Tufts professor chews on the nutrition-oral health connection

December 07, 2005

Sitting and snacking on treats in front of the television for several hours a day increases a child's risk of developing ... dental decay? Many would probably have finished that sentence with the word, "obesity." Actually, both versions are correct, according to Carole A. Palmer, EdD, RD, professor of general dentistry at Tufts University School of Dental Medicine. In an article entitled, "Dental Caries and Obesity in Children: Different Problems, Related Causes," Palmer shares some insights about possible relationships between obesity and dental decay in children.

"When children watch a lot of TV, they tend to snack more frequently, particularly on foods that are high in fat and/or sugar," Palmer, also a professor at Tufts' Friedman School of Nutrition Science and Policy, explains. "This not only increases their overall caloric intake, which we know can lead to obesity, but it also increases their risk of developing tooth decay because the amount of time food is in contact with the teeth increases."

"It is the usage pattern of certain foods and beverages, not the total consumption, that is associated with an increased risk of tooth decay in children," Palmer explains. "In that way, the cause of dental disease in children does differ slightly from that of obesity, but both diseases clearly share common denominators." Childhood obesity and dental decay result from complex interactions among several factors. "Many of the contributing factors are rooted in evolving changes in lifestyle and environment, including changes in physical activity and school food services," writes Palmer.

"A number of schools have reduced their physical activity programs," Palmer observes. "And parents are hesitant to allow their children to play outdoors because of concerns about safety. As a result, children are spending more time engaged in sedentary indoor activities, especially television viewing."

Palmer extends the comparison by noting that both childhood obesity and dental cavities are nearly twice as likely to affect Americans with lower income, those with less education, and those of specific ethnic groups.

According to a recent report from the Centers for Disease Control and Prevention (CDC), while prevalence of dental decay in permanent teeth decreased in the overall population between 1988-1994 and 1999-2002, prevalence of decay in baby teeth among preschool-aged children (2-5 years) did not decline. Among children aged two to eleven years, prevalence of tooth decay was approximately five percent higher among Black, non-Hispanic children and 17 percent higher among Mexican-American children than among White, non-Hispanic children. More than half of children from families with incomes below the Federal Poverty Level (FPL) had tooth decay, compared to less than one third of those from families with incomes that were at least double the FPL.

Soft drinks and fruit juices, which are consumed in many households and are readily accessible in many school vending machines, represent another high sugar source that may contribute to the potential for tooth decay. Palmer cautions that even diet soft drinks, when consumed frequently, can pose a risk because the acid content of these beverages can damage tooth enamel, making teeth more vulnerable to decay.

"The dental team should be in the forefront in promoting good nutrition for general health and oral health by informing caregivers and parents about the importance of integrating healthful snack and meal patterns into their oral hygiene practices," Palmer concludes.
Palmer, CA. Quintessence International. 2005; 36(6):457-461. "Dental caries and obesity in children: Different problems, related causes."

Beltrán-Aguilar ED, Barker LK, Canto MT, Dye BA, Gooch BF, Griffin SO, Hyman F, Jaramillo F, Kingman A, Nowjack-Raymer R, Selwitz RH, Wu T. Morbidity and Mortality Weekly Report: Surveillance Summaries (CDC). August 26, 2005; 54 (SS-3): 1-44. "Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002."

Tufts University

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