Fluoride Action Network

Factors eat away at area’s dental health

Source: The Herald-Dispatch | March 7th, 2009 | By LAURA WILCOX

HUNTINGTON — From soda in sippy cups to Mountain Dew before dentist appointments, Huntington dentist Dr. Scott Edmonds has seen a lot in his five years of practice. Three years ago, he made a complete denture set for a 15-year-old boy.

“I couldn’t believe it. I was appalled,” he said.

Experts say a lack of education, poor nutrition and widespread soda consumption contribute to bad dental health across the Tri-State. That gained national attention last month when ABC Television aired a “20/20” report by Diane Sawyer that focused on poverty and included what has become known as the “Mountain Dew mouth” epidemic in nearby eastern Kentucky.

Kentucky dentist Dr. Edwin Smith said he has seen the rampant tooth decay known as “Mountain Dew mouth” for years.

In his 20 years of practice, he has repeatedly asked kids with cavities along their gum lines about their eating and drinking habits. He said 90 percent of them reported drinking a lot of Mountain Dew.

Smith said he’s not bashing the soda, but the way many people drink it should be addressed. Many people will sip on the highly caffeinated and acidic drink all day, every day, he said.

He said the bacteria feed off of the drink’s sugar and produce acidic waste that weakens the enamel and leads to tooth decay.

Pepsi spokesperson Larry Jabbonsky said Friday that education is key and the company has committed to work with Smith. Pepsi plans to give the Kentucky dentist an additional van for his Kids First Dental Care mobile dental program as well as work with schools and nonprofit organizations across the U.S. to encourage healthy lifestyles. He said Pepsi does not advocate consumption of its products as portrayed on “20/20.”

“Wherever we do business, education about health and nutrition and the proper consumption of our products is paramount,” Jabbonsky said.

Pepsi also continues to provide healthier products and offers a wide range of sugar-free and caffeine-free products, he said.

Nevertheless, area dentists say the common consumption of many types of soda and sugary drinks hurts children across the region.

Smith once looked out his office window to see a mother with a cigarette in her mouth pouring soda into her toddler girl’s sippy cup. He’s seen it inside his office, too, with parents giving children Mountain Dew in the waiting room. He has treated some preschoolers who had decay in every tooth.

Soft drinks aren’t the only problem. Edmonds said juice or milk also can be harmful, as many parents put their children to bed with bottles.

A lack of dental care knowledge is common across West Virginia, according to Dr. Richard Meckstroth, dentist and chair of the department of dental practice and rural health at West Virginia University.

“What goes in a baby bottle is atrocious sometimes. Pop and sugary juices — they put them to bed with it. It just lays and pools in their teeth,” Meckstroth said. “The teeth just don’t have a chance.”

He said some parents think bedtime bottles are OK because baby teeth fall out, but disease in baby teeth can be passed on to permanent teeth.

Toddlers aren’t the only ones sipping on soda, though.

One local dental health educator recalls visiting an area elementary school when she noticed something surprising.

“The kids all had either soda or sweet tea on their desks,” said Bobbi Jo Muto, community oral health coordinator for the Robert C. Byrd Center for Rural Health at Marshall University.

A teacher told Muto the kids were allowed to bring in drinks because the school’s water fountain was bad. After talking to Muto, the teacher said she’d advise the students to bring water.

Muto said seeing an elementary-age child carrying a liter of soda is not uncommon. Part of the problem is economic, she said, with a two-liter bottle of soda less than $2 and a gallon of milk almost $4.

“Which are you going to pick if you are on a limited income?” she said.

Experts say many factors contribute to bad teeth, including a lack of fluoride, access to care and preventive action.

Children in communities with water FLUORIDATION experience 29 percent fewer cavities, according to the Robert C. Byrd Center for Rural Health. Only 12 of the state’s 55 counties have at least 75 percent of their population receiving adequately fluoridated water.

Edmonds said water fluoridation is a factor, but not an excuse.

“With preservatives and additives in food today and if you use toothpaste, you’re going to get the fluoride you need,” he said.

Edmonds said parents also must understand that few bottled water products provide adequate fluoride.

Low Medicaid reimbursement rates add to the state’s problems, Edmonds said. He said many dentists don’t accept Medicaid because it reimburses offices for less than half the cost of services.

Still, many of the children eligible for Medicaid dental coverage aren’t getting services, Muto said.

In 2006, 56 percent of Medicaid eligible children received dental service, according to the U.S. Department of Health and Human Services. In 2007, that dropped to 41 percent.

Meckstroth said getting children to dentists before they have problems is important.

“Once that first appointment is traumatic, then they’re a little afraid to go back. That can set them up for fear of going to the dentist for the rest of their lives,” he said.

Only 31 percent of West Virginia children visit a dentist regardless of income level, according to West Virginia Partners for Oral Health.

Meckstroth said dental disease doesn’t hurt until it’s advanced.

“Once you start having pain as a result of dental disease, it’s quite involved and it can be expensive. If you’re waiting for a child to tell you that they have a problem, you’ve waited way too long,” he said.

Sixty-six percent of West Virginia children have cavities by age 8, according to the Robert C. Byrd Center for Rural Health.

Meckstroth said the new Head Start Dental Home Initiative will get more children into dentists’ offices sooner.

The American Academy of Pediatric Dentistry and the Office of Head Start will launch the program to provide quality dental homes to Head Start children in West Virginia and 11 other states this spring.

Smith said a Head Start dental program already exists in Kentucky and has influenced positive changes in children and adults.

“Education is the bottom line. As people get educated and know better, they are going to do better,” he said.

Experts say efforts must be stepped up by dentists, educators and parents. Meckstroth said parents need to take their children to see dentists earlier, get them to brush their teeth better, and be aware of their diets.

Muto has three children and still helps her 9-year-old brush his teeth.

“They’re too young to be accountable at that age,” she said. “You have to make a decision that you’re going to be responsible for your kid’s health.”

Meckstroth said part of the problem reflects priorities.

“People say they can’t afford dental care, but there’s plenty of hunting rifles, four-wheelers,” he said.

He said another factor is tobacco, which is expensive and damaging to the mouth.

Muto said prevention should be a top priority.

“If we can just make people realize they don’t have to lose their teeth. They don’t have to have a cavity. It’s 100 percent preventable and yet we have all these children with rampant decay,” she said.

West Virginia dental statistics

61.5 percent of West Virginians visited the dentist or dental clinic within the past year.

31 percent of West Virginia children visit a dentist regardless of their income level.

42.9 percent of the population 65 or older have lost all of their teeth.

66 percent of children have cavities by age 8.

33 percent of 15-year-olds have untreated decay compared with the national average of 20 percent.

By age 8, only 37 percent of children have received protective sealants.

Sources: Centers for Disease Control and Prevention and the Robert C. Byrd Center for Rural Health at Marshall University