cancer treatments and care for related health complications over the course of several years, says the release.

Blakely highlighted several other examples of public health’s potential return on investment. For example, says the release, every dollar spent on childhood immunizations saves $18 on vaccine-preventable disease-related costs, every dollar spent in prenatal care translates to $6 in health care cost savings and for every dollar spent on fluoridated water saves $20 in dental care.

Public health research will continue to find effective ways to generate these cost savings, such as finding researching how to modify environments to encourage exercise or how to send strong messages that promote regular physical activity (Read more)

Louisville dental school to mark Women's History Month with women's art and oral-health fair and reception

The University of Louisville School of Dentistry will kick off its Women's History Month celebration March 18 with "Chew Art," an all-women's art and oral-health fair and reception.

In an effort to better engage with the community on issues related to oral health, increase oral health literacy and celebrate Women's History Month, the fair will focus on specific oral health care needs of women. The school will provide oral health information, and in some cases, limited screenings for women who live with diabetes, hypertension, who are pregnant or undergoing various treatments for cancer.

But the school says this event will not be like an ordinary trip to the dentist or health fair; it will be much more exciting! It is teaming up with Kristen Hughes, Arts in Healing manager at the Kentucky Center for the Performing Arts, to employ an innovative Arts in Health Care approach. Unlike the normal clinical environment, original works of art, created by a group of local female artists, will be on display at the fair.

The "Chew Art" event will take place Monday, March 18, from 5 to 7 p.m. on the second floor of the newly renovated dental building at 501 S. Preston St. and will feature tapas, wine, sangria and live music in addition to the art displays.  To RSVP, email Deborah Wade at D0wade01@louisville.edu.

Poll finds four out of five Kentuckians are comfortable seeing a nurse practitioner or physician assistant for routine care

New poll figures indicate the majority of Kentuckians are comfortable seeing a nurse practitioner, physician assistant or mid-level clinician for their routine care, especially if they have been treated by such clinicians. The findings come as the General Assembly considers a bill that would allow physician assistants to practice more independently.

In the Kentucky Health Issues poll last fall, 79 percent of Kentucky adults said they would be comfortable seeing a nurse practitioner for routine health care, and half of those people said they would be very comfortable. Eighty-one percent said they would be comfortable seeing a physician assistant for routine health care, and 42 percent of those respondents said they would be very comfortable.

Reported comfort was higher among people who had received care from a nurse practitioner or physician assistant in the past year; 86 percent of those people said they would be comfortable seeing an NP again for routine care. Eighty-eight percent of those who had received care from a PA in the past year said they would be comfortable doing that again.

The poll also inquired about a proposed new “mid-level” profession: advanced dental hygiene practitioners. These practitioners would provide routine dental care, including diagnostic and preventive services such as filling cavities. Although advanced dental hygiene practitioners cannot currently be licensed to practice in Kentucky, polling data indicated 73 percent of Kentucky adults would be comfortable with such a practitioner providing routine dental care.

"As providers move to create a system of care that includes a range of skill sets and training in its care teams, new strategies emerge that hold promise to increase access to affordable care – not just in urban centers but also in rural and underserved communities,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which sponsored the poll. “The data suggest that the public is very receptive to health care services from different types of clinicians.”

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points. (Read more)

Health-care law addresses the most common chronic health problem in children, tooth decay, by requiring coverage for kids

Tooth decay is children's most common chronic health problem, and the 2010 federal health-care law addresses this problem by requiring insurers to cover pediatric dental services. But some advocates are concerned that the new benefits may not be sufficiently comprehensive or affordable, Michelle Andrews writes for The Washington Post.

She notes that by the time children enter kindergarten, more than a quarter of them have decay in their baby teeth. As they age, the problem gets worse and nearly 68 percent of those age 16 to 19 have decay in their permanent teeth, according the the Centers for Disease Control and Prevention. 
   
Beginning next year, the Affordable Care Act requires individual and small-group health plans cover pediatric dental services, unless a plan has a specific exemption under the law. Those services are already part of the Medicaid benefit package, but most Kentucky dentists don't accept Medicaid.
For the expansion to private insurance, "Coverage requirements will be determined by each state within guidelines set by the federal Department of Health and Human Services," Andrews writes.

Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said Kentucky is awaiting the publication of the final rule from HHS, which will define essential health benefits for each state and provide further guidance relating to coverage of benefits. Although no specific publication date for this rule has been announced, she said its release is expected within the next several weeks to allow insurers to modify existing health plans to be made available to individuals and small businesses for purchase through health exchanges by Oct. 1. (Read more)

Kentucky parents' overall perception of Kentucky children's health doesn't match the statistics, foundation survey finds

Many Kentucky parents' perception of their children's health doesn't match statistics, suggesting that many health problems are going undetected or untreated.

That is the upshot of the Foundation for a Healthy Kentucky's first Kentucky Parent Survey, conducted by the University of Virginia's Center for Survey Research this summer and released today.

Only 4 percent of Kentucky parents said a health professional had told them their child was obese, but the National Survey of Children's Health in 2007 found that almost 37 percent of Kentucky children were obese.

Just 5 percent of Kentucky parents said they had been told that their child had depression or anxiety, but about 25 percent of children 13 to 18 will have struggled with anxiety and 11 percent will have battled depression, according to a 2010 national study. And a recent study found that Kentucky teens were more likely than the national average to have attempted suicide.

About 17 percent of Kentucky parents reported that their child had decayed teeth or cavities, but a national survey of third graders in 2001-02 revealed that 35 percent had untreated dental issues.

Only 3 percent of parents said their child was diagnosed with a hearing problem, but 15 percent of children nationally have measurable hearing loss. And 14 percent reported being told their child had a vision problem, but about one in four preschoolers nationally have vision issues.

Parents also seem not to get enough advice from health care providers about how to treat their children's health issues, even though there are high rates of children suffering from tooth decay, vision problems, asthma, ADHD, depression/anxiety, obesity, hearing impairment and diabetes, the survey found.

While 92 percent of parents said their child had a regular doctor, just 80 percent said their child had a regular dental care provider. And a 74 percent majority of parents surveyed said they were always encouraged by their child's healthcare provider to ask questions during visits. "The exceptions are worth noting," said Susan Zepeda, president and CEO of the foundation. "If three in four parents said their child's provider always encouraged questions, this means that one in four were not always encouraged to ask questions." (Read more)

Electric cooperatives' monthly magazine looks at the poor health of our state's children

Courtney Cagle, 14, of Clinton learns
how to cook healthy spaghetti in UK's
Cooperative Extension nutrition program

The November issue of Kentucky Living magazine, published monthly for member-customers of the state's electric cooperatives, focuses on children's health. Editor Paul Wesslund writes that the stories and statistics on the current state of the state's kids are "scary."

Reporter James Nold Jr. writes that when experts were asked about their concerns for the state, childhood obesity was front and center. The state ties Georgia and Arkansas for the second highest share of children (37 percent) who are obese, and it trails only Mississippi among children 10 to 17. That’s more than one in three kids who are grossly unfit.

Also of concern are Kentucky children's high rates of asthma, abuse, neglect, and cigarette smoking. The numbers for these are so bad and so seemingly out of control now that health professionals would be happy just to see them remain stable in the future, instead of continuously rising.

Nold writes that the experts' urgency on these matters was palpable. A lot of them talked about the way poor nutrition can harm children now and throughout the rest of their lives.  They also expressed deep concern for the lack of dental education and care, the need for more exercise and for more parent involvement in all of their children's choices.

The magazine, which has a Health Club for children, notes that the University of Kentucky's Cooperative Extension Service provides nutrition education to students in all 120 counties. For more information on the club, or to join, go to www.KentuckyLiving.com and click on "KL Health Club." (Read more)

Brushing teeth twice a day, two minutes at a time, is the way to prevent cavities, a new campaign advises

Kids should brush their teeth twice a day for two whole minutes at a time, a new public-service campaign urges. The “Kids’ Healthy Mouths” campaign includes TV spots, print ads, a website, social media messages and other materials, reports Jennifer LaRue Huget for The Washington Post.

Campaign materials point out that “dental decay is the most common chronic childhood disease.” More than 16 million children across the United States suffer from it. In Kentucky, nearly 35 percent of third-grade students had untreated tooth decay, the Centers for Disease Control and Prevention's State Oral Health Profile shows.

“The mouth is the gateway to a person’s overall health, and an unhealthy mouth can be linked to diabetes and even heart disease,” the campaign says. “In the U.S., oral disease causes kids to miss 51 million school hours and their parents to lose 25 million work hours annually. Additionally, oral disease disproportionately affects children from low-income families and these children have almost twice the number of decayed teeth that have not been treated by a dentist as compared to others in the general population.”

The campaign includes a YouTube video channel on which there are videos that are each 120 seconds long. The goal is for kids to watch the videos while they’re brushing.

Research has shown brushing two minutes at a time, twice a day, is the “optimal prevention brushing regimen,” because it “takes two minutes for the tooth enamel to uptake the fluoride” in toothpaste, said Maria Lopez Howell, consumer adviser for the American Dental Association. When enamel absorbs fluoride it makes the surface harder and more resistant to bacteria. Brushing for two minutes additionally removes plaque on teeth. (Read more)

Students with tooth problems don't do as well in school

More evidence shows students who have dental problems struggle more in school. A new study of almost 1,500 disadvantaged students in Los Angeles public schools found those who had had recent tooth pain were four times more likely to have a low grade-point average (below 2.8) than those who didn't have problems.

Another recent survey found that one in nine American children ages 9 to 11 have untreated tooth decay in their permanent, adult teeth. A 2011 study in North Carolina concluded students with poor oral health were three times more likely to miss school because of dental pain.

Parents and policy makers should be concerned with the findings, says Matt Jacob for the Pew Center on the States. In California, about 504,000 children missed at least one school day in 2007 because of a toothache or another oral health-related problem. (Read more)