Friday, May 9th, 2014
The government-backed U.S. Preventive Services Task Force (USPSTF) is now recommending that pediatricians apply a painted-on fluoride treatment to baby teeth as soon as they emerge, as a cavity-prevention measure. More from Reuters:
“Only one in four preschool children is seeing a dentist, but most see a primary care clinician,” Dr. Michael LeFevre told Reuters Health. “Primary care clinicians can play an important complementary role in helping dentists keep children’s teeth healthy.”
A family physician from the University of Missouri School of Medicine in Columbia, LeFevre chairs the USPSTF.
The panel declined to state how often doctors should apply fluoride varnish to infants’ teeth, saying research is inconclusive.
Pediatric dentist Dr. Mary Hayes welcomed the help from pediatricians, family doctors and nurse practitioners.
“It’s a good thing that dentistry and medicine are working hand in hand trying to attack decay in kids’ mouths,” she told Reuters Health. Hayes is an American Dental Association spokeswoman and was not involved with the new recommendations.
In addition to applying fluoride varnish to all baby teeth, the task force continues to urge doctors to prescribe oral fluoride supplements to infants who have not had fluoride added to their drinking water. Supplements come in daily doses of drops, tablets or lozenges.
In an effort to prevent tooth decay, fluoride was first added to the water supply in Grand Rapids, Michigan, in 1945. Since then, communities throughout the U.S. have debated whether to add the naturally occurring mineral to public water systems.
About two-thirds of Americans currently drink water from fluoridated community systems, according to the Centers for Disease Control and Prevention.
The task force last updated its recommendations on prevention of tooth decay in preschool-aged children 10 years ago.
Earlier this year, the American Dental Association recommended parents use a tiny amount of fluoride toothpaste on children before they turn 2, though fluoride remains controversial in some circles amid allegations–based, medical officials say, on questionable science–that fluoride is a carcinogen and can lower children’s IQs. In 2012, New Jersey was embroiled in the controversy when it considered legislation that would require each town in the state to fluoridate its water.
Image: Baby teeth, via Shutterstock
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Thursday, March 6th, 2014
A number of dental groups and individuals have filed a lawsuit in D.C. District Federal Court alleging that the Food and Drug Administration (FDA) has not adequately addressed concerns over the use of “amalgam,” a material that contains mercury, in dental fillings. Among other claims, the suit alleges that such filings are particularly dangerous to children and should be restricted for use in kids and other vulnerable populations.
Attorney James M. Love, who filed the lawsuit, said in a statement that American consumers and dental professionals are being misled by the American Dental Association (ADA) — the largest and most powerful advocate for continued amalgam use.
“The ADA has misrepresented FDA’s lack of regulation as proof of safety, and continues to use this toxic dental filling, despite scientifically demonstrated risks,” said Love. “Most individuals remain unaware that those ‘silver’ fillings, prevalently used as a dental restoration and covered by insurance policies, consist of 45-55% metallic mercury, and that there are health and environmental risks associated with those fillings.”
Scientific studies cited by the plaintiffs claim that mercury is a persistent toxic chemical that can build up in the body, particularly in the kidneys and the nervous system. Young children, they say, are more sensitive to mercury and can be exposed to mercury through breast milk. Unborn fetuses can be exposed to mercury from placental transfer of mercury from a pregnant woman’s teeth if she has fillings containing amalgam.
“We have banned mercury in disinfectants, thermometers, and many other consumer products,” said Griffin Cole, DDS, President of the IAOMT. “There is no magic formula that makes mercury safe when it’s put into our mouths. It’s inexcusable to use mercury in dental fillings when there are much safer alternatives.”
A previous 2007 lawsuit, Moms Against Mercury v. Eschenbach, alleged that more than thirty years ago the FDA was legally obligated to classify dental amalgam, but did not do so. In direct response to this lawsuit, the FDA agreed to classify dental amalgam. However, FDA classified the device in Class II, assigning no controls or other measures intended to protect the public. The new lawsuit is claiming the FDA has not responded appropriately to petitions requesting amalgam be classified as Class III, which would require higher safety standards, environmental impact studies, and restricted use in vulnerable populations, including children.
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Image: Child at the dentist, via Shutterstock
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Tuesday, February 18th, 2014
The American Dental Association is now recommending that children begin using a tiny amount of fluoride toothpaste twice daily as soon as their first teeth appear. This is a change from the previous guidelines, which had suggested brushing with water until age 2, when a pea-sized amount of fluoride toothpaste could be used. More on the new recommendation from The New York Times:
To fight the rising number of cavities in the very young, the dental group now advises getting a jump-start on prevention. However, they emphasize only the tiniest amount of fluoride toothpaste should be used to minimize the risk of mild discoloration, white spots or streaking of the teeth, a condition called fluorosis that is caused by ingesting fluoride toothpaste at a young age.
“We want to minimize the amount of fluoride consumption to reduce the risk of fluorosis while simultaneously adding a preventive tool for kids 2 and under that we haven’t recommended previously,” said Dr. Jonathan Shenkin, a spokesman for the A.D.A. and a pediatric dentist in Augusta, Me. Only a tiny amount of toothpaste should be smeared on the brush since some youngsters are likely to ingest some of the fluoride, he said.
The change comes after a systematic review of 17 studies published in The Journal of the American Dental Association this month. It concluded that scientific evidence, though limited in children under age 6 and more robust in older children, demonstrated that fluoride toothpaste is effective in controlling tooth decay, and that “the appropriate amount” should be used “by all children regardless of age.”
An early start is crucial, Dr. Shenkin said, because children with dental decay are at greater risk of developing cavities as adults. “By starting earlier, we can effectively reduce a lifetime of disease for a lot of kids.”
Dr. Man Wai Ng, the dentist in chief at Boston Children’s Hospital, applauded the new recommendation and said, “It’s a great thing for parents to know: ‘Use a tiny amount of fluoride, and brush two times a day to counter the effects of frequent snacking.’”
Most of the children she sees with tooth decay are using “a training toothpaste without fluoride,” she said.
The new A.D.A. guidelines stress that children should spit out toothpaste as soon as they are able, but not being able to spit does not preclude the use of a rice-grain-size bit of fluoride toothpaste.
Fluoride is controversial in some circles, amid allegations–based, medical officials say, on questionable science–that fluoride is a carcinogen and can lower children’s IQs. In 2012, New Jersey was embroiled in the controversy when it considered legislation that would require each town in the state to fluoridate its water.
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Image: Child’s toothbrush, via Shutterstock
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