Children & Adolescent Health
Advances in medicine have either eliminated or significantly reduced the incidence of the more common disease of childhood such as poliomyelitis, measles, mumps, or chicken pox. Today, health threats to children and adolescents come from lifestyle, particularly adoption of adult habits such as smoking and overeating, coupled with a lack of physical activity. These lifestyle changes contribute to two chronic diseases; diabetes and asthma. In the past twenty years, the number of children who are overweight has doubled for those ages 6 - 11 and tripled for those ages 12 - 19.1 Research shows that poor nutrition, lack of exercise and watching too much television all contribute to this increase.2 An overweight child is more likely to become an overweight adult, especially if one or more parent is overweight or obese.3
Up to 85% of children diagnosed with type 2 diabetes are overweight or obese at the time of diagnosis. Children may have no symptoms and go undiagnosed for a period of time. The peak time for diagnosis is middle to late puberty. Children may also have prediabetes. Prediabetes is defined as having an impaired fasting glucose (IFG) of 100 - 125 mg/dL. A recent study found that 17.8%, or 1 in 6 overweight adolescents, had IFG. Those with IFG also had risk factors for heart disease such as high cholesterol, triglycerides, and blood pressure.
Smoking is the leading preventable cause of disease and death in the US. Everyday 4,000 children aged 12 - 17 try their firs cigarette. More than half of high school students have tried smoking. Currently, about 23% of high school students report smoking cigarettes, and 14% report smoking cigars, cigarillos, or little cigars. If current smoking patterns continue, 6.4 million of today's children will die prematurely from a smoking-related cause.
The risks of active smoking and diabetes have been studied extensively and are well established as detriments to good oral health. Adolescents with type 1 diabetes have been shown to have increases in the incidence and severity of gum inflammation. Importantly, it is not related to increases in dental plaque but seems to be related to poor glycemic control. Better control of blood glucose levels may help improve gum inflammation along with better oral hygiene. Severe gum (periodontal) disease has also been shown to start earlier and the incidence increases after puberty.
Smoking is strongly associated with gum disease in adults. While not studied in children, young adult smokers ages 19 - 30 years have been shown to have a higher prevalence and severity of periodontal disease. Severe periodontal disease is also more prevalent in smokers younger than thirty-five.
The first step to improving oral health in children and adolescents is to reduce the risk of gum disease by better nutrition, exercise, and quitting smoking. This should be coupled with an oral hygiene regimen that is easy and effective. Proper brushing with a manual or power toothbrush is mandatory along with a device to clean between the teeth and under the gum line. Dental floss can accomplish cleaning between the teeth but all too often it is either done incorrectly or not at all, especially with younger individuals. An easy way to clean is the Waterpk® dental water jet. The unique combination of pressure and pulsations gently flush bacteria from between the teeth and under the gum line to reduce gum inflammation.
- Headley AA et al. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 2004; 291(23):2847-2850.
- American Academy of Pediatrics: Policy Statement: Prevention of pediatric overweight and obesity. Pediatrics 2003; 112(2):424-430.
- Overweight and Obesity: Health Consequences. US Department of Health and Human Services. www.surgeongeneral.gov. Accessed December 12, 2007.
