No, it's not just sugary food that's responsible for poor oral health in America's children, especially in Appalachia

Brushing your teeth is essential for maintaining optimal oral health, but like most aspects of health, the full story is more complicated.

As directors of theCenter for Oral Health Research in Appalachia,weknowfirsthand that inequalities exist when it comes tooral health公司luding inchildren. Some people or groups have considerably moreoral health problemsthan others because of a combination of factors beyond personaldental hygiene.

For example, Appalachia—which stretches from the northern part of Mississippi, Alabama and Georgia up through the southern part of New York, and includes all of West Virginia—has one of thegreatest burdens of oral health problems per personin the U.S.

October isNational Dental Hygiene Month, which provides an opportunity to draw more attention to this chronic but often preventable problem.

Oral health defined

While the terms dental hygiene and dental health are largely focused on the teeth and gums,oral healthis more comprehensive. According to theFDI World Dental Federation, oral health encompasses theproper functioning of the mouth公司luding one's "ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions" without pain or discomfort. Oral health affects not only a person's teeth butalso overall well-being and quality of life.

Tooth decayaffects children all across the U.S., but far too little attention is paid to how preventable and treatable it is. Cavities, or caries, are the most commonchronic disease in kids—five timesmore common than asthma and seven times more commonthan environmental allergies, despite being preventable. More than40% of children have tooth decaywhen they start kindergarten.

However, people who have lessformal educationor lower incomes,marginalized ethnic and racial groupsand those living in more rural areas, such as Appalachia, tend to havemore oral health problems than others, andat younger ages. Thegreater prevalence of childhood tooth decayin specific populations is not only an inequity but also a serious public health problem. Oral health problems early in life extend into adulthood and can be lifelong.

Beyond personal dental hygiene

It's a common misconception that consumingsugary foodsand beverages is the only cause oftooth decay. While that is undoubtedly a problem, there's much more to good oral health. It includesconsistent 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 careare also critical, as they provide an opportunity for cleanings and preventive care.

Oral health in kids is areflection of their overall healthand that of their families; however, in addition to behavioral andsocial influences, genetic and other biological factors are also at play. For example,genes influencing taste preferences—such as those for sweet foods—are associated with cavities on certain teeth and surfaces of teeth. It's possible that our taste genes predispose some of us to prefer consuming sweet foods and drinks, which is a risk factor for developing cavities.

Bacteria and other microorganisms in the mouth, known as the oral microbiome, also play a role. Some parts of theoral microbiome are beneficial甚至需要良好的口腔卫生。其他bacteriaare invaders that can lead to oral diseases.

Just as important areenvironmental factors公司luding air quality, access to healthy foods, the cost of dental care, access to transportation to and from the dentist, and school-based programs that encourage good oral hygiene among children. Whether one lives in a community with fluoridated water or otherwise has access to fluoride treatments is also important, asfluoride helps to prevent tooth decay.Water qualityin communities is another factor. If the only available water is toxic or unappealing, people may turn to soda and other sugar-sweetened beverages.

Additionally,mothers' perceived social supportandparents' social networkscan influence their children's oral health too. Among mothers with a high number of cavities, the availability ofsomeone to talk to about problemshas been shown to be associated with fewer cavities in their children.

Role modeling good oral health

Parents' and caregivers' own oral healthgreatly influences that of their children. Kids and their parents typically drink the same water and many of the same beverages and eat a lot of the same foods. Children often follow the dental hygiene habits of their parents as well. Children typically take on their parents' and caregivers'feelings about dental visitstoo—whether it's comfort, stress, anxiety or fear.

Parents' thoughts about dental care influence their decisions about preventive care. Dental fear and anxiety can lead to delay or avoidance of dental appointments for themselves and their children. "Oral health values"—the importance one places on maintaining natural and good-looking teeth—affect decision-making about dental hygiene and professional dental care.Depression in parentscan even influence their own dental hygiene and oral health and that of their children.

Dental problems in kidscan lead to missed school, pain and embarrassment about visible decay, and missing or crooked teeth. Teeth and gums are critical for speaking, eating, development and appearance. They affect social functioning and one's enjoyment of food. Kids' dental problems affect their parents, too, as they can result in parents' unexpectedly missing work to bring their child to the dentist.

What can be done to improve oral health?

To a great extent,dental problems in kids can be prevented. Some preventive steps are affected byeconomic, educational and health care factors. One of the best things parents or caregivers can do is to establish a relationship for their child with a dental practitioner, practice, office or clinic to promote prevention but also to provide emergency care if needed. Within the oral health world, this relationship is called a "dental home." TheAmerican Academy of Pediatric Dentistryand other professional health organizations recommend that children see an oral health care provider before age 1 or at the emergence of the first tooth. Access to dental treatment, especially preventive care, has been shown toimprove oral health in familiesand their communities.

System-level changesare surely needed too. Since cost affects whether parents can provide their children with routinedental care, greater access to dental insurance is an important step to ensuring equal access and reducing oral health inequities. Integrating oral health practices intoschools and educational programsis another system-level change that would benefit all children regardless of their family's socioeconomic status.

Oral health is a critical factor in a person's overall health. Teaching kids this early can help them develop a healthy smile and care for their pearly whites throughout their lives.

This article is republished fromThe Conversationunder a Creative Commons license. Read theoriginal article.