Poor oral health in children isn't just from too much sugary food; education, income and environment play a role

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While brushing your teeth is important to maintaining good oral health, dental-health experts say it's not the only thing responsible for poor oral health, especially when it comes to children in Appalachia, where sugar is usually blamed.

"It’s a common misconception that consuming sugary foods and beverages is the only cause of tooth decay. While that is undoubtedly a problem, there’s much more to good oral health," Daniel W. McNeil and Mary L Marazita write for The Conversation, a site for journalistic writing by academics. "It includes consistent brushing and flossing; eating healthy foods, like fresh fruits and vegetables; avoiding tobacco products; and wearing mouth guards while playing certain sports. Regular visits for dental care are also critical, as they provide an opportunity for cleanings and preventive care." 

McNeil and Marazita, who run the University of Pittsburgh's Center for Oral Health Research in Appalachia, say the region's poor oral health stems from a combination of factors beyond tooth brushing and other personal hygiene.

Poor oral health, they write, is more common among "people who have less formal education or lower incomes, marginalized ethnic and racial groups and those living in more rural areas, such as Appalachia," which has one of the highest rates of oral health problems in the nation. And among these groups, oral health issues tend to show up at younger ages. 

Other than education, behavioral and social influences, reasons for poor oral health can include genetic influences that dictate a preference for sweet foods, mouth bacteria that can lead to oral diseases, environmental factors such as air quality, access to healthy foods, the cost of dental care, access to transportation to and from the dentist, access to school-based programs, water quality and whether one lives in a community with fluoridated water, which can keep cavities from forming.

McNeil and Marazita note that cavities are the most common chronic disease in children, despite being preventable and that "more than 40% of children have tooth decay when they start kindergarten. . . . Dental problems in kids can lead to missed school, pain and embarrassment about visible decay, and missing or crooked teeth." 

They write that parental and caregiver role modeling can greatly influence children's oral health habits. Examples include drinking water instead of sugary beverages, eating a healthy diet, practicing good dental hygiene habits and expressing a positive attitude about going to the dentist. 

The article offers several other suggestions to improve oral health, saying one of the best things parents or caregivers can do is to take their child to the dentist.  

"The American Academy of Pediatric Dentistry and other professional health organizations recommend that children see an oral health care provider before age 1 or at the emergence of the first tooth," they write. "Access to dental treatment, especially preventive care, has been shown to improve oral health in families and their communities."

McNeil and Marazita also call for system-level changes that ensure routine dental care is affordable and accessible to everyone. They also call for integrating oral health practices into schools and educational programs, saying this will benefit all children regardless of their family's socioeconomic status.