Heart Healthy, Healthy Smiles and More! National Children s Dental Health Month! Smile Smile Smile INSIDE

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1 INSIDE National Children s Dental Health Month Oral Health Matters to School Success! Tips for Parents from the American Dental Hygienists Association American Month and Dental Health Activities: Cape Crusade Week for Congenital Heart Disease Pre-K to 1st Grades 2 to 4 Grades 4 to 6 Fun Activities Jennie M. Fleming, RDH, BS, MEd, Editor Winter 2015 Heart Healthy, Healthy Smiles and More! February is National Children s Dental Health Month and American Heart Month. We all know someone who may be affected by health and/or dental issues, but we may not be aware of the connection! Learning more about the oral health-systemic-health connection helps reveals how good oral health can also help keep you healthy overall! School nurses, clinic staff, counselors, and teachers can help get this message across, not only to your students and their parents, but also to your fellow staff members. Surgeon General [Ret.] C. Everett Koop informed Americans that, You can't have good health without good oral health." You can make a difference! The mission statement of the Georgia Department of Education is:... to promote student achievement and preparation for global competitiveness by fostering educational excellence and ensuring equal access. A healthy smile is necessary for the ability to learn by being able to pay attention in school. It is linked to a good self-image, employability, social mobility, acceptance, and interpersonal relationships. Oral Health matters! Healthy Smiles are Happy Smiles! National Children s Dental Health Month! February celebrates National Children's Dental Health Month, which helps raise awareness about the importance of oral health to overall health! Tooth decay is the most common chronic disease in childhood. It s almost entirely preventable. Approximately, 1 out of 5 children aged 5 to 11 years have at least one untreated decayed tooth. For ages 12 to 19, it is 1 of 7. In recent years, tooth decay has increased in preschool age children even though the overall rate has decreased over the past four decades. Preventive measures can protect teeth and are safe and effective. Good daily home-care such as brushing well with fluoride toothpaste and flossing can help prevent cavities. Visiting the dentist for check-ups twice a year not only helps prevent cavities. It also helps to catch them early before a large filling or more is needed. Health department dental professionals recommend the use of dental sealants. Sealants are thin plastic coatings painted on the chewing surfaces of the back teeth filling in the deep pits and fissures where bacteria and food are easily trapped. They are cost effective and are a non-invasive service which help children get through the cavityprone years until they can readily take care of their own dental hygiene needs. Smile Smile Smile Your county health department has low-cost dental clinics for children. We also have a nocharge, In-school dental prevention program providing sealants and other services available for elementary schools with 50% and higher participation in the Free and Reduced Lunch Program. Our dental hygienist holds a Master of Education Degree and provides classroom dental health education and tobacco awareness presentations at no cost. Tooth brushes and activity sheets are also provided. For more information, Jennie.Fleming@gnrhealth.com.

2 Page 2 Oral Health Education Matters to School Success Fifty-one (51) million school hours a year are lost because of dental problems. When a child s oral health suffers, so does his ability to learn. We know that poor oral health can have detrimental effects on a child s quality of life, his school performance, ability to speak properly, and life success. For millions of children, persistent dental pain is a reality every day with dental abscesses, headache, facial pain, difficulty chewing, and self esteem issues because of the odor, tooth discoloration, and obvious damage. This constant pain causes the inability to pay attention at school leading to learning distraction. These children are unlikely to score as well on tests. Children from low-income families are 4x more likely to suffer toothaches within the last 6 months than other children. Grade point averages in this group tend to be below 2.8. Children in low-income families are 6x more likely to miss school because of oral health problems. When their dental problems are treated and their pain is eliminated school attendance and learning improves.¹ Oral health education should be part of the yearly curriculum. Students and parents need to know about good health habits, services available in school-based oral health programs, and low-cost dental services either in health department dental clinics or other dental offices. Curriculum required for health and PE courses should include dental and facial injury prevention, not only for the children and their families, but staff members as well. Injuries of this nature can result in aesthetic, social, psychological, and therapeutic problems, some of which may be permanent. One in 14 children/adolescents between ages 5 to 14 years suffer from these types of injuries. Fractured teeth can impact socialization skills and self esteem issues among ages 12 to 14 and into adulthood. The classroom provides a great place to teach the importance of oral health in regards to overall health: Incorporate this information into lesson plans in math, reading, writing, social studies, health and science. Provide a water break to allow children to sip, rinse, and swallow which will help preventing cavities by clearing the mouth of food particles causing bacterial acid attacks. (Your health department dental clinic may also have classroom fluoride-rinse programs available at no cost to the child.) Invite dental professionals to come and speak to their classes. Health department dental staff are wonderful resources for oral health information and have experience working with children. The state public health dental clinics are targeted towards children. Classroom and group presentations may include free toothbrushes, supplies, and/or dental activity sheets and include subjects on: Oral Hygiene and Nutrition Tobacco and Drug Awareness First Aid for and Prevention of Dentofacial Injuries Oral Fad Awareness and Dangers including Piercings and Tattoos High School Parenting Classes regarding the importance of oral health for moms and babies Career Day to help interested students learn more about oral health-related careers. Dental Prevention Services Programs may be available for your school offering dental screenings, dental pit and fissure sealants, fluoride treatments and possibly cleanings at no charge or lower cost for your students. General health and oral health are linked. You can t have one without the other.² Poor oral health, not only affects learning ability, but may also may be related to school performance numbers. Providing oral health education in your classroom is as important as the rest of the subjects. 1. Oral Health and Learning Factsheet. CDC: 2. Oral Health in America, A Report of the Surgeon General, 2000: Sugarless Valentine s Day Treats Celebrate with hand-made valentines Give: heart themed toothbrushes, activity sheets, stickers, pencils, bookmarks, heart-shaped erasers, etc. Xylitol based treats are natural cavity fighters and are diabetic friendly. Candies, lollypops, and mints are available. Xylitol can be purchased by the pound and used just like sugar if you d like to bake your own treats. For more information regarding Xylitol, read the American Academy of Pediatric Dentistry s Policy on the Use of Xylitol in Caries Prevention : (As with any sweets, too much can cause issues. Diarrhea has been reported in patients who have consumed three to 60 grams of xylitol per day.)

3 Page 3 Tips For Parents from the American Dental Hygiene Association ADHA Emphasizes Early Education and a Proper Oral Health Regimen In observance of National Children's Dental Health Month (NCDHM), the American Dental Hygienists' Association (ADHA) emphasizes the importance of early education on a proper oral health regimen. This focus builds upon October s National Dental Hygiene Month message, "It's Simple. Healthy habits for a healthy smile." "Educating children on the importance of their home care, and teaching proper brushing and flossing, creates a routine of healthy behavior that kids can continue into adulthood," said Pam Quinones, RDH, BS, ADHA President. "Teaching kids at a young age sends the message that oral health care is important, and this message will have a tremendous impact on their oral and overall health for the rest of their lives. It really is a simple matter of creating habits that keep your mouth, and your entire body, healthy." To prevent cavities and gum disease, affecting millions of Americans including children, good oral hygiene routines should be established as early as infancy and continued throughout life. Some tips for parents include: Even before teeth begin to erupt, thoroughly clean your infant's gums after each feeding with a water-soaked washcloth or gauze pad to stimulate the gum tissue and remove food. When the baby's teeth begin to erupt, brush them gently with a small, soft-bristled toothbrush using a pea-sized amount of fluoridated toothpaste. A small amount of fluoridated toothpaste will help to inhibit decay. Fluoride is also found in some foods, in mouth rinses, and community water supplies. At age 2 or 3, begin to teach your child proper brushing techniques. You will need to follow up with brushing and gentle flossing until age 7 or 8, when the child has the dexterity to do it alone. Change your child's toothbrush 3 to 4 times a year, and after every illness to avoid bacteria and germs. Limit the amount of sugar children eat by encouraging them to eat fruits and vegetables for snacks instead of candies and cookies. Also, limit snacking between meals, and make sure they brush afterward. Determine if the water supply that serves your home is fluoridated. If there is not fluoride in your water, discuss supplement options with your dental professional or pediatrician. Set a good example for your child by brushing, flossing and eating healthy foods, and scheduling regular oral health visits for yourself. Continually remind your child about the benefits of good oral health and stress that good nutrition helps maintain it. Schedule regular oral health appointments starting around your child's 1st birthday. Instilling proper oral habits is vital, but even the best oral hygiene routine needs to be supplemented by regular oral health checkups. As preventive oral health experts, dental hygienists are the best educators when it comes to your children's mouths. During a routine visit, your oral health professional will check for cavities in the primary teeth and watch for developmental problems, as well as help to create a positive experience that may alleviate fear at future visits. Tips for preparing children for oral checkups: Schedule visits to the dental hygienist at a time when your child is likely to be well rested and cooperative. Never mention the words "hurt" or "pain" around your child when discussing an oral health visit. Saying "it won't hurt" instills the possibility of pain into your child's thought process. Do not discuss your own negative experiences in your child's hearing range. Allow and encourage your child to discuss any fear he or she might have about oral health visits.

4 Page 4 February is American Heart Month (The Oral Health Connection) One out of every 4 deaths in America is from heart disease. It is the leading cause of death for both men and women. Approximately, 715,000 have a heart attack and approximately 600,000 people in the US die from heart disease each year. Heart disease refers to several heart conditions. The most common in the US is coronary heart disease (also called coronary artery disease). This occurs when plaque builds up in the arteries that supply the heart causing heart attack, angina, heart failure, and arrhythmias. Children Suffer from Heart Disease, Too Children who have had occasional high blood pressure readings are more likely to develop the condition of hypertension as adults. Childhood obesity, diabetes, inflammation, high cholesterol levels, lack of exercise, congenital heart defects, rheumatic fever, heart murmurs, heart failure, and arrhythmias, are among many causes. ( HEARTORG/Conditions/More/CardiovascularConditionsofChildhood/Cardiovascular-Conditions-of- Childhood_UCM_314135_SubHomePage.jsp ) Some of these causes we can change. One in particular is the inflammation caused by gum diseases including gingivitis and periodontal diseases. Children are Not Immune to Gum Disease Many children have some form of gum inflammation. Their parents may not even be aware of it, especially if they are not supervising or taking part in the child s bedtime brushing and flossing. (Dental professionals recommend that children continue to have assistance and supervision until they are 8 years old.) Some signs of inflammation include gums that bleed during brushing, swollen or puffy gums, gums that have pulled away from the teeth or underlying bone (recession), and chronic bad breath. During puberty, hormonal changes can put children at risk for gum diseases during adolescence. Adolescent gums can become red, swollen, and irritated due to increased blood circulation from higher hormone levels. Greater intake of sugary, acidic sodas, missed meals, poor nutritional habits, dry-mouth from stress or medications a child might be taking - all can add to a higher tendency toward oral inflammation. These conditions are perfect environments for the breeding of the type of bacteria that causes diseases. Establishing good oral health habits are the most important steps to preventing periodontal diseases. Below are four basic steps parents can take to help children maintain good oral health care ( 1. Establish good dental hygiene habits early. a. Begin using toothpaste during brushing when the child is 12 months old. b. Start flossing when the gaps between the teeth close. 1. Be a good role model by practicing good dental hygiene habits. 3. Schedule dental visits for family checkups and cleanings regularly. 4. Check your child's mouth regularly for the signs of periodontal disease including: a. Bleeding gums b. Swollen and bright red gums c. Receding gums which are pulling away from the teeth d. Bad breath The Oral Health Connection: Your mouth contains mostly harmless bacteria and the body's natural defenses along with daily brushing and flossing can help keep these bacteria under control. But, they can sometimes grow out of control and the harmful ones can cause tooth decay and gum disease among other problems. This harmful bacteria can also enter your bloodstream if the normal balance of bacteria in your mouth changes or the mouth's normal protective barriers are broken. A dry mouth can help this bacteria break through by allowing places in the mouth to crack or bleed. If an infection gets into your heart or if you have a damaged heart valve, it may infect the inner lining of the heart causing endocarditis. Some studies suggests that oral bacteria from gum inflammation (periodontitis) may be linked to heart disease, atherosclerosis (clogged arteries) and stroke.

5 Page 5 Cape Crusade for CHD Week (Feburary 7-14) Congenital Heart Defect Awareness Week is Feb and to help raise awareness that CHDs are among the most common birth defect in the U.S. & the leading killer of infants with birth defects, the American Heart Association and the Children s Heart Foundation are asking families to make capes to honor their loved ones that have been affected by CHD and post the picture to their social media accounts. Learn more about the cape design and how to tag your creation by visiting A "congenital" condition exists at birth. The term "congenital heart disease - CHD" is a heart ailment is not a disease, it is a defect or abnormality. A defect results when the heart or blood vessels near the heart don't develop normally before birth. They result when a mishap occurs during heart development soon after conception and often before the mother is aware that she is pregnant. Defects range in severity from simple problems, such as "holes" between chambers of the heart, to very severe malformations, such as complete absence of one or more chambers or valves. Congenital heart defect can also increase your risk of developing certain medical conditions. Any child can be born with a congenital heart defect. Out of 1,000 births, nine babies will have some form of congenital heart disorder, most of which are mild. If you or other family members have already had a baby with a heart defect, your risk of having a baby with heart disease may be higher. Virtually all children with simple defects survive into adulthood. Although exercise capacity may be limited, most people lead normal or nearly normal lives. Limitations are common for complex lesions. Some children with congenital heart disease have developmental delay or other learning difficulties. Capes in the CHD community are the symbol of that child being a heart hero. To celebrate those heroes both big and small, this CHD Week (Feb. 7 14th) the American Heart Association and the Children s Heart Foundation are asking families to make capes to honor their loved ones that are living, or that they have lost, to a CHD and post the picture to social media throughout that week using the hashtag #HeartCrusade and #LifeisWhy. Here are some ideas: The capes can be any material you can use an old sheet, fabric, paper get creative! Take pictures of your family making the cape together or have each family member make a cape so everyone is involved! Take pictures of the final product either stand alone or wearing them! Post them with a caption on why you re supporting a heart hero and use the hashtags when posting.

6 Page 6 American Dental Association Activities (Pre-K through 1st) Talking About Teeth Why Teeth Are Important? Display pictures from magazines that show people smiling, eating, talking. Ask the children: What are these people doing with their mouths? Possible Responses: Eating, talking, smiling, chewing, etc. Ask: Could you smile without a mouth? What do your teeth do for your smile? Possible Responses: Teeth make your smile look nice; make you look happy Have children pronounce the words 'teeth' and 'toothbrush.' Then have them try to say these words without their tongues touching their teeth. Ask: them to say the word 'smile.' Then ask them to try to say 'smile' without their upper and lower teeth touching. Ask: What other words would be hard to say if you didn't have teeth? (Examples are words beginning with S, L, and D.) Ask: What is your favorite food -or- What do you like to eat for dinner? Make a list of some of these. Ask: Which of these foods could be easily eaten without teeth. Which ones must be chewed? Ask: How many of you have baby brothers and sisters? How many teeth do they have? Is a baby's food different from the food you eat? Talk about this. Keeping Teeth Clean Ask: What are some of the things you do to keep yourself clean? Possible Responses: Take a bath; wash hair; wash hands Ask: Why do we need to clean our teeth? Possible Responses: To get rid of germs; so we don't get cavities; because it feels better to have a clean mouth Explain: Some germs in our mouth stick to the teeth. This is called plaque. We can't see plaque. It's 'invisible.' Plaque can cause a cavity (a little hole in the tooth). So we want to clean plaque away. Ask: How can we clean teeth? Answer: Brush them. Floss. Show how to brush teeth (using large toothbrush and mouth model): How we brush our teeth: gently, back and forth, getting to all sides of our teeth. Use just a tiny bit of toothpaste. Spit it out after brushing. Brush 2 times each day. Note: Pre-school children are not yet capable of safe and effective flossing. If you choose to talk about flossing and show how it is done, be sure to stress that this is something to do only with the help of their parents. Brushing should be supervised also because an adult should discourage the child from swallowing the fluoride toothpaste. The Dentist and the Dental Helpers Ask: How many of you have visited the dentist? What things did you see when you went there? (As the children identify these things, incorporate information about what each of these is used for.) Possible Responses: Chair that moves up and down (so people of different sizes can sit in it and the dentist can look in the mouths more easily); special light (so the dentist can see your mouth better); small round mirror (to see the backs and sides of teeth); the X-ray machine (to take pictures of teeth); the explorer, or 'tooth feeler' (helps dentist count your teeth and helps find decay). Ask: Who else (besides the dentist) did you see at the office? Possible Responses: Dental hygienist, dental assistant, receptionist. Talk briefly about how they help the dentist. Ask: Why is it important to visit the dentist? Possible Responses: The dentist helps you keep your teeth healthy. The dentist will see if you have a cavity and if you do, may fix it with a filling. To see if we are cleaning our teeth properly, if they are growing properly.

7 Page 7 American Dental Association Activities (Grades 2 through 4) Why is it important to have healthy teeth? There's Magic in Your Smile You have a nicer smile. You make other people happy and feel happy yourself when you can give them a big bright smile. (Ask children to smile at one another or two other children in the room.) Eating is easier and more fun. Can you imagine settling down to watch your favorite T. V. show with a big bowl of popcorn and not having teeth to chew with? Or having a big, juicy, red apple but no teeth? Talking is easier, too. Say, "There's magic in a healthy smile." Now, say it again, only this time don't let your tongue touch your teeth. Pretty tough talk! Your teeth help other people understand you, whether you are giving an answer in class, telling your moms and dads about school, or playing with your friends. What keeps teeth from being healthy? Sticky, colorless PLAQUE is always forming on your teeth. Plaque contains bacteria, or germs. When you eat sugary, sweet foods, the bacteria mix with the sugar and make acid. The acid attacks your teeth, and makes teeth decay. This acid attack lasts 20 minutes unless you stop it! The decay doesn't get better by itself. Only your dentist can get rid of the decay, and place a filling. If you don't go to a dentist, the decay can spread to the rest of the tooth. What can we do to stop the attack? How can we fight the enemy, plaque, and keep our teeth healthy? Brush your teeth twice every day. Floss every day. Brushing and flossing will break up the bacteria and sugar team so they cannot attack your teeth. Your parents may need to help you floss now, but when you're older, you'll be able to floss by yourself every day. Eat nutritious foods from the 5 main food groups --grains, fruits, vegetables, meat/poultry; and dairy products - everyday. 1. Cut down on snacks and sugary beverages. 2. The more often you eat snacks and drink sugary beverages, the more acid attacks you have. 3. Eat and drink sweets with meals. 4. If you must snack, instead of soda, candy, cake or cookies, ask your Mom for some nutritious foods like milk, fresh vegetables, fruit or cheese. Suggested Activities: Use disclosing tablets to demonstrate plaque build-up. (optional) Give each child a toothbrush to practice the correct brushing technique. Give each child a piece of yarn 18 inches long. Have children get a partner and illustrate flossing by using yarn and the partner's hand. One student holds hands together with fingers straight and held tightly together. The other student flosses between the fingers. Ask students to draw a picture of bacteria and the weapons to fight them (toothbrush, toothpaste, floss, etc.) Ask children to name foods from the 5 main food groups (vegetables, fruits, grains, meats/poultry, dairy).

8 Page 8 American Dental Association Activities (Grades 4 through 6) Suggested Introductory Activities: Smile Power Involve the students in a "Dental Health Quiz." Each student will need paper and pen or pencil. 1. If you brushed after breakfast this morning, give yourself two points. 2. If you visited your dentist in the last year, give yourself two points. 3. If you had no cavities at your last visit to the dentist, give yourself two points. 4. If your toothbrush is less than four months old, give yourself two points. 5. If you haven't had a soda pop, candy bar or other sweet snacks today, give yourself two points. If you have 8 or 1O points, you're a winner! These are important things to protect your smile. Today you will find out why. Ask: But first, what would you like to know about dental health? List: their questions on the chalkboard. Refer to the questions as you answer them during the talk; any questions not addressed during your speech can be used as a starting point for the question-and-answer session. Why is it important to have healthy teeth? A. You have a nicer smile. You look better, and feel better about yourself, when your smile is attractive. (Ask students to smile at one or two other students.) B. You enjoy your meals more. Remember what it was like trying to bite into an apple or corn on the cob when your front teeth were missing? C. Talking is easier, too. Say "Teeth are for Keeping." Notice how different parts of your mouth work together to form dif ferent sounds. Now, say it again, only this time don't let your tongue touch your teeth. It's difficult to speak clearly! The ability to be understood by others is important, whether you are giving the right answer in class, calling a friend on the phone, or telling a parent about your last game. D. Healthy teeth are part of being in top physical shape. Did you know that the United States Olympics Team has a pro gram to assist athletes in keeping their mouths healthy? Obviously, an athlete with a dental problem may not play well for the team. What keeps teeth from being healthy? A. Sticky, colorless PLAQUE is always forming on your teeth. B. Plaque contains bacteria. C. When you eat sugary or starchy foods, the bacteria in plaque makes acid. This "acid attack" last 20 minutes. D. The acid causes dental decay (cavities) by making holes in the enamel of the tooth. E. Your body cannot repair all the damage by itself. The dentist must remove the decay and place a "filling." If not treated by a dentist, decay can spread through the tooth. What can we do to fight plaque and keep our teeth healthy? A. Brush your teeth twice a day with a fluoride toothpaste. Just put a pea-sized amount of toothpaste on your brush. B. Floss every day. Brushing and flossing will break up the bacteria and sugar team so they cannot attack your teeth and fluoride in toothpaste strengthens the tooth enamel and makes teeth less likely to decay. What else can we do to protect our teeth? A. Learn what to do in a dental emergency. (Discuss when dental injuries are most likely to occur.) If a tooth is broken or loose, see the dentist immediately. If a tooth is knocked out, find it but don't clean it. Put it in a cup of milk, and get to the dentist right away. B. Wear a mouthguard when playing sports. C. Don't chew pencils or similar objects, or hold them in your mouth. D. Don't smoke or use smokeless tobacco. E. Ask your dentist about sealants, an invisible film a dentist can paint on your teeth to prevent decay. Activities

9 Page 9 (continued) Suggested Activities: Suggested Activities (Grades 4 through 6), continued 1. Bring a few extracted teeth to the class. 2. Soak them in a 5 percent solution of sulphuric acid. The teeth will start to dissolve immediately. 3. Bring a diagram of the parts of the tooth to discuss with the class. Alternative: 1. Use a washed chicken bone and soak in vinegar or a soft drink (particularly a cola) for about a week or more. The tooth will become week rubbery. 2. Compare and contrast to what soft drinks can do to teeth. Discussion: 1. Cut down on snacks. 2. The more often you eat snacks, the more "acid attacks" you have. 3. If you drink or eat sweets, do so with meals. 4. If you need a snack, choose nutritious foods like fresh vegetables or fruit or cheese. Suggested Activities: 1. Use disclosing tablets to demonstrate plaque build-up. (optional) 2. Give each child a toothbrush to practice the correct brushing technique. 3. Show students how to floss. Give them floss and allow them to practice. For younger children: 1. give them a piece of yarn 18 inches long. 2. Have children get a partner and illustrate flossing by using yarn and the partner's hand. 3. One student holds hands together with fingers straight and held tightly together. The other student flosses between the fingers.) Suggested Activities: 1. Ask children to name foods from the 5 main food groups (vegetables, fruits, meat/poultry, grains, dairy). 2. Ask students to make a list of everything they have eaten during the day and the day before, if possible. Suggested Activities: 1. Have students make posters about safety to place in the classroom or hall. 2. Ask several students to "act out" a dental emergency involving a knocked-out tooth. 3. Bring in a mouthguard and show students how it works. 4. Ask students to make a list or a display of objects people frequently bite, chew, or hold in the mouth which are potentially harmful to the teeth or gums Smile Smile Smile Smile Smile Smile Smile Smile Smile Smile Smile Smile Smile

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