Summer is kids' favorite time of year. School is out, the sun is shining, and sugar-laden foods are widely available at cookouts, fairs, friends' houses, and the local ice-cream shop. Unfortunately, kids consume a lot more sugar during the summer months and all that sugar wreaks havoc on children's dental health.
Pennsylvania is especially vulnerable to the downsides of poor dental care. WalletHub put the state at 24th compared to all U.S. states in terms of overall dental care, but 37th in terms of dental habits and care. These middling rankings may soon worsen, however: The loss of COVID pandemic-era Medicaid funding for dental care is expected to cause dental care coverage to lapse for almost 600,000 residents just as their kids prepare to consume more soda, sugary snacks, and lemonade.
Studies have shown repeatedly that we underestimate the risk to our health from poor dental hygiene. Tooth decay causes inflammation in surrounding gum tissue, abscesses, and eventually, tooth loss. And that's just the start — decay and gum disease have been linked to an increased risk of cardiovascular events, organ damage, and pregnancy complications. It all starts with the effects of sugar eroding enamel, the thin white line protecting your mouth and your body.
One particularly dangerous aspect of dental health is how easy it is to ignore it. Most Americans fail to heed dentists' urging to brush and floss daily, book professional cleanings, and drink less-sugary liquids. This starts a process that progresses to inflamed and bleeding gums, with varying degrees of discomfort. We gradually get used to these "new normals," while plaque on our teeth is preparing to be a Trojan Horse for the rest of our body.
This bad news comes with a big dose of good news, however: Our bodies have evolved to keep our mouths and bodies healthy. Our saliva is naturally alkaline, allowing us to neutralize acids, lower the number of mouth bacteria, and protect our tooth enamel. Saliva also contains calcium and phosphate ions, allowing the enamel to remineralize and restore its protective capacities.
But Americans' high-sugar diets, especially during the summer, mean that our mouths need extra help. Fluoridated water helps teeth to recover these ions, and hydroxyapatite is added to our toothpastes for the same reason. Brushing to remove excess sugars that bacteria can feed on, and flossing to remove harder-to-reach plaque which causes tartar build-up in less accessible areas also helps.
Finally, there is another intervention that is unobvious, easily available, effective, and far more enjoyable than a dentist's tools jammed into our kids' mouths: sugar-free chewing gum.
This isn't the gum of our childhoods, loaded with sugar that promotes the growth of bacteria which, in turn, give rise to plaque and cavities. Sugar-free gum, in contrast, doesn't stimulate the growth of those bacteria in the first place, and the act of chewing itself causes the mouth to produce alkaline saliva, which neutralizes acids and remineralizes tooth enamel. It can also replace other, undesirable habits — chewing sugar-free gum means your kids are not drinking a can of Coke or sucking down a popsicle.
The benefits of chewing gum have long been described by researchers. A rigorous randomized control trial — the gold standard of clinical testing -— performed in Finland found that children who chewed xylitol-sweetened gum had 60% fewer cavities than the control group, and another in Belize found a reduction of 70%.
A 2019 meta-analysis by investigators at Guy's Dental Hospital in London of 17 dental and medical journal articles found that chewing sugar-free gum could significantly reduce tooth decay. And a 2022 multi-center cluster randomized trial based on the known link between poor oral health and premature birth or low birth weight demonstrated the benefit of chewing xylitol-sweetened gum daily during pregnancy in rural Malawi, where 24% of pregnancies end in dangerous pre-term births.
Hundreds of thousands of Pennsylvanians are about to lose their dental coverage, on top of almost 25% of Medicaid patients losing COVID-era health coverage. This means that the 12% of Pennsylvanians who live at or below the poverty line may not get a professional cleaning just as we enter the most dangerous time of year for teeth. Whether or not you're in that cohort, it's smart to be pro-active, and that starts with prevention — especially, with easy solutions like brushing, flossing, and chewing sugar-free gum.
Henry Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. He was the founding director of the FDA's Office of Biotechnology. Find his articles at henrymillermd.org.