You may be horrified to learn how much sugar is really in your child’s lunchbox.

Leederville dental encourages parents to cut the amount of sugar in their children’s lunch boxes.

In NSW alone more than 100 children each week are having multiple rotting teeth extracted, filled and capped under general anaesthetic, the latest NSW hospitalisation data shows.

How much sugar is recommended per day?

Australians currently consume on average 14 teaspoons of sugar per day. It is recommended for dental health that we reduce this to 6 teaspoons.

Australian adults and children should consume no more than 51 grams in free sugars a day, according to World Health Organisation guidelines, and halving this amount can lead to extra health benefits.

One teaspoon of granulated sugar equals 4 grams of sugar. To put it another way, 16 grams of sugar in a product is equal to about 4 teaspoons of granulated sugar.

So we should be eating no more than 51g (13 teaspoons) of sugar and aiming for 26 grams of sugar per day (6.5 teaspoons) per day.

As these below examples of lunch boxes show your child may be eating 7 x this amount just for lunch.

See the results of a Fairfax Media analysis consisting of five basic lunch items in 5 different Lunch Boxes.

High sugar lunchbox with over 160g of sugar.

Sweet lunchbox – Total sugar 135g (33 teaspoons)

Healthy lunchbox – Total sugar 28.8g (7 teaspoons)

Light lunchbox – Total sugar 31.9g (8 teaspoons)

Quick ways to reduce sugar in your child’s lunch box.

1. Send a bottle of water rather than drink, especially high sugar drinks.
2. Choose low or no sugar yogurts & snacks ‘natural’ or ‘low fat’ can be full of sugar so its always best to read food labels.
3. Reduce the amount of processed or packaged items to 1 per day and choose a low-sugar option such as popcorn, rice crackers, cheese & wholegrain crackers.
4. Pack fresh fruit and vegetables rather than juices or processed fruits.
5. Teach your children to read food labels and what they mean.

Use the Healthy Lunch Box website from the Cancer Council to grab some great ideas for packing a healthy lunch. Your kids can use this online tool too and ‘pack’ their own healthy lunch online and see the results.

Lunch Box examples and sugar amounts from the Sydney Morning Herald article – http://www.smh.com.au/national/tooth-decay-crisis-dentists-plead-with-parents-to-reduce-childrens-sugar-intake-20180125-h0o6ux.html. 

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1. Intrinsic sugars  (natural sugars)  where sugar is held inside the food molecule in foods like fresh fruits.

2. Extrinsic Sugars or sugars outside of the food cells.

Extrinsic sugars can be further broken down into a) milk sugars  & b) non milk sugars.

a) Milk Sugars (also natural sugars) are in milk and milk products and cause less tooth decay. In Fact eating some cheese after a meal can help reduce tooth decay – you still have to brush twice a day !!!

b) Non Milk Sugars – also called added sugars or free sugars are the greatest concern for teeth. These have no nutritional value and add unnecessary kilojoules. Examples are glucose or sucrose (table sugar) and are often added to foods we buy and also in honey, syrups and fruit juices.

Natural sugar or added sugar – which sugar is better for teeth?

How much sugar?

Australians currently consume on average 14 teaspoons of sugar per day. It is recommended for dental health that we reduce this to 6 teaspoons. This also has the added benefit to our over health by reducing our risk of obesity and diabetes.

For dental health we should have only 6 teaspoons of free sugar a day in total.

Tips to help you reduce sugar intake & the effect of sugar on your teeth.

• Develop healthy dietry habits to children early in life. (see australian guide to nutrition below)
• Don’t add sugars/ sweetners to baby and childrens drinks.
• Reduce the number of times you eat food with added sugars. This is important so that your teeth are not exposed to sugars throughout the day.
• Limit drinks with sugars – to rarely rather than daily. Choose water and milk instead.
• Eat more fruit and vegetables, grains and unsweetened breakfast cereals.
• Avoid sticky sugars like dried fruits, fruit leathers or hard chewy sweets especially close to bedtime.
• Read nutrition labels you will be surprised how much sugar is added to many food. 1 teaspoon of sugar is 4 grams X 6  = 24 grams for the whole day.
• Brush your teeth twice a day, drink tap water and use a fluoride toothpaste.
• Follow the Australian guidelines for healthy eating (below)

Australian guide to healthy eating.

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The brand of dental implant that we place is usually Nobel Biocare – a large international company and producer of the original ‘Branemark’ tooth implant.

Implant tooth replacement is a two stage procedure.  

First the dental implant is placed during a small surgical procedure and then after allowing  a sufficient period of time for the implant to integrate with the surrounding bone, then an implant crown is placed on top of the implant.

It takes three months for the implant to integrate, or six months if there was a bone graft at the same time or if the implant is initially unstable.

During integration, if the implant is initially stable a titanium healing abutment is placed that is smaller than a tooth and cylindrical in shape.  If short term cosmetic appearance is important, it may be possible to place a temporary crown on top of the implant that is the same size, shape and colour of the original tooth.

During integration, if the implant is initially unstable, a cover screw is placed on the implant and it is completely buried under the gum until it becomes stable.

How a dental implant is made to look and function similarly to a natural tooth

The implant crown is usually screwed onto the underlying implant.

We place the dental implants and the implant crowns at Leederville Dental.  We have the implant crowns made locally using 3D scanning and CADCAM technology.  I choose each crown with the technician based on the individual patient’s needs but they are often made of the metal free material Zirconia.

dental implant to replace a missing tooth

The main clinical benefit to using a dental implant to replace a missing tooth is that it is retained independently in the mouth and biologically conservative.  In other words, the adjacent teeth on either side are not used to support the replacement tooth (as in the case of a dental bridge) saving the need for adjacent teeth to be drilled.

By contrast, a fixed bridge is a restoration that is fixed in place by attaching to the natural adjacent teeth. The way that the bridge attaches is that the neighbouring teeth are “prepared” by removing the enamel layer and are replaced by crowns to which the false tooth is attached. Thus a three-unit bridge is three crowns joined together with the middle crown being the false tooth, with the side crowns cemented or bonded to the neighbouring natural teeth.

Dental Implants last longer than dental bridges and in many cases last a patient’s lifetime, reducing the amount of dental work to be done in future. 

X- Rays taken during stages of tooth implant to a patient’s replace a missing tooth.

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Intravenous Conscious Sedation (IV sedation) is when a drug, usually of the anti-anxiety variety, is administered into the blood system during dental treatment.

You remain conscious during conscious IV sedation. You will also be able to understand and respond to requests from your dentist. However, you may not remember much (or anything at all) about what went on because of two things:

IV sedation induces a state of deep relaxation and not being anxious by what’s going on. The drugs used for IV sedation produce either partial or full memory loss (amnesia) for the period of time when the drug first kicks in until it wears off. As a result, time will appear to pass very quickly and you will not recall much of what happened. Many people remember nothing at all so it may feel as if you were “asleep” during the procedure.

Dr Richard Kozlowski administers IV sedation to patients for different procedures weekly for procedures such as;

• Extraction of wisdom teeth – all four can be removed in one procedure if needed.
• Fillings and tooth extractions.
• Crown preparation work such as root canal
• Dental implants placement to replace missing teeth.

Most dental procedures can be done under IV dental sedation and are good for patients who are anxious or fearful of the dentist or even for children with special needs or for people who would prefer not be ‘aware’ or “I don’t want to know” or have memory of the procedure. Another advantage is that it reduces the gag reflex and more dental work can be done in one sitting, reducing the number of visits you need to make to the dentist.

Dr Richard Kozlowski is Perth’s most experienced sedation dentist and is often booked into other Perth Dental Practices to perform the IV sedation on their behalf.

Leederville dental staff attend annual CPR training by St John of God Hospital.

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What makes a patient a good Inman Aligner candidate?

An adult patient with mild crowding of the four front incisor teeth in the upper or lower jaw.

 Are all Inman Aligners the same? 

The Inman Aligner is custom made. Impressions (moulds) of your teeth and photos are taken of the upper and lower jaw along with x-rays of the teeth that are to be straightened. Dr Richard Kozlowski does an online assessment using this information and sends the impressions to a dedicated Inman dental laboratory where an Inman Aligner is custom made for each individual patient.

Impressions and x-rays are taken of your teeth to customise an Inman Aligner

How many appointments will I need?

You will need an initial consultation and discussion with Dr Kozlowski to see if the Inman Aligner will work for you. You will then need an appointment to take x-rays, impressions of your teeth.

When your Inman Aligner is ready for you we will schedule an appointment to fit it. Fitting the Inman Aligner takes 40 minutes and includes take home care instructions and a storage box.

Review appointments then are a quick 20 minutes  every 2 weeks. 

 Is there any special care needed by a patient while using the Inman Aligner? 

The Inman Aligner should be kept clean and removed for eating and having hot drinks.  During these times the Inman Aligner should be kept in the storage box provided. 

 How long is the Inman Aligner worn each day?  

The Inman Aligner should be worn a minimum of 16 hours per day.  The Inman Aligner should only be removed whilst eating, having hot drinks, playing sport but it can also be removed for important work, contact sport or social activities if necessary.

 What happens after Dr Kozlowski is happy with the Inman Aligner results? 

After the teeth are aligned, minor adjustments are made to improve the aesthetics if necessary.  The next stage is a final impression to provide a retainer which must be worn to prevent a relapse and a return of teeth crowding.  The retainer is either a fixed wire bonded to the teeth or a removable plastic one worn only at night times. 

How long does the Inman Aligner take to straighten my front teeth? 

Treatment with the Inman Aligner typically takes about 3 months. 

How much will it cost to straighten my front teeth with an Inman Aligner? 

The dental fee does depend on the time needed to achieve the results. Attached is an estimate for a patient attending Leederville Dental. Please note this is an estimate only. Book an appointment today so we can assess suitability of your teeth and give an accurate estimate.

Inman Aligner Estimate

Do you have any before and after images of teeth straightened with an Inman Aligner?

You can view Leederville’s dental portfolio showing some of the teeth straightened using the Inman Aligner.

I’ve had braces before can I still use the Inman Aligner? 

The Inman Aligner is a popular choice for patients who have had braces while younger but their teeth have moved over time and crowded in the front on the upper or lower jaw and can be worn by adults of any age.

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Hormonal changes during pregnancy alter the way the body responds to bacteria (plaque). You should keep up your Oral Hygiene routine as per normal.

Pregnancy can lead to dental problems in some women, including gum disease and increased risk of tooth decay. During pregnancy, your increased hormones can affect your body’s response to plaque (the layer of germs on your teeth).

Pregnancy does not automatically damage your teeth. The old wives’ tale that warns a woman to expect a lost tooth for every baby is false. If the mother’s intake of calcium is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped. However, the demands of pregnancy can lead to particular dental problems in some women.

With proper hygiene at home and professional help from your dentist, your teeth should remain healthy throughout pregnancy.

Your dental health can affect your developing baby

Dental disease can affect a developing baby

Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing.

Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant mother can reduce the risk of premature birth by more than 80 per cent, according to one study.

Pre-pregnancy dental health

You are less likely to develop dental problems during pregnancy if you already have good oral hygiene habits.

• Brush your teeth twice daily with fluoridated toothpaste.
• Floss between your teeth.
• Visit your dentist regularly (generally every 6 months)

Gum problems

The hormones associated with pregnancy can make some women susceptible to gum problems including:

Gingivitis (gum inflammation) – this is more likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, particularly during brushing and flossing between teeth

Periodontal disease – pregnancy may worsen this chronic gum infection, which is caused by untreated gingivitis and can lead to tooth loss.

During pregnancy, the gum problems that occur are not due to increased plaque, but a worse response to plaque as a result of increased hormone levels.

Talk to your dentist about any gum problems or queries that you might have. Switch to a softer toothbrush and brush your teeth regularly, at least twice every day. Use toothpaste that contains fluoride (if you’re not already) to help strengthen your teeth against decay.

If you had gum problems during pregnancy, it is important to get your gums checked by a dentist after you have given birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve.

Vomiting can damage teeth

Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can coat your teeth with strong stomach acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.

don’t brush teeth straight after vomiting

Don’t brush your teeth immediately after vomiting. While the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch the tooth enamel.Rinse your mouth thoroughly with plain tap water. Follow up with a fluoridated mouthwash. If you don’t have a fluoridated mouthwash, put a dab of fluoridated toothpaste on your finger and smear it over your teeth. Rinse thoroughly with water. Brush your teeth at least an hour after vomiting. 

Retching while brushing teeth

Some pregnant women find that brushing their teeth, particularly the molars, provokes retching. However, you risk tooth decay if you don’t brush regularly. Suggestions include:

• Use a brush with a small head, such as a brush made for toddlers.
• Take your time. Slow down your brushing action.
• It may help to close your eyes and concentrate on your breathing. Try other distractions, such as listening to music.

If the taste of the toothpaste seems to provoke your gag reflex, switch to another brand. Alternatively, brush your teeth with water and follow up with a fluoridated mouthwash. Go back to brushing with fluoridated toothpaste as soon as you can.

Food cravings while pregnant

Some women experience unusual food cravings (and food avoidance) while they are pregnant. A regular desire for sugary snacks may increase your risk of tooth decay. Try to snack on low-sugar foods instead.

If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits. Rinse your mouth with water or milk, or brush your teeth after having sugary snacks.

Increasing your calcium intake during pregnancy

You need to increase your daily amount of calcium during pregnancy. Sufficient calcium will protect your bone mass and meet the nutritional needs of your developing baby. Foods containing high quantities of calcium include but are not limited to milk, yogurt and cheese.
Why you need vitamin D during pregnancy

Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby’s bones and teeth. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It may also have an impact on birth weight.

If you’re lacking vitamin D during pregnancy, your baby may be short on the vitamin at birth. This can put her at risk for rickets (which can lead to fractures and deformity), abnormal bone growth, and delayed physical development. And the results can be long lasting: Researchers believe that a vitamin D deficiency during pregnancy can affect bone development and immune function from birth through adulthood.

Things to remember

• The demands of pregnancy can lead to particular dental problems in some women.
• Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums.
• You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits. Awareness of the oral-health conditions you are likely to face at different stages of life can help you stay a step ahead of potential dental problems, and build a lifetime of healthy smiles.

Dental Health: Pregnancy and Children

Expectant mothers can give children a head start by eating different kinds of healthy foods and taking calcium supplements while pregnant. Also, taking folic-acid supplements can decrease the risk of a baby being born with a cleft lip and palate. After the baby’s birth, parents should wipe the infant’s gums with a soft, damp cloth after feedings, as this helps prevent the buildup of bacteria. When teeth come in, typically at six months old, parents can use a soft children’s toothbrush twice a day to clean the teeth and gum line, where decay starts.

cleaning baby’s teeth can help prevent gum disease and tooth decay

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Fruit, Fibres and Vegetables
Eating high-fibre foods keeps saliva flowing, which helps create mineral defences against tooth decay. Good sources of fibre are dried fruits such as dates, raisins and figs, and fresh fruits, like bananas, apples and oranges. Other options include veggies, such as beans, Brussels sprouts and peas, along with peanuts, almonds and bran.

Whole Grains
Whole grains provide B vitamins and iron, which help keep gums healthy. Whole grains also have magnesium-an important ingredient for bones and teeth. In addition, whole grains are high in fibre. Look for foods such as bran, brown rice, and whole-grain cereals and pasta to be good sources of whole grains.

Sugar Snacks
You should always focus on choosing healthy foods; see the food pyramid below for the foods and appropriate quantities. Steer clear of sweets, because sugar partners with plaque to weaken enamel. This leaves your teeth vulnerable to tooth decay. In fact, each time you eat a sugary snack, your teeth are under siege for the next twenty minutes. Eating sugary snacks and drinks throughout the day causes teeth to be under attack throughout the day.

Using the The Food Pyramid to help you find foods that help prevent tooth decay. For A healthy diet that’s good for your teeth and the rest of your body, try sticking to the proportions suggested in the food pyramid. The pyramid is structured to give you a healthy serving of all the necessary food groups you need throughout the day in the amounts your body needs.

Eating foods in the proportions suggested in the food pyramid will help reduce tooth decay

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Your never too old to improve your smile.

Dental repair on elderly man to improve his dental health and the appearance of his teeth.

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You wouldn’t eat 22 packets of sugar so why would you drink them?

As the name suggests the campaign is designed to raise awareness on the impacts that sugary drinks have on our bodies and of course our teeth!
A recent study shows that a Mega Slurp Slurpee contains a whopping 25 teaspoons of sugar. I know what you’re thinking. “I would never eat 25 teaspoons of sugar” but you would drink it without even noticing it! The campaign itself takes the drinks you would normally consume without thought or awareness of the sugar content and tests how much sugar is actually it.

Effects of sugary drinks on your body

To the left is a diagram of what sugary drinks are doing to your body. Energy and fizzy drinks contain sugar and acids, these acids erode the teeth and leave the exposed enamel or Dentine which then leads to decay. Even if you brush your teeth immediately after consuming one of these drinks the teeth have already been exposed to enough of the acid to cause damage.
While these drinks lead to decay you can also see from the diagram that they have a major impact on various other parts and organs of the body and can eventually lead to weight gain and Diabetes.

The campaign “time to rethink sugary drink” contains important and useful information on how much sugar we consume and what products contain the most of it.

Australians are in the top 10 consumers of sugary drink worldwide.

Did you know?

“Soft drink” refers to any beverage with added sugar or other sweetener, and includes but is not limited to soda, fruit punch, sports and energy drinks.

Sugar sweetened beverages are high in kilojoules, leading to weight gain and obesity.
Obesity is a leading risk factor for type 2 diabetes, cardiovascular disease and some cancers.
Research has shown that consuming 340ml of sugary drinks a day (which equates to less than one can) increases your risk of type 2 diabetes by 22% when compared to drinking one can a month or less.

American estimates show that consuming one can of soft drink per day could lead to a 6.75kg weight gain in one year.

Young Australians are very high consumers of sugar sweetened beverages, and sugar sweetened soft drinks in particular. The 2007 Australian National Children’s Nutrition and Physical Activity Survey found that 47% of children (2 to 16 years of age) consumed sugar sweetened beverages (including energy drinks) every day.

In the 12 months to October 2012, Australians bought 1.28 billion litres of carbonated/still drinks with sugar, with regular cola drinks being the most popular (447 million litres).

effects of sugary drinks on teeth

Many drinks contain acid that harm your teeth, including regular and diet soft drinks, sports/energy drinks and fruit juices. Acid weakens tooth enamel which can lead to tooth decay. Tooth decay is the most prevalent disease in Australia.
Sugar sweetened beverages produce more acid when the sugar combines with bacteria in the mouth. Try drinking water instead – it has no acid, no sugar, no kilojoules and if you get it from the tap it’s free.

Energy and sweetened powder drinks
What are energy drinks?
Energy drinks are beverages that contain varying amounts of caffeine, taurine, guarana, amino acids, vitamins and sugar. Energy drinks are promoted as being beneficial in increasing stamina, and improving physical performance, endurance and concentration.
What are the ingredients of energy drinks? Energy drinks typically contain a mixture of:
Caffeine is a stimulant that acts on the central nervous system to speed up the messages to and from the brain. Caffeine is the main active ingredient in energy drinks.
Guarana is an extract from a plant that contains about twice the amount of caffeine as coffee beans.
Theobromine comes from the cacao plant. It has a similar effect to caffeine and is found in chocolate and many other foods.
Taurine which occurs naturally in food, especially in seafood and meat, and is necessary for normal skeletal muscle functioning.
Ginseng is a substance that comes from a variety of plants and is believed to have medicinal properties, but has been found to interact with a number of prescription and herbal drugs.

Caffeine content of some popular energy drinks and soft drinks

Popular ‘energy’ drinks

Mother energy drink 500 ml can 160 mg

Red Bull 250 ml can 80 mg

V energy drink 250 ml can 50 mg

Cola soft drink 375 ml can 40–50 mg

Diet cola soft drink 375ml can 48 mg

Short-term effects
• Feeling more alert and active
• Needing to urinate more frequently
• Rise in body temperature
• Stimulation of the brain and nervous system.

Higher doses
Serious injury from caffeine overdose can occur. The Australian Medical Journal has reported an increase in energy drink related reports to the Poisons Information Service in NSW, and they assume that this increase would be reflected in national statistics.
Some of the adverse health effects associated with excessive energy drink consumption includes:
• insomnia
• nervousness
• headaches
• nausea
• vomiting
• rapid heart rate
• Heart-palpitations.

For more information visit http://www.rethinksugarydrink.org.au/go-free
The website listed above contains all the useful information regarding the campaign. It informs readers of how much we are consuming and how much we should be consuming. It includes tips on how to cut back on the amount we consume and how schools can remove sugary foods from their menus and how parents can avoid sugary products for their children and promote healthier choices.
There is also a drinks calculator which allows you to put in the required details and notifies you on how much exercise you would need to participate in to burn off the calories you just consumed. Below is one that we entered for one bottle of Vitamin water. You would need to walk over two kilometres to burn off the kilojoules.

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