Preventing Zombie Mouth

Don’t want your teeth looking like this after Halloween? Read a dental professor’s tips. Photo courtesy of Flickr user fortinbras

It may be Halloween, but you don’t want your kids’ (or your own) teeth to look like Night of the Living Dead. Cavity-ridden teeth can be avoided if you keep treat-eating modest, but that’s easier said than done. “Consuming sweets in moderation and sensibly is fine for most kids. But Halloween is not just one day of sugar gluttony among children,” says Jonathan Shenkin, a Henry M. Goldman School of Dental Medicine clinical assistant professor. “Many children are able to collect pounds and pounds of candy that can last months in some cases.”

So what’s a parent (or candy-craving grownup) to do? BU Today interviewed Shenkin—also a pediatric dentistry spokesman for the American Dental Association—about keeping dead creatures on the TV screen and out of your mouth this Halloween. The ADA notes that tooth decay is on the rise in kids for the first time in decades, and it has launched a public health campaign during the Halloween season—“Stop Zombie Mouth”—to promote good oral health.

BU Today: Is it OK to allow a child occasional sweets—on Halloween, say? If so, should the amount of treats be restricted?

Shenkin: I prefer recommending that parents “monitor and manage” sugar consumption, rather than restricting consumption. Parents need to be aware that in relation to tooth decay, the frequency of exposures to sugar is more important than the quantity of sugar their children eat. So, minimizing the number of times between meals that food and beverages with sugar are consumed is the best method to reduce decay risk, along with brushing twice a day with fluoride toothpaste.

If children are going to eat candy, it’s best that parents have them eat it along with a meal, when sugars are going to be consumed normally. Parents should avoid letting children snack on candy between meals, which would promote tooth decay more rapidly.

I understand some foods actually promote healthy teeth. What are these, and which are appropriate to give out on Halloween without children turning up their noses?

Fresh fruits, vegetables, and nuts are great for oral health, as well as cheese. However, these are not really treats that kids would rave about during Halloween. An option that might actually get kids excited and promote oral health is sugar-free chewing gum. Sugar-free gum stimulates saliva flow, which dilutes the sugars present on their teeth. The only caution is that chewing gum is a choking hazard in younger children. A low-cost alternative is stickers, which have an astounding ability to get children excited.

If people are determined to hand out candy during Halloween, they should consider a few rules. Try to find candies that clear the mouth quickly; the longer sugar stays in the mouth, the worse it is in promoting tooth decay. This is why sticky, chewy candies are to be avoided, as well as hard candies that take an extended time to dissolve. People handing out candy should choose the smallest size available, to reduce overall sugar consumption.

Surely we know more about dental health than we did when we were children. Have children’s teeth generally, and has trick-or-treating specifically, gotten healthier over the years?

We have seen dramatic improvements in oral health in the United States among most age groups since I was a kid in the 1970s. This is mostly attributed to better availability of fluorides and the application of dental sealants. However, sugar consumption since the 1970s has skyrocketed, specifically because of the increase in calories coming from sugar-sweetened beverages. This means any excess sugar consumed by children should be avoided if at all possible. It’s imperative that parents reduce sugars in children’s diets during the Halloween season; otherwise, they tip the balance of oral health in favor of tooth decay. It also risks children becoming accustomed to eating larger quantities of sugar, especially if the Halloween candy lasts weeks or months.

The greatest challenge ahead for truly improving oral health among children and adults in the United States is increasing oral health literacy. This is the only way we can expect children and adults to understand the importance of brushing twice daily with fluoride toothpaste and eating more balanced diets. Aside from the dramatic rise in sugar consumption among children, only 44 percent of children brush their teeth twice a day. We will never reduce oral health disparities with increased drilling and filling; we need to focus on improving the basic behaviors that ensure good oral health. Halloween is the one holiday that concerns dentists because of the sugar free-for-all it has long been known for. Parents learning to balance what they themselves hand out to children and managing the sugar consumption and appropriate hygiene of their children can lead to better oral health.