PREVENT ORAL DISEASE IN CHILDREN

PREVENT ORAL DISEASE IN CHILDREN

Part One:
New Oral Hygiene Instruction Preferred to Prevent Oral Disease in Children.

Part Two:
Oral Hygiene Instruction 'Brush Your Teeth' is Flawed.

Part Three:
Campaigns to Prevent Oral Disease in Children

Part Four:
MouthWise Oral Health Education Resources to Prevent Oral Disease in Children

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Part One:
New Oral Hygiene Instruction Preferred to Prevent Oral Disease in
Children.

7th November 2004

In the period from January 1997 to July 2002 I observed a quite remarkable and dramatic reduction, even elimination in the incidence of tooth decay, gum disease and bad breath in one particular group of the school children in a remote community school in Australia. Existing decay had become arrested, there were only rare signs of new decay and the whole group had healthy gums and no breath problems. I was writing the resources for a children’s oral healthcare education program at that time and wanted to incorporate the information into the resources. What was this group of children doing to successfully prevent oral disease? The answer was eventually found in these children’s unique interpretation of and execution of the oral hygiene instruction ‘Brush Your Teeth’. The details of that story are referenced at the end of Part One.

From these highly unusual observations two deductions was drawn and one conclusion subsequently followed:

· Deduction: The oral hygiene instruction ‘Brush Your Teeth’ was inherently flawed. The instruction cannot always prevent oral disease in children. The instruction may even contribute to oral disease in children. Children should no longer be instructed to ‘Brush Your Teeth’.
· Deduction: A new oral hygiene instruction to prevent oral disease in children was needed. It should overcome the inherent flaws in ‘Brush Your Teeth’. The instruction should be easy for children to execute and be highly effective with greater certainty.
· Conclusion: The new oral hygiene instruction ‘Treat Your Mouth’ will prevent oral disease in children with greater certainty.

‘Treat Your Mouth’. The New Oral Hygiene Instruction for Children.

‘Treat Your Mouth’ is a whole of the mouth, truly oral, oral hygiene instruction. ‘Treat Your Mouth’ leaves the entire mouth clean and leaves the surfaces of teeth, gums and tongue fully protected against oral disease. ‘Treat Your Mouth’ will prevent oral disease in children with greater predictability and with more certainty.

· ‘Mouth’ implies everything within the mouth. Teeth, gums and tongue in particular. Also other important ‘Mouth’ surfaces are the roof of the mouth, inside surfaces of lips and cheeks and the floor of the mouth.
· ‘Treat’ is a word that implies ‘giving medical treatment to’. As an example, when a wound to the skin is treated, firstly the wound is cleansed of debris and dirt and secondly chemicals are applied to the wound to kill any germs in the wound. It is a two-step chemical process. A skin wound may also have a third step and be covered to prevent further contamination. But ‘Treat Your Mouth’ is essentially a two-step procedure.
· ‘Treat Your Mouth’ is therefore an overall two-step process involving at least, teeth, gums and tongue. The first step to ‘clean’, the second step to ‘apply’. Within each overall step there are mini steps, just as ‘Brush Your Teeth” has brush your teeth has mini steps; brush, rinse your mouth with water, spit into the bowl.

The new oral hygiene instruction ‘Treat Your Mouth’ has only subtle but important differences to ‘Brush Your Teeth’. It is not difficult for children to execute. Explanations given to children will help them to understand why they are doing what they are doing and will then make children self motivated to ‘Treat Your Mouth’. It can be made fun.

The first step of ‘Treat Your Mouth’ is to ‘clean’ the mouth surfaces:

· ‘Treat Your Mouth’ starts with treat the surfaces of your teeth, to clean away the plaque and food debris.
· Next, treat the surfaces of your gums, to clean away the plaque and food debris.
· Next, treat the top surface of your tongue, to clean away the plaque and food debris.
· Next, rinse water thoroughly around the mouth to prepare to get rid of the plaque and food debris and drink debris..
· Next, spit out the plaque and all debris in the water.
· At this point the surfaces treated within the mouth are CLEAN but not protected.

The second step of ‘Treat Your Mouth’ is to ‘apply’ the mouth paste ingredients to the mouth surfaces:

· Next, with just a small amount of mouth paste on the mouth treater ( NOT tooth brush please!), treat the surfaces of teeth, then gums, then tongue again TO APPLY the highly desirable chemicals in the mouth paste.
· Next, SWISH the foam in the mouth, around and around the mouth. Also SWISH it in between the teeth to make certain all surfaces are treated.
· Next, spit out the excess foam from the mouth. DO NOT RINSE WITH WATER. NO, NO, NO, NO, NO!
· Next rinse the mouth treater under the tap.

The result?

· The mouth has successfully been treated.
· The surfaces of teeth, gums and tongue will have been cleaned
· The surfaces of teeth, gums and tongue will be coated with and protected by the chemicals from the mouth paste.
· Any mouth treated in this way everyday, preferably three times each day, but at a minimum two times each day, has it’s best ever chance to prevent oral disease.
· It takes only a minute or so longer than ‘Brush Your Teeth’ and one extra pea size amount of mouth paste.
· ‘Treat Your Mouth’ does easily prevent oral disease in children.


Children can be taught to sing the oral health song ‘4 Your Smile 2 Shine’, the song lyrics of which are the oral hygiene instruction ‘Treat Your Mouth’. Go to the website ‘All About A Smile’ at www.allaboutasmile.com

A more detailed story of the origin of the oral hygiene instruction ‘Treat Your Mouth’ is related on the website, ‘Kids Oral Health Books ‘n C.D.’ at www.oralhealthhelpsite.com/site/708332/page/402127

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Part Two:
Oral Hygiene Instruction 'Brush Your Teeth' is Flawed.


An effective oral hygiene instruction will instruct children to execute a set of procedures to achieve the specific, desired outcome to prevent oral disease in children. The oral hygiene instruction ‘Brush Your Teeth’ is ineffective for several general and several specific reasons.

General reasons why ‘Brush Your Teeth’ can be ineffective:

· The very first oral hygiene instruction given to children should be precise, complete, oral, unambiguous and when executed result in oral health over a lifetime. ‘Brush Your Teeth’ is imprecise, incomplete, dental, ambiguous, often resulting in oral disease throughout a lifetime.
· It comes often with appendages such as ‘brush your teeth and your gums too’. But on the spur of the moment or after time the effective instruction often reverts to ‘Brush Your Teeth’.
· ‘Brush Your Teeth’ is a ‘tooth’, a ‘dental’ hygiene instruction. It is not a complete ‘ORAL’ hygiene instruction.
· ‘Brush’ is used in sense only of ‘cleaning’. Children are often told to ‘clean your teeth’ instead of ‘brush your teeth’.
· Teeth are not the only important structures in the mouth in need of a ‘clean’. Besides teeth there are gums and a tongue. Children should be made to think ‘orally’, to clean every surface in the mouth, even the roof and floor of the mouth, the inside surfaces of lips and cheeks. ‘Oral’ health includes ‘tooth’ health, ‘gum’ health, etc. Every structure in the mouth.


Specific reasons why ‘Brush Your Teeth’ can be ineffective become obvious as the instruction is executed using ‘tooth’ paste and a’ tooth’ brush (both terms poor terminology):

· Brush the surfaces of teeth to get rid of plaque, food debris and drink debris.
· Rinse the mouth thoroughly with water.
· Spit out to rid the mouth of all debris.
· At this point the surfaces of the teeth are clean.
· The objective, ’Brush Your Teeth’, has been achieved.


Closer study of what has occurred reveals four problems:

· The first problem is that plaque remains on the gums. Gums are not clean.
· The second problem is that plaque remains on the top of the tongue. Tongue is not clean.
· The third problem is that plaque and debris may remain on every other surface in the mouth. The mouth is not clean.
· The fourth and major problem is that all the wonderful ingredients in the mouth paste (I refuse to call it ‘tooth paste’) went out in the ‘rinse and spit’! On the mouth paste package it is claimed, quite rightly, that the ingredients in mouth paste will do lots of wonderful things. Things like kill bacteria, prevent tooth decay, repair tooth decay, prevent gum disease, prevent bad breath, prevent plaque build up, protect for hours, etc. They can and will do these wonderful things if they are in the mouth. But they went out with the ‘rinse and spit? So they can’t! The mouth is left unprotected.


The reasons for the ineffectiveness of ‘Brush Your Teeth’ as an oral hygiene instruction for children become obvious with just a little study of these problems. It even becomes logical to anticipate the problems. The oral cavity, after ‘Brush Your Teeth’, is a potential disaster area, a breeding ground for tooth decay, gum disease and bad breath.

The oral hygiene instruction ‘Brush Your Teeth’ is undoubtedly contributing to the incidence of ‘easily preventable oral diseases’ in children. ‘Brush Your Teeth’ is NOT the ideal oral hygiene instruction to give to children to prevent oral disease.

For as long as ‘Brush Your Teeth’ continues, world wide, to be the oral hygiene instruction given to children to prevent oral disease we can confidently expect little future change to the current 21st Century reports of unacceptable levels of oral disease in children.

For a graphic comparison of the two oral hygiene instructions ‘Brush Your Teeth’ and ‘Treat Your Mouth’ please go to the oral healthcare information site at:
http://www.oralhealthcare.info/week/fromtoday.shtm

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PART THREE:
Campaigns to Prevent Oral Disease in Children


Early in the 21st Century oral disease affecting young children has often been reported as at crisis levels. The following two reports are typical of a problem extending across the globe:

The report ‘Oral Health in America: A Report of The Surgeon General’, published on May 25th 2000, (http://www.surgeongeneral.gov/library/oralhealth ) cites ‘ the silent epidemic’, oral disease in children in crisis .
The Australian report ‘Child Dental Health Survey, Australia 1999: Trends Across The 1990’s’, published in May 2003, cites increasing rates of decay across all age groups.

Oral disease in children is cited almost daily somewhere in information media, on radio, in television, in the popular press, on websites and in professional journals. Oral disease in children exists in almost every country around the world. Oral disease in children is well summarised in an article dated May 2001, since when little has changed, at http://www.Prevent.org/Priorities/PinP_0501_oralhealth.pdf

Children's oral health is undoubtedly in crisis. Children are suffering three major oral diseases, not just tooth decay, but also gum diseases and bad breath. These diseases are the most prevalent of all diseases suffered by children. Skeletal remains from thousands of years ago prove enamel on teeth can and will remain, intact, well beyond a lifetime. But early in the 21st Century we are unable to help young children prevent oral disease.

Early in the 20th Century oral health was virtually non-existent. Children’s deciduous teeth were considered of little importance because the then prevailing attitude was more permanent teeth would follow. Then when permanent teeth became diseased it was almost fashionable to have all teeth extracted, even healthy teeth, and to be replaced by vulcanite based dentures which had porcelain teeth and which did not rot. It was about that time the dental profession initiated research into the causes of tooth decay.

In the second half of the 20th Century, the dental profession succeeded in drastically reducing the incidence of oral disease in children. They made fashionable the statement ‘ tooth decay, gum disease and bad breath are easily preventable diseases’. Evidence, however, has proven they have not been ‘easily’ preventable diseases and not totally preventable diseases. Reports quoted above in the opening paragraph clearly state children’s oral health remains in crisis in the 21st Century. More alarmingly, the Australian report in May 2003 proves a trend showing reduction in tooth decay in children can be reversible.

There have been numerous campaigns to prevent oral disease in children. Major types of campaigns include; public oral health and healthcare awareness campaigns, introduction of school dental services, improved oral health and oral healthcare education in schools, fluoridation of public water supplies, introduction of fluoride in tooth pastes, fissure sealants placed by dentists, introduction of oral hygienists, introduction of dental therapists and creation of more university places for dentists.

The major contributors involved in these campaigns have been National Dental Associations, Governments at different levels, Multi International Manufacturing Companies of tooth pastes, tooth brushes and mouth washes. Many minor contributors have also been involved. Thankfully, the number of campaigns to prevent oral diseases in children continues unabated in the 21st Century. These are well documented in all media, in press releases and especially in web pages.

The most recent campaign to come to my attention is from a press release Friday October 1, 2004; “Colgate-Palmolive and The American Dental Association Launch ‘Save The World from Cavities’ Campaign to Prevent Tooth Decay in Children”. This press release can be found at http://biz.yahoo.com/prnews/041001/nyf038_1.html In this article I particularly noted and agreed with the objective to ‘help children how to take charge of their oral health’. This closely mirrors my own publicised, ‘ educate children to become self motivated to prevent oral disease’. Unfortunately for children needing to prevent oral disease, if this campaign also is based on the oral hygiene instruction ‘Brush Your Teeth’, then it will fall far short of ‘Save The World From Cavities.

21st Century oral health campaigns need 21st Century oral hygiene instructions for children if children are to successfully prevent oral disease. Now is an opportune time for all campaigns and campaigners whose aim is to prevent oral disease in children, to seriously consider their continuing efforts in the light of the revelations I first made public in mid 2002 regarding the inadequacies of the oral hygiene instruction ‘Brush Your Teeth’ and my reasons for recommending a more suitable oral hygiene instruction for children, ‘Treat Your Mouth’.

I believe, to permanently prevent oral disease in children, the following considerations should be implemented:

Oral health and oral healthcare awareness campaigns to alert the public to the problems associated with the oral hygiene instruction ‘Brush Your Teeth’.
Oral health and oral healthcare awareness campaigns to alert the public to the advantages associated with the oral hygiene instruction ‘Treat Your Mouth’.
Oral health education programs for children to be updated to include the latter information, made more comprehensive and made mandatory.
Teachers of children between the ages of 5 years and 11 years must be recognised as children’s ideal oral health educators. School oral health education programs that depend on the dental profession for advice should make certain the advice they receive is the best advice available.
Parents must be recognised as being children’s ideal oral healthcare educators and be given adequate support and resources for that role.


The advice I have continuously made throughout this article that the oral hygiene instruction ‘Brush Your Teeth’ significantly contributes to oral disease in children equally applies to people of all ages. Likewise, my recommendations for the oral hygiene instruction ‘Treat Your Mouth’ to prevent oral disease, equally applies to people of all ages. Children instructed in the oral hygiene instruction ‘Treat Your Mouth’ will translate into adults preventing oral disease!


PART FOUR:
MouthWise Oral Health Education Resources to Prevent Oral Disease in Children.


Several MouthWise oral health education resources are currently available. All resources have been prepared by the author of this article. All resources are based on the oral hygiene instruction ‘Treat Your Mouth’. All resources aim to educate children to become self motivated to prevent oral disease. The resources have been prepared for use by children’s parents and teachers in their roles as oral healthcare and oral health educators. Older children can use the resources with less help.

MouthWise oral health education resources include:

· A set of 10 children’s oral health books.’ Visit 1 to GarGar The Dentist’ through to ‘Visit 10 to GarGar The Dentist’.
· An oral health C.D. for children titled ‘4 Your Smile 2 Shine’, the song lyrics of which are the oral hygiene instruction ‘Treat Your Mouth’.
· The oral health website where all MouthWise Oral HealthCare Education resources can be viewed and purchases made at www.oralhealthhelpsite.com
· The MouthWise oral health information website 4 Your Smile 2 Shine at www.oralhealthcare.info
· The kids oral health website All About A Smile where children can learn the oral health song ‘4 Your Smile 2 Shine’, the song lyrics of which are the oral hygiene instruction ‘Treat Your Mouth’, at www.allaboutasmile.com
· Book previews of the ten MouthWise oral healthcare books for children at www.oralhealthhelpsite.com/site/708332/page/394498
· Track information of the MouthWise Oral Health C.D. for children at www.oralhealthhelpsite.com/site/708332/product/ISBN-1-920712-12-7
· ‘The MouthWise Oral HealthCare School-on-the-Web’ for children’s parents, teachers and anyone teaching children oral health or oral healthcare. Suitable also for older children in the 5 to 11 years old bracket to teach themselves. www.oralhealthhelpsite.com/site/708332/page/260688
· ‘Lesson Guidelines’ for ‘The MouthWise Oral HealthCare School-on-the-Web’ at www.oralhealthhelpsite.com/site/708332/page/292398


Anyone anywhere interested in helping any children to prevent oral disease such as tooth decay, gum disease and bad breath, could start RIGHT NOW with these resources. All MouthWise oral health resources are free except for the MouthWise Oral Health Books and the MouthWise Oral Health C.D.

Hopefully, information in this article ‘New Oral Hygiene Instruction Preferred to Prevent Oral Disease in Children’, has stimulated sufficient interest to trigger active campaigning on behalf of children who deserve a better deal in all aspects of their oral health education.

Comments most welcome.