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Oral Disease: Talking To Children About Tobacco

Over the past several decades, the number of adult smokers has substantially declined, however, the number of youths who smoke has remained unchanged. More disturbing is the fact that the use of snuff (also called chewing or spit) tobacco has tripled.

Tobacco use is the largest avoidable cause of death and disability in the United States. A tobacco-related illness or condition is the cause of 25% of all deaths in the United States. On average, each smoker who dies would have lived another 15 years if he or she were a non-smoker.

Smoking causes or contributes to the following diseases and conditions:

• Lung cancer
• Laryngeal cancer
• Esophageal cancer
• Oral and oropharyngeal cancer
• Cervical cancer
• Bladder cancer
• Pancreas cancer
• Kidney cancer
• Heart disease
• Emphysema
• Chronic bronchitis
• Stroke
• Slows wound healing
• Slows illness recovery

More than 9,000 individuals die each year from oral and oropharyngeal cancer. The risk of having oral and oropharyngeal cancer is much greater among tobacco users. Over 90% of people with oral and oropharyngeal cancer are tobacco users. The mouths of tobacco users have more red and white patches and nodules, sores, and ulcers that could be oral and oropharyngeal cancer. Tobacco users also have a higher incidence of gum disease, coated tongue, cavities, wearing of teeth, and gum recession.

Also consider that about 3,000 children begin to smoke each day. Approximately 90% of new smokers begin before age 20, and children and adolescents who smoke become addicted faster than adults do. Nicotine, a drug found in all forms of tobacco, is very addictive.

Pregnant women who smoke have a higher risk of having an unhealthy baby than those who do not smoke. New mothers who smoke put their babies at risk for sudden infant death syndrome (SIDS), poor lung development, asthma, and infections.

Tobacco use occurs in the form of cigarettes, cigars, or smokeless (spit) tobacco. Kids need to be educated about the harmful effects of tobacco. Bring up the subject of tobacco use. This can be done when you see or hear things about tobacco on TV, on advertisement billboards, t-shirts, hats, or in magazines. Explain that buying tobacco is a waste of money and that the tobacco companies target advertisements toward young people in order to hook another generation of tobacco users. Tell them tobacco kills about a half million people each year. More people die from tobacco-related illnesses than from car accidents, alcohol, AIDS, suicides, homicides, fires, and illegal drugs combined. Let kids know that tobacco use will stain teeth and dental fillings, cause their clothes and hair to smell, cause tooth decay, tooth loss, gum disease, bad breath, and will dull their sense of taste. Young people may be more receptive to the fact that their boyfriend or girlfriend may think they have bad breath or stained teeth than the number of deaths caused by tobacco use. Tobacco use does not improve athletic ability, increase popularity, or make one appear grown-up.

by Denise J. Fedele, DMD, MS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Tooth Care: Space Maintainers

What happens when a primary (baby) tooth is lost too early? An appliance called a space maintainer will be recommended by your pediatric dentist. The area of the mouth and the age of the child will determine the need for and type of space maintainer.

The primary teeth save the space for the permanent teeth. The 20 primary teeth are replaced by 20 permanent teeth. The six-year molars, twelve-year molars, and wisdom teeth will erupt (come in) in the back of the jaw. The bone will begin to grow around five years of age to make room for these teeth. If a primary tooth is lost before the permanent tooth is ready to erupt, other teeth will drift or tip into the empty space. This may block out the spot for the permanent tooth that replaces the primary tooth. The space maintainer will hold the teeth in their proper position.

Primary teeth may be lost early because of decay, crowding, injury, or improper eruption of the permanent teeth. Most space loss occurs during the first six weeks after the loss of the tooth. This may continue over the next six months. A space maintainer should be placed before this loss occurs. Sometimes, space loss cannot be avoided and your dentist can only attempt to preserve the remaining space.

There are many types of space maintainers, but two are most often used. The band and loop is used to hold the space for one tooth. The lingual arch is used to hold the space for two or more teeth that have been lost from both sides of the jaw.

If a primary molar is prematurely lost and the six-year molar has not yet erupted (come in), the parent must watch closely for the eruption of the six-year molar. This is very important because the six-year molar will rapidly tip or drift forward causing space loss. The teeth that replace the first and second primary molars ordinarily do not erupt until between nine and eleven years of age. The six-year molar must be partially erupted to make the space maintainer for early loss of a second primary molar.

Space maintainers are usually made with orthodontic bands and wires. Two appointments are necessary. During the first dental appointment, an orthodontic band is fitted on the tooth next to the space. An impression is taken. Next, the band is removed from the tooth and placed in the impression. A mold of the teeth is made with the band on the tooth. A laboratory will custom make an appliance to exactly fit the space. During the second appointment, the appliance is cemented in place.

The space maintainer is not removed until the permanent tooth begins to erupt. The parent must be sure to tell the dentist when the permanent tooth is erupting. If the space maintainer is not removed at the proper time, the permanent tooth may come in improperly. Your dentist will inform you of the age when your child's permanent tooth will likely appear. Early tooth loss may cause the permanent tooth to be delayed in its eruption or to erupt earlier than expected.

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.