The good news is that parents today are increasingly interested in promoting good dental health for their children. The bad news is there are so many things to worry about, from what’s the best toothpaste to when to expect the first baby tooth, that it can be overwhelming. Let’s take a look at a couple of hot topics that parents frequently ask about when it comes to their child’s dental health.

Xylitol’s Relation to Cavities

Xylitol is a naturally occurring sugar substitute made from a sugar alcohol. It’s widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwood trees, and corn cobs. One cup of raspberries contains under a gram of xylitol.

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol related to the oral health of infants, children, adolescents, and persons with special health care needs. According to the U.S. Food and Drug Administration, scientific research confirms that xylitol, unlike other sweeteners, does not cause cavities. For this reason, it is now being used in a variety of specialty and mass-market gum products commercially available in the United States.

Many mainstream chewing gum companies such as Trident and Wrigley’s Orbit, are now putting very small amounts of xylitol in their products with potentially beneficial results. Also, health food stores and online resources offer gums with higher amounts of xylitol, which are claimed to be even more effective in reducing tooth decay.

We are also seeing an increase in pediatric clinicians who recommend xylitol use for patients with a moderate or high risk for caries. Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.
Finally, studies suggest that xylitol therapeutic intake ranging from 4-20 grams per day and divided into 3-7 consumption periods, consistently produced positive results. Higher intake did not result in greater reduction of decay and may even lead to diminishing results. Similarly, consumption frequency of less than three times per day showed no effect.

Fluoride – How Much is too Much?

Fluoride is an element which, in the right amount, has been shown to be beneficial to teeth. However, too little will not be effective inpreventing cavities, while excessive fluoride ingestion by very young or preschool-aged children can lead to dental fluorosis, causing a chalky white to brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride intake can help parents prevent the possibility of dental fluorosis.

Children ages one to three years may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride while brushing their teeth. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

In addition to toothpaste, certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the labels and contact the manufacturer if you have concerns. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents should take the following steps to decrease the risk of fluorosis in their children’s teeth:

• Use baby tooth cleanser (training tooth paste with no fluoride) on the toothbrush of the very young child that cannot spit it out.
• Place only a pea-sized drop of children’s toothpaste on the brush of little ones who are still learning how to spit appropriately (usually between 3 and 5 years of age).
• Account for all the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
• Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
• Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

Parents should ask their pediatric dentist or pediatrician about fluoride supplementation when:

• They are on well water. Well water does not usually have the appropriate amount of fluoride.
• They have a reverse osmotic or other high tech water filter (check with manufacturer to see if fluoride is filtered out).
• They live in rural counties that do not add fluoride to the city water.

*****Ask your pediatric dentist if you have concerns or want to know more about either xylitol or water fluoridation.