Children with limited exposure to fluoridated water and a high sugar intake are 70% more likely to develop cavities in their permanent teeth, according to a team of Australian researchers.

The study of 24,664 Australian children raised particular concerns, said Loc Do, PhD, professor in dental public health and research chair at the University of Queensland School of Dentistry.

“The coverage of water fluoridation in Queensland is the lowest in the country, while our intake of free sugars is among the highest,” Do said.

“We hope these results will convince policymakers in jurisdictions without fluoridated water to implement this effective and cost-saving community measure,” he continued.

“We also hope to see the promotion of healthy behaviors like reducing the intake of sugars, which would both improve dental health and help prevent other conditions such as obesity,” he said.

More than half of the 5- to 14-year-olds in the study were considered to have either low exposure to fluoridation (less than 25 of their life) or medium exposure (between 25% and 75% of their life).

Also, approximately 60% of the children analyzed consumed four or more daily servings of food or drinks high in free sugars.

Those who consumed more than four daily servings of high-sugar food or drinks but with high exposure to fluoridation were 40% less likely to develop cavities in their baby teeth than those with low or medium fluoridation.

Those with a diet rich in sugars but with high exposure to fluoridation were 50% less likely to develop cavities in adult teeth than those with lower levels of fluoridation.

It was well known that dental cavities are largely preventable, water fluoridation was effective, and high free-sugar intake was detrimental to child dental health, said lead author Diep Ha, PhD, a research fellow at the University of Queensland School of Dentistry.

“These facts are not surprising or new, but the results from almost 25,000 young people in this study show there is still a need to address these issues to improve child dental health in Australia,” said Ha.

“To achieve maximum prevention of dental decay, lack of exposure to fluoridated water and high intake of sugars should be targeted,” said Ha.

The research used data collected in the National Child Oral Health Study 2012-14, funded by a National Health and Medical Research Council Partnership Grant to the University of Adelaide and a collaboration with state/territory dental health services.

The study, “Excess Risk of Dental Caries from Higher Free Sugars Intake Combined with Low Exposure to Water Fluoridation,” was published by the Journal of Dental Research.

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We’re celebrating Dentistry Today’s 40th anniversary by interviewing 40 of the profession’s top leaders. Today we’re speaking with Dr. Wenyuan Shi, CEO and chief scientific officer of the Forsyth Institute, about the role his organization has played in pioneering oral health research, its community outreach efforts, and how it facilitates innovation by partnering with key entrepreneurs.

IQ Dental Supply recently hosted the Fourth Annual Tee for the ToothFairy Charity Golf Tournament to benefit America’s ToothFairy and resources for children’s oral health programs.

Held at the Crystal Springs Resort & Spa in Hamburg, New Jersey, the event featured an appearance by Ken Daneyko, formerly of the New Jersey Devils of the National Hockey League.

Funds raised through the event will provide educational resources to help 3,500 children in disadvantages communities learn to prevent dental disease, America’s ToothFairy said.

“This is an event we look forward to every year. The golfers had a wonderful time while also helping kids stay healthy,”  said IQ Dental Supply president Sergey Kunin.

“As a board member of America’s ToothFairy, I see firsthand all the great work they do. It is an organization that I am proud to support,” said Kunin.

“After a year of lockdowns, it was great to get together with the wonderful people who support our mission to improve the oral health of our nation’s most vulnerable kids,” said Jill Malmgren, executive director of America’s ToothFairy.

“We are incredibly grateful for everyone who participated and of course for our thoughtful host and generous sponsors who made the event possible,” said Malmgren.

Proceeds will fund educational initiatives that help families in underserved communities avoid the consequences of poor dental hygiene habits, America’s ToothFairy said.

Since its founding in 2006, America’s ToothFairy has helped more than 8.8 million children and their caregivers learn how to keep their smiles healthy, the nonprofit said.

Other sponsors of the event included 3M, KaVo Kerr, DMG, GC America, Coltene, and Vatech.

The next Tee for the ToothFairy outing will be at Pine Island Country Club in Charlotte, North Carolina, on November 12, 2021. Opportunities to participate are available.

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As summer gets underway and kids get more active, including sports, DentalPlans.com is encouraging parents to take steps to protect their children from dental injuries.

Approximately a quarter of dental injuries among children can be attributed to sports, the company said, including those that include impact and speed such as baseball, soccer, volleyball, tennis, bike riding, and skateboarding.

DentalPlans.com has put together a checklist for parents and guardians to ensure families understand ways they can reduce the likelihood of sports-related dental injuries and how to get kids on board too.

First, get the right mouth gear. Children should wear a mouthguard during contact sports. In some cases, a face shield may be an option, as it protects delicate bones around the eyes, nose, and jaw. DentalPlans.com advises parents to speak to their dentist if they need advice on which gear to purchase.

Dentists also can make personalized mouthguards for children that fit correctly and do not interfere with breathing or cause distractions while playing. Equipment aimed at protecting other parts of the body may be required or encouraged depending on the sport as well.

Next, protect braces. Protective gear is especially important for children who wear braces, DentalPlans.com said, because braces can cut the inside of the mouth during a collision. The braces themselves can be damaged as well. Most orthodontists will recommend that children wear a mouthguard while playing sports to protect their teeth and braces.

Third, get children on board. Encouraging children to consistently wear protective gear can be challenging, DentalPlans.com said, but ensuring the gear fits correctly can reduce irritation and make it more likely they will continue to wear it.

Finally, DentalPlans.com said, parents should be prepared in advance. Treatment for dental injuries should not be delayed, so families should have a dentist that parents and child both trust. Preventing care like checkups and cleanings can help children feel comfortable with their dentist in advance of any unforeseen injuries. Regular dental care also will ensure their mouth is as healthy as possible in the event of a trauma.

“You can take all the precautions, but accidents and injuries can still happen. While the injury may be lessened thanks to protective gear, seeing a dentist as soon as possible will still be vital,” said Jenn Stoll, chief commercial officer at DentalPlans.com.

“Make sure you have an affordable way to pay for your family’s dental care so there are no delays. Consider that you may need emergency or restorative treatments following a dental injury, as well as any follow-up care, your dentist will likely want to see how your child is recovering afterwards,” Stoll said.

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As the government of the United Kingdom prepares a ban on television advertising for foods high in sugar, fat, and salt before 9 pm, the Oral Health Foundation (OHF) said it welcomes the move but believes more work is necessary.

“Nutrition is a key part of taking care of not just our general health but also our oral health. The amount of sugar we consume has a devastating impact on the nation’s oral health,” said Dr. Nigel Carter, chief executive of the OHF.

“Cutting down on sugar consumption is the number one way to stop tooth decay, and junk food is often filled with sugar in order to make the taste more appealing,” Carter said.

“Tooth decay remains the number one reason for hospital admissions among young children. The NHS carries out almost 900,000 tooth extractions on children under 18 every year, and nine of 10 of these are down to tooth decay,” he continued.

“Tooth extractions take a great physical and emotional toll on children and is often a source of trauma. All measures we can take to prevent a child having to go through this are things we welcome wholeheartedly,” Carter said.

“When you’re holding a parent’s hand because you’ve just had to take all of their child’s teeth out under general anesthetic and the child’s looking you in the eye, saying, ‘Why have you done this to me?’ you will welcome any new rules brought in to help protect children and stop situations like this occurring,” said Dr. Ben Atkins, OHF president.

“Performing tooth extractions on a child is risky, especially under general anesthetic, which comes with a lot of risks itself. That child might not have woken up from anesthetic. I could have put their life in danger over something which could have easily been managed with proper diet and proper oral healthcare,” said Atkins.

“The proposed ban on junk food television advertising is a great first step, however, it will still be allowed through audio media, such as podcasts and radio, and there will be no new restrictions for the out-of-home sector, which includes billboards, poster sites, on buses, and in locations such as railway stations and airports,” Carter said.

“With many young children now also consuming more and more media online through things like Amazon Prime and YouTube, they may still be able to see junk food advertising through these channels,” Carter said.

“Extending these restrictions to cover all media types, especially streaming platforms, is the next natural progression,” Carter said.

“Ultimately, the buying decision is still down to caregivers,” Atkins said. “They largely control what their children consume, and while this advertising ban is welcomed, we all need to change our attitudes and reduce our consumption of sugary foods to effect change.”

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Colgate Bright Smiles, Bright Futures (BSBF) is partnering with Save the Children to provide oral health and hygiene products to respite shelters serving migrant children and families.

Hosting new arrivals entering the United States with documentation via border towns in California and Texas, the shelters will receive more than 25,000 units of toothpaste, toothbrushes, and soap from Colgate as well as oral health educational materials via a product donation to Save the Children.

Hundreds of migrants from Guatemala, Nicaragua, and Honduras arrive weekly and sometimes daily at respite centers in such cities as San Diego, Mecca and Bell, San Antonio, Brownsville, El Paso, and Laredo.

“These children and families are fleeing unimaginable violence and disasters at home,” said Betsy Zorio, Save the Children’s vice president of US programs. “They are arriving exhausted and distressed, often with only the clothes they are wearing, to seek legal asylum.”

As temporary refuges, the respite shelters provide a place to sleep and bathe, clean clothing, oral health products, toiletries, and diapers. With assistance from Save the Children and other partners, they also provide safe care and activities for children.

“The adults are overwhelmed by trying to keep their children safe, navigate the immigration process, and connect with family members here in the US,” said Zorio.

“To best support these children, Save the Children assists shelter partners with critical supplies to set up play areas so children have a place to be a kid and engage in age-appropriate activities. We also provide training so shelter staff can support children’s social and emotional needs,” said Zorio.

“As a global children’s health initiative, Colgate Bright Smiles, Bright Futures has an important role to play in helping to prevent disease and protect the health and well-being of vulnerable children and their families,” said Dr. Gillian Barclay, vice president, global public health and scientific affairs, Colgate-Palmolive Company.

“Last year in North America, Colgate Bright Smiles, Bright Futures donated more than 3 million units of oral care products and delivered oral health education to more than 27 million children and families,” Barclay said.

“By partnering with Save the Children, a leading humanitarian organization and authority on child health and education, we can positively impact the lives and health of vulnerable children now and in the future. Together, we are promoting lifelong learning opportunities and the promotion of well-bring for all,” said Barclay.

As a company, Colgate has supported Save the Children since 1999. It began its global partnership with the organization in 2016, working together to increase access to oral healthcare for children in need in the US, Africa, and Latin America.

In addition to supporting the organization’s emergency response efforts at the US-Mexico border, this year Colgate is supporting Save the Children with programmatic funding for its US-based Head Start, Healthy Choices, and rural education programs, as well as infant toothbrushes for its home visitation program, Early Steps to School Success, which offers home visits for families beginning with a mother’s pregnancy until a child reaches age 3.

“For 30 years, Colgate Bright Smiles, Bright Futures has supported and partnered with organizations that mobilize communities to improve health,” said Barclay. “Together with Save the Children, Colgate Bright Smiles, Bright Futures engages, educates, and empowers children and their families to embrace a healthy future we can all smile about.”

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America’s ToothFairy has launched a new opportunity for children to win prizes while learning about the importance of flossing. Kids between the ages of 6 and 13 can sign up for the HERO Challenge, a superhero-themed education initiative, for the chance to win the grand prize, a Nintendo Switch gaming console or a $300 Nintendo or PlayStation gift card.

“Last year’s HERO Challenge was so much fun. We are thrilled to partner with DentaQuest once again to continue the campaign this summer,” said Jill Malmgren, executive director of America’s ToothFairy.

“Prevention of dental disease through education is a major component of our mission. The HERO Challenge is a fun way for kids to learn while being creative, and the videos they create help spread awareness about the importance of healthy dental hygiene habits,” Malmgren said.

Made possible by a donation from DentaQuest, the campaign originally was developed last summer after COVID-19 lockdowns brought most in-person group instruction and educational projects to a halt. But since the HERO Challenge could be completed by kids at home, learning about the consequences of tooth decay could continue, America’s ToothFairy said.

By accepting the challenge, children donned superhero costumes, completed oral health lessons, and submitted videos telling what they learned about defeating the villain “Bio-Film” and his gang of bacteria.

“Participation in last year’s challenge was such a success that we knew we wanted to do this again and reach even more children,” said Steve Pollack, chief executive officer of DentaQuest.

“Throughout the pandemic, DentaQuest has been committed to our mission of meeting oral health needs across the country. This campaign provides a kid-specific opportunity to learn lessons they can carry with them, and live a healthy lifestyle well into adulthood,” Pollack said.

This summer’s participants will learn about gum disease caused by a new villain, “Ginger Vitis,” and how it can be prevented by daily flossing. To qualify for prizes, participants must submit a video telling what they learned through the challenges. The grand prize winner will be determined by online voting.

Scout troops also may participate as a group to earn free Oral Health Action HERO patches. Participants must register online by July 16, 2021, to receive their mission instructions.

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The British Dental Association (BDA) is promoting a free set of downloadable Makaton prompt cards to help break down barriers in communication with patients in support of Learning Disability Awareness Week, June 14 through June 20.

Makaton Library visitors can create a free login and then search for “Your dental appointment.”

Makaton is a unique language program that uses symbols and signs alongside speech to enable people to communicate more effectively, the BDA said, adding that all people with learning disabilities should have the support they need to access dental care. More than 100,000 children and adults use Makaton symbols and signs.

This tool can be used to support communication in day-to-day practice. To highlight these resources, the BDA has collaborated on a short film about the experience of someone with a learning visibility visiting the dentist, available on YouTube.

The film features Charlotte Waite, senior community dentist and chair of the BDA’s England Community Dental Services Committee, and Gary Parker, an actor with a learning disability who is part of the MiXit theater group.

The collaboration has been led by Health Education England and supported by Amanda Glennon, a Makaton tutor and ambassador, and Helen Laverty, MBE, University of Nottingham professional lead for learning disability nursing, and the BDA.

“I was delighted to be asked to support this project. Figures provided by Health Education England indicate that there are over 1.2 million people in England who have a learning disability. It is also important to recognize that many adults, as well as children, will benefit greatly from communications tools like Makaton,” Waite said.

“A number of patients with a learning disability will visit a high-street dentist. By taking some time to learn a few of these Makaton signs, you will be enhancing your communication skills, as well as supporting your patients,” Waite said.

“The Directorate of Multi-Disciplinary Dental Education was delighted to be able to participate in the project,” said Rachel Lish, clinical lead for oral health education at HEE North-East England and North Cumbria.

“It has been an excellent example of a multi-disciplinary approach to bring together all of the expertise to develop resources which will assist our dental colleagues in supporting patients with learning disability. This will help make a visit to the dentist a positive and inclusive experience, and we look forward to educating our workforce using the resources developed,” Lish said.

Glennon is the mother of a 15-year-old daughter, Alice, who has Down syndrome and has experienced difficulties in communicating with health professionals.

“If dentists and their teams learned just a few phrases of Makaton, it could make a huge difference for people like Alice. Communications barriers mean that people with learning disabilities often end up with a negative experience of care,” Glennon said.

“At the dentist, my daughter would feel out of control. There is something that is being discussed around here and she’s not being included, she said. The difference in just being able to say, ‘Hello. My name is.’ Even that is enough to help set that person at ease and make the whole experience a lot more inclusive and positive,” Glennon said.

“During the lockdown, the experiences of the fear people with a learning disability have in visiting the dentist has been highlighted, and we want to help turn that around by making sure dentists are aware of good communication aids, strategies, and, more importantly, Makaton,” said Laverty.

“It’s about disabling barriers and enabling environments so that confusing sentences like ‘hop on the chair’ are not used, and the need for clear, concise, and effective communication is used to make the experience a positive one for everyone,” said Laverty.

Many patients are anxious about visiting the dentist, the BDA said, and research has shown that those with learning disabilities also face extra barriers to dental care, including communications barriers, access problems, anxiety, sensory overload, and the concerns of carers or their families. Some of these anxieties have been thrown into sharp relief by the COVID-19 pandemic, the BDA added.

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Bruce Rotter, DMD, MS, dean of the Southern Illinois University School of Dental Medicine (SIU SDM), will retire in December. He was named dean in November 2012 after serving as interim dean for more than a year.

An alum of the SIU SDM class of 1982, Rotter joined the SDM as a member of the faculty in 1993. He brought a unique perspective to the dean’s position, SDM said, fully participating in the school’s progress as a student, faculty member, and administrator.

“On behalf of SIUE and the SIU School of Dental Medicine, I want to thank dean Rotter for nearly 30 years of service,” said chancellor Randy Pembrook.

“In particular, I want to commend dean Rotter and the school for their dedication to the community as evidenced by their free clinics for veterans and the Give Kids a Smile program, which annual provide more than $100,000 of free dental service to valued constituencies, as well as their work at the WE CARE Clinic in East St. Louis,” Pembrook said.

“We wish Bruce and his wife, Cindy, best wishes as they plan for retirement in 2022,” Pembrook said.

Rotter was SDM associate dean for academic affairs for six years prior to serving as interim dean. He joined the SDM faculty as an assistant professor in 1993 and was named associate professor in 1997 and professor in 2009.

During that time, Rotter created and administered one of the first implant fellowship training programs in the country, SDM said. That program led to the creation of a freestanding implant clinic that he designed, helped develop, and directed.

Other career highlights include:

• Led the school through reaccreditation from the Council on Dental Accreditation (CODA) three times
• Appointed Cornell Thomas, DDS, as SDM chief diversity officer and director of the Office of Diversity, Equity, and Inclusion to increase concentration on diversity, equity, inclusion, and well-being in January 2021
• Was elected vice chair of CODA in November 2020
• Launched the SDM clinical endodontic training graduate program in November 2020
• SDM received a $2 million grant from the Illinois Children’s Healthcare Foundation in April 2019 to build a medical operating suite with general anesthesia capabilities for children with special dental care needs within a new Advanced Care Patient Clinic
• Showcased SDM’s renovated clinic in University Park on the Edwardsville campus in February 2017, expanding the scope of SDM’s available care, providing that care to a greater demographic, and ensuring an even higher level of training to SDM students
• SDM’s new and expanded presence in Alton earned an Award of Achievement from Pride, Incorporated, a local nonprofit organization dedicated to community beautification, in March 2014, recognizing the construction of the school’s Multidisciplinary Simulation Laboratory and adjacent space, an 18,000-square-foot, $9.5 million project

Throughout his academic career, SDM said, Rotter continued to be active in the private practice of oral and maxillofacial surgery to maintain his knowledge and skills while bringing that experience to the academic setting.

Rotter worked with Southern Illinois Oral and Maxillofacial Surgery in Belleville and Glen Carbon from 2002 until his appointment as dean. He also has served the Veterans Administration Medical Center in St. Louis as an oral and maxillofacial surgeon and/or a consultant since 1994.

A member of 15 dental professional associations, Rotter has been elected to fellowship by the American College of Dentists, the International College of Dentists, and the American Association of Oral and Maxillofacial Surgeons.

Rotter also has been associated with more than a dozen hospitals throughout his career including affiliations with St. Anthony’s Medical Center in Alton, Belleville Memorial Hospital, Healthsouth Surgical Center in Belleville, and the Veterans Administration Medical Center in St. Louis.

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Children from lower-income backgrounds and who experience greater adverse childhood experiences get their first permanent molars earlier, according to researchers from the University of Pennsylvania and the University of Missouri-Kansas City.

Neuroscientist and assistant professor Allyson Mackey, PhD, of Penn’s Department of Psychology began the study by asking whether the arrival of these teeth might indicate early maturation in children.

“I’ve long been concerned that if kids grow up too fast, their brains will mature too fast and will lose plasticity at an earlier age. Then they’ll go into school and have trouble learning at the same rate as their peers,” said Mackey, who studies brain development. “Of course, not every kid who experiences stress or [is] low income will show this pattern of accelerated development.”

Mackey then thought that a scalable, objective way such as a physical manifestation could indicate how children embodied and responded to stresses in their world. Eruption timing of the first permanent molars proved to be just that, the researchers said.

Generated initially from a small study and replicated using a nationally representative dataset, the study’s findings align with a broader pattern of accelerated development often seen under conditions of early life stress, the researchers said.

“It’s really important for us to understand how to detect early maturation sooner,” said Mackey. “Right now, we’re relying on seeing when kids hit puberty, which might be too late for some meaningful interventions. If we can inexpensively see that a child is experiencing this maturation earlier, we might be able to direct more intervention resources toward them.”

Broadly speaking, the University of Pennsylvania said, Mackey’s lab studies how the brain changes and grows as people learn. It has been well established that stress during childhood accelerates maturation and that children who hit puberty earlier are at greater risk for both physical and mental health problems in adulthood, the university continued.

Beyond that, in studies across primate species, molar eruption has been used to measure childhood length and correlates with a number of other developmental events, the university said. Similarly, for human beings, the timing of dental events often plays a role in estimating biological age.

“That all made molar eruption a compelling developmental indicator,” said Penn doctoral student Cassidy McDermott, who is training to be a clinical psychologist.

It helped that more than a hundred children between the ages of 4 and 7 had been participating in two Penn brain development studies that included structural and functional MRI scans.

“There’s on type of MRI scan called a T2 weighted scan where you can visualize the morphology of the tooth pretty well,” said McDermott.

These scans, which typically are used to look at the brain, showed the researchers just how close these molars were to breaking through the gumline. Once Mackey and McDermott realized this, they partnered with Penn Dental Medicine student Katherine Hilton and Department of Oral Medicine professor Muralidhar Mupparapu, DMD, MDS, to develop a novel scale to precisely rate each tooth’s position.

“The scale ranges from one to four,” said McDermott. “At the low end of the scale is one, which is before the tooth has really developed at all. As the tooth emerges, there are intermediate stages, and the highest rating, a four, is when the tooth is fully in the mouth and parallel with the other teeth.”

Four molars each received a score, which then got averaged, leaving a single score per individual. Controlling for factors like age and gender, the researchers than looked for associations between early environment and molar eruption.

“What we found is that income and adverse childhood experiences are both individually associated with molar eruptions status,” said McDermott.

The researchers derived their findings from just 117 participants, they said, so although the correlation was clear, Mackey and McDermott hoped to replicate what they’d seen.

Collaborators at the University of Missouri-Kansas City told the Penn researchers about the National Health and Nutrition Examination Survey (NHANES), which is a large and publicly available population-representative dataset that includes dental data, demographic data, and family income, among other measures.

“Because our sample is only from one city and is much smaller than a population-representative study like that, we saw it as an opportunity to verify that the findings exist outside of what we had collected in Philadelphia,” McDermott said.

Some facets differed. For example, NHANES measures dental development a little differently. But the models showed similar results, indicating a connection between lower family income and earlier first molars.

Whether this overall trend is new or just now coming to light is something Mackey wants to study further. She also is curious about when the rate of maturation gets set.

“Is it as early as in utero or is it dynamically adjusted based on stressors in the world?” she asked. “If it’s the later, that tells you there are more opportunities to intervene.”

There are still significant unknowns as well as findings that need further examination, Mackey said. For instance, the researchers found racial disparities in this timing, with first molars emerging in Black children sooner than in White children.

“These race differences in molar eruption have been known for a long time, but no one thought critically about where the come from,” said Mackey. “It’s consistent with higher levels of stress due to structural racism. This is a clear indication that it’s not just speculation that experiences with racism can cause stress and early aging. They are having an effect on kids that we can’t ignore.”

For all children, more than a year of pandemic-driven grief and social isolation most certainly amplified stress levels, making it even more important to understand who is at greatest risk for early maturation, Mackey said. However, the researchers emphasize that molar timing shouldn’t become another parental fear.

“What I really don’t want is for parents to either worry or feel complacent just based on when their kids get their molars,” said Mackey. “We don’t have those data yet.”

The Penn researchers said they are working on it. They hope to collaborate with dental offices to recruit children into studies based on their molar-eruption status. The goal would be to follow them into adulthood to get more information on what precisely early first molars may indicate.

“If this is the meaningful discovery that I think it is,” Mackey said, “I would love for many scientists to jump on board and test these hypotheses.”

The study, “Early Life Stress Is Associated with Earlier Emergence of Permanent Molars,” was published by the Proceedings of the National Academy of Sciences of the United States of America.

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