By Lory Laughter, RDH, BS
We have all been in the situation of overhearing a conversation that does not involve us, yet we know our input is greatly needed. Our dental knowledge and science-based insight might not be sought at that moment, but sharing it is vital to our sense of sparing the world of dental disease. This very thing happened to me in line at the grocery store, and as hard as I tried, I could not keep quiet.
A well-meaning mother was explaining to another woman that her child could not go to sleep without a bottle, and if the child didn't sleep, no one slept. The other woman, who I assume was her friend, explained that almond milk would not have any effect on cavities for the child because it was a different sugar. My uninvited input, though scientifically correct, was met with resistance and annoyance. I was not intimidated about trying to explain the harm of baby bottle tooth decay to unreceptive strangers, yet the response from these women took me by surprise.
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After asking me if I even had children (I had to laugh), the almond milk advisor told me she got her information from a well-respected parenting blog, and then asked where I got my misinformation. My four-year university education and 20 years of late night insomnia-induced research did not impress her in the least. I was told to get online and update my education.
When undertaking my directed task, it occurred to me that laypeople need resources they can understand, not the studies written in dental jargon with really long bacteria names. I set forth to find quality research written and published in sources most parents can find, read, and apply to daily life.
As dental professionals, our first step in a journey for information often starts at PubMed.1 Knowing that clinical practice cannot be based on abstracts alone, I encourage my peers to seek full-text articles or subscribe to receive full articles. PubMed has great information on early childhood caries (ECC), most of which makes for good naptime reading for the nondental parent. While I would like every parent and health-care provider to read the International Journal of Dentistry's 2011 article regarding ECC and prevention,2 I know this is not a reality.
Another aspect of ECC of interest to professionals but not the general public is the association between poverty and decay in children. This is a touchy subject to discuss among professionals, much less a stranger needing guidance. Several studies point to socioeconomic factors influencing ECC.3,4,5 Often the low socioeconomic status information is buried deep in a research publication. Reading rather than scanning is imperative.
DentaQuest Institute is in Phase 3 of their Early Childhood Caries Collaborative, and the work being done and results reported should change the way we deliver dental care to children. Parents and health-care professionals alike will benefit from taking time to study this report6 and continuing studies.
Parents will benefit more from articles specific to their questions about childhood caries rather than from research written for professionals in strict publication guidelines. A keyword search for early childhood decay brings up several blog sites written by parents, dental practices, or alternative health practitioners. Some of these sites may contain correct and valuable information, but a vast majority is written from personal experiences and anecdotal instances. Providing reliable resources is now part of our occupation.
Medline Plus is a good source of health information, and one I often recommend to patients.7 A helpful article addressing childhood tooth decay on this site gives parents fact-based tips for decreasing decay and promoting oral health in children.8 There is no hype or outlandish claims in the article, but the information is well written and the suggestions are easy to follow. I am adding this one to my resource list for new parents.
Wikipedia is seldom my go-to source for health-care information, but their description of ECC is quite good.9 The article relates the disease in terms known by the general population, such as baby bottle tooth decay and bottle rot. Just enough science is given for reliability, and a focus on sugar intake quantity and frequency is a big focus. The article also mentions xylitol, though it does not link to any other articles or even mention where to find xylitol information.
A Yahoo! search yielded other sites parents may find useful in their quest to prevent caries. While not all are written by scholars or dental professionals, they contain valuable information and dietary guidance.10,11,12 Not one promotes almond milk as a healthy nighttime bottle ingredient.
Guiding parents to reliable sources is extremely important. Without guidance or professional input, sites with miracle cures catch their attention and hold their interest. One site I ask parents and patients not to visit, or to visit only for unverifiable rhetoric, claims to heal tooth decay with no professional intervention. In fact, parts of the site13 suggest a dental visit could do more harm than good.
It fascinates me how a wealth of information is available on demand and can even be accessed by a small smartphone I carry in my pocket. The age of instant information helps with patient education and recommendations for further study. Unfortunately, it also offers a place for misinformation to spread like wildfire. Our role, our duty, is to share verifiable, reliable, and sound research and results with those we educate. Using modern technology to accomplish the task is icing on the cake.
Websites referred to in this column
1. http://www.ncbi.nlm.nih.gov/pubmed/
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191784/
3. http://www.ncbi.nlm.nih.gov/pubmed/21551940
4. http://www.ncbi.nlm.nih.gov/pubmed/24619785
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328230/
6. https://www.dentaquestinstitute.org/learn/quality-improvement-initiatives/early-childhood-caries-ecc-collaborative
7. http://www.nlm.nih.gov/medlineplus/
8. http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm
9. http://en.wikipedia.org/wiki/Early_childhood_caries
10. http://www.dentalhealth.ie/dentalhealth/nutrition/earlychildhoodc.html
11. http://www.lalecheleague.org/llleaderweb/lv/lvaprmayjun06p27.html
12. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-at-Any-Age/Infants-and-Children/Toddler-Child-Transitional-Care/article/Oral-Health-for-Children.cvsp
13. http://www.yourreturn.org/Baby-Tooth-Decay/ecc-controlling-diet.htm
LORY LAUGHTER, RDH, BS, practices clinically in Napa, Calif. She is owner of Dental IQ, a business responsible for the Annual Napa Dental Experience. Lory combines her love for travel with speaking nationally on a variety of topics. She can be contacted at [email protected].
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