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Orthodontics for ALL AGES



Early Influences on Development of Sensory Perception and Eating Habits


Findings from a research article in Advances in Nutrition




April 3, 2025


Over the years in my 20+ years of practicing dentistry and working with children and adults, I see a trend where more and more children are having sensory and eating habit issues. Given this observation, an article “Early Influences on Development of Sensory Perception and Eating Habits” published in Advances in Nutrition, an international review journal, provides some interesting findings that may be worth your consideration.


Here are some key findings based on the article on the importance of early introduction to a variety of healthy food choices:


Infancy and early childhood are important periods for the development of food choices and eating preferences into adult life, influencing weight gain, body composition, and metabolism and ultimately affecting the balance between health and disease.


Food preference can be influenced by early direct contact with flavors, textures, and aromas, as well as by environmental adversities during early development. Evidence suggests that exposure to intrauterine growth restriction is associated with increased preferences for highly palatable foods, such as those rich in carbohydrates and fats, over the life course.


Early flavor experiences, whether from amniotic fluid or human milk, may also shape the development of food preferences. Some researchers indicate that there may be a sensitive period in the first year of life when children are more receptive to new food flavors and textures, suggesting that delaying the introduction of solid foods may lead to feeding difficulties in later childhood. Children are more likely to accept textures that they are able to manipulate, and early exposure to a range of textures facilitates the acceptance of foods of various textures later on.


Improving dietary habits during gestation (fetal) and postnatal periods is of critical importance for the establishment of positive eating habits and healthy growth in infants and should be an important focus of primary prevention efforts.


Several studies have shown that weight gain during infancy may have long-term consequences on health. Rapid growth that follows early growth retardation has been associated with increased risk of overweight and obesity in children, and differences in weight gain during early infancy are at least partly explained by means of infant feeding. Therefore, it is of primary importance to develop effective evidence-based strategies to promote the development of healthy eating styles.


Infant growth must be carefully monitored, both as a prevention of stunting as per the original intent of the growth chart, but also for tracking rapid and excessive growth. Irregular mastication or chewing difficulties must be identified and treated to avoid potential long-term detrimental effects. Providing support and counseling about stimulating healthy food choices to families raising young children is inevitably beneficial to everyone, but may be more so to individuals during sensitive periods of their lives (e.g., pregnancy, lactation, infancy, adolescence).


In adolescents, individuals with overweight showed more changes in orofacial myofunctional aspects than normal-weight ones, and females reported peeling and cutting fruit (apples) in small pieces to better chew them. In the elderly population, many studies have suggested that weaknesses of the masticatory muscles and decreased chewing efficiency due dental problems can have a negative impact on food intake, resulting in avoidance of foods that are difficult to chew, such as meat, fruits, and vegetables.


Future studies are needed to clarify early factors in orofacial development that may impact the acceptance of foods with different textures.




Bottle feeding to sleep beyond 12 months is associated with higher risk of tooth decay and overweight in children


Findings from the Healthy Smiles Healthy Kids cohort study in Australia




March 28, 2025


Published last week in the Australian and New Zealand Journal of Public Health, the research used data collected on over 700 toddlers involved in Western Sydney University’s Healthy Smiles Healthy Kids (HSHK) study – a cohort study that followed children from birth.


Researchers analyzed the results of a survey of mothers, as well as dental checks and body measurements and considered other factors that could influence dental hygiene and weight, finding that:


  • More than 30 percent of children were still bottle fed to sleep at two years old.
  • Children who were bottle fed to sleep at two years old were almost twice as likely to have overweight in early childhood.
  • Children who were bottle fed to sleep at three years old had nearly twice as many teeth affected by tooth decay in early childhood.

In Australia, public health messages are guided by the national dietary guidelines, which advise bottle cessation at 12 months of age and cup use from 6 months of age.


Consistent with the recommendations in national infant feeding guidelines, these findings contribute to the importance of avoiding bottle feeding to sleep at bed or nap times and is consistent with the recommendations for age-appropriate cessation of bottles after 12 months age and transition to cup use.


Bottle feeding at 24 and 36 months of age, beyond the recommended age of bottle cessation, is associated with greater early childhood caries (ECC) prevalence and overweight risk in early childhood. This highlights the importance of communicating bottle cessation and appropriate sleep and settling behaviors as part of a common risk factor approach to ECC and overweight prevention.


Parents and care givers “want to do the right thing” but may not be aware of the health risks of bottle feeding before naps and at bedtime. Bottle feeding in bed is not recommended at any age.


Common drinks for toddlers, including milk and formula, often contain either natural or added sugars, increasing the risk of tooth decay.


A bottle offered at bedtime is often being used by carers to calm an unsettled child or encourage the child to drift off to sleep. Because the bottle isn’t being offered in response to hunger, it can lead to overfeeding, putting children at risk of unhealthy weight gain.


A common myth is that dental health is less important for young children because they still have ‘baby teeth’, however, dental decay in childhood is more likely to result in poor dental outcomes later in life.



SPRING INTO HEALTHY HYDRATION


Best drinks for kids smile and overall health




Mar 20, 2025


Useful information from the American Academy of Pediatric Dentistry:

New expert recommendations from the American Academy of Pediatric Dentistry and other top health organizations highlight which drinks support children’s overall health—and which ones invite unwanted guests like the Mouth Monsters.


What Kids Drink Matters for Their Teeth

As temperatures rise, kids naturally reach for refreshing drinks. Unfortunately, many popular options like sports drinks, flavored waters, and sodas are loaded with sugar and acids that can weaken enamel and feed cavity-causing bacteria. Even "healthy" options like fruit punches, diet sodas, and energy drinks contain artificial sweeteners and caffeine that don’t support kids' teeth or overall health.


So, what’s the best way to fight off the Mouth Monsters this spring? According to new health recommendations, the best drinks for kids and teens are plain water and plain pasteurized milk, with limited amounts of 100% fruit and vegetable juice. And if they do enjoy a sweet drink occasionally, have them rinse with water or brush their teeth afterward to wash away harmful sugars.


Making Healthy Hydration Fun This Spring

Hydration doesn’t have to be boring! Get kids excited about making healthy drink choices by giving them their own reusable water bottles in fun spring colors or patterns. Try adding slices of fresh fruit to their water for a refreshing twist without added sugar. At snack time, pair a glass of milk with crunchy, fiber-rich foods like apples or carrots, which naturally help clean teeth.


Spring is all about fresh starts, so why not refresh your family’s drink choices? By making water and milk the go-to drinks, you’re setting your child up for a season full of healthy smiles and Mouth Monster-free adventures!




Children should avoid drinking slushies with Glycerol


Findings from a study in the UK and Ireland




March 14, 2025


The brightly colored slushy drinks are designed to appeal to children - but most contain the naturally occurring sweetener glycerol, instead of sugar, to stop them freezing solid and give the slushy effect.


Children should completely avoid "slushy" ice drinks containing glycerol, which can make them very ill, until they are at least eight years old, say researchers calling for official health advice to change.


Researchers at University College Dublin said the brightly colored icy drinks can cause "glycerol intoxication syndrome" in youngsters, which leads to loss of consciousness and low blood sugar. Other potential symptoms of "glycerol intoxication syndrome" can include lactic acidosis - which occurs when the body produces too much lactic acid - and hypokalemia, or low potassium.


The researchers studied the cases of 21 two-to-seven-year-olds in the UK and Ireland who needed emergency treatment soon after drinking a slushy product.


Current Food Standards Agency (FSA) advice says under-fives should avoid the drinks and under-11s should have no more than one. The advice is due to concerns that if a young child drinks a slushy too quickly, glycerol intoxication could cause shock, hypoglycemia (low blood sugar) and loss of consciousness.


All of the children in the study, published in the journal Archives of Disease in Childhood, needed accident-and-emergency (A&E) treatment after becoming acutely ill within an hour of having the drinks, mostly between 2018 and 2024. Doctors said they had "glycerol intoxication syndrome" and were affected in a variety of ways:

• most lost consciousness and showed signs of low sugar and high acidity in the blood.

• four needed brain scans

• one had a seizure


The children all recovered and were discharged from hospital, with advice to avoid slushies.


Researchers said there is currently "poor transparency" around slush ice drink glycerol concentration, so estimating a safe dose is not easy. They said factors including speed of ingestion and whether the drink is consumed alongside a meal or during high-intensity exercise may be contributing factors.



Food emulsifiers making us sick?


Emerging research suggests there might be a link between the texture-tweaking agents and health risks




Mar 7, 2025


The last decades have been marked by an increase in the consumption of ‘ultra-processed’ foods, i.e. foods undergoing multiple physical, biological, and/or chemical processes and containing various food additives. Results of observational epidemiological studies linking ‘ultra-processed’ food intake and health outcomes is accumulating worldwide. Many common emulsifiers were considered safe because they aren’t readily absorbed by the body, however, now researchers understand that these very quality enables emulsifier to disrupt the microbiome.


Here are some excerpts from an article by Andrea Petersen published in The Wall Street Journal that you might find interesting:


Emulsifiers are harder to avoid than some other food additives, like artificial sweeteners and colors, because they are difficult to taste and see and their use is so widespread. The ingredients are cheap and increase stability and shelf life.


‘ Emulsifiers are commonly found in junk food, but they are also used in foods that have a healthy image—like some yogurts, whole grain crackers and breakfast cereals, said Mathilde Touvier, research director at the National Institute of Health and Medical Research in France. In one study by Touvier and colleagues, researchers analyzed the ingredients in 126,000 packaged food and drink products available in France: Emulsifiers were in about 54% of them.


There are dozens of different emulsifiers and thickeners. Some, like carboxymethylcellulose and polysorbate 80, are synthetic. Others, like soy lecithin and guar gum, are derived from natural sources.


People who have higher intakes of several common emulsifiers are more likely to develop Type 2 diabetes, cardiovascular disease and cancer, according to three recent studies by Touvier and colleagues. The studies, which followed about 92,000 to 104,000 people over approximately seven years, controlled for a variety of factors, including age, body-mass index and family medical history. The research being observational doesn’t prove that emulsifiers are causing health problems and some of the increased risks are small. But emerging science is finding that some emulsifiers alter the gut microbiome in a way that can cause inflammation. Inflammation has been implicated in a host of diseases.


In a small study with 16 people, the microbiomes of subjects who ate the emulsifier carboxymethylcellulose for 11 days were altered: They had fewer types of bacteria, more bacteria associated with poor health and less “good” bacteria than those who didn’t get the substance. (The diets of the two groups were identical, except for the emulsifier.)


You can avoid emulsifiers altogether by not eating ultra-processed foods. But that isn’t realistic for a lot of us.


The most concerning emulsifiers are the synthetic ones like carboxymethylcellulose, which is widely used in packaged baked goods, and polysorbate 80, which is often used in ice cream and other dairy products, says Gewirtz. He suggests avoiding the gums, like guar gum and xanthan gum, too. These substances generally aren’t digested. They pass through the large intestine, where they disrupt the microbiome, says Gewirtz.


Watch out for carrageenans, too, says Benoit Chassaing, head of the Microbiome-Host Interactions Group at Institut Pasteur in France. These are particularly common in low-fat yogurt and other low-fat dairy products. In his research, carrageenans reduce the amount of beneficial bacteria and promote the growth of bacteria associated with poor health.


The common emulsifier soy lecithin is likely less harmful, Gewirtz says, because it is a natural product that is more readily absorbed.


Touvier recommends the website and app Open Food Facts, a crowdsourced food database, that flags emulsifiers and other food additives.


The actual food you’re eating is still the most important factor in rating its healthiness, Mozaffarian notes. “If you’re consuming yogurt or a fruit dish or bean dish and it has one of these stabilizers in it, it’s still better for you than consuming bacon or, you know, candy,” he says.



Pacifiers influence on Malocclusion


Conclusions from a Randomized Controlled Trial in Finland




Feb 26, 2025


Non-nutritive sucking habits (NNSH) with pacifiers are common among young children. Some articles suggest that almost 82% of young children use them. Such habits are known to be associated with the development of malocclusion, particularly in relation to the duration of the NNSH. The most common features of NNSH-related malocclusion include anterior open bites and posterior crossbites.


Recently a team in Finland (Irma Arpalahti et al) published a paper in the European Journal of Orthodontics that concluded that the use of pacifiers was associated with posterior crossbites, especially if their use was continued for 11 months or more.


It may be important to note that the study was based on a relatively small number of participants as the study was extremely challenging to conduct owing to the task of tracking a group of children from birth to the age of 7. That said, the information is useful to inform parents of young children of the risks of pacifier use so that they can consider for themselves a risk benefit analysis of their children using a pacifier.



Regrowing Teeth Is on the Horizon and May Represent the Future of Dentistry


Promising prospects for new treatment options




Feb 13, 2025


Approaches that replace — rather than patch up — teeth with crowns or fillings may be closer than you think. Scientists have been exploring multiple methods in the past few decades including RNA-based medicines, stem cell therapy, and mineral regeneration.


Tapping stem cells

Stem cells seem like a promising approach, because they are pluripotent — meaning a more generic progenitor cell can produce more specific offspring. The trick is controlling what kind and how many of the right kind of offspring can be coached from a stem cell parent.


A team from the University of Washington School of Dentistry in 2023 demonstrated proof of principal in the lab. They created organoids from stem cells that secrete the proteins that then form enamel. It might be possible to patch up teeth with this approach. The team envisions using it as a living filling that would essentially regrow space formed by a cavity.


Ongoing research in Japan

Another approach being explored by doctors in Osaka Japan is to regrow teeth. Teeth, unlike bones, lack the ability to heal and regrow themselves. Japanese researchers are moving forward with an experimental drug that promises to regrow human teeth.


It might be years before we have mastered these new technologies and medicines but there is hope for some new treatments available in the future.




Understanding impacted teeth


Early recognition is key to treatment outcome




Jan 24, 2025


An impacted tooth is a tooth that doesn't break through the gum in the right place or at the right time. This can happen to baby teeth or permanent teeth.


Signs

  • Pain in the mouth
  • Red, swollen, or bleeding gums
  • Headaches
  • Bad breath or a bad taste in the mouth
  • Difficulty opening the mouth
  • Swollen lymph nodes in the neck


Causes

  • The jaw is too small for the teeth to fit
  • Baby teeth don't fall out when they should
  • Other teeth crowd the area
  • The tooth is twisted, tilted, or displaced

Possible complications of an impacted tooth can include:

  • Abscess of the tooth or gum area
  • Chronic discomfort in the mouth
  • Infection
  • Malocclusion (poor alignment) of the teeth
  • Plaque trapped between teeth and gums
  • Periodontal disease on the neighboring tooth
  • Nerve damage, if the impacted tooth is near a nerve in the jaw called the mandibular nerve


Early Recognition Of An Impacted Eyeteeth Is The Key To Successful Treatment

The older the patient the more likely an impacted eyetooth will not erupt by natural forces alone, even if the space is available for the tooth to fit in the dental arch. A panoramic xray and a dental exam can help identify an impacted tooth problem. Routine dental exams are helpful for good oral health and identifying issues as such as impacted teeth that can be corrected with appropriate treatment if needed.


Speak with Dr. Shah if you have any concerns regarding your child’s impacted teeth.



Nasal Breathing vs. mouth breathing


Benefits of nasal breathing




Jan 18, 2025


Breathing, particularly through the nose, plays a significant role in overall health and in growth and development in children, especially in facial structure. Proper nasal breathing helps guide the growth of the upper jaw and promotes proper tooth alignment, while chronic mouth breathing can lead to abnormal facial development and potential issues with growth patterns in children.


Chronic mouth breathing can affect not just health but even behavior and performance.


Key points about breathing and growth:


Effect on children:

• Nasal breathing benefits: When breathing through the nose, the tongue naturally positions itself higher in the mouth, which helps to properly develop the upper jaw and facial structure.

• Mouth breathing concerns: Habitual mouth breathing can lead to a narrow upper jaw, crowded teeth, a long face, altered facial proportions due to improper tongue placement and teeth health.

• Impact on facial development: Studies show a strong connection between mouth breathing and changes in facial growth, with children who mouth breathe often exhibiting a more elongated facial structure.


Effect on children and adults:

• Effect on performance: Chronic mouth breathing can affect behavior and even academic or athletic performance and energy levels.

• Sleep disruption: Mouth breathing can also disrupt sleep patterns, leading to snoring and potential issues with oxygen levels, which can further affect overall development and or performance


Few of the factors that can contribute to mouth breathing:

• Nasal congestion: Allergies, sinus infections, or anatomical issues that obstruct nasal breathing.

• Poor oral habits: Thumb sucking, tongue thrusting etc.

• Improper jaw alignment: Mouth breathing can lead to dry mouth increasing risk for cavities, can also affect airway impacting oxygenation

• Large tonsils or adenoids: Enlarged tissues at the back of the throat can obstruct the airway.


If you are concerned about your or your child’s breathing speak with Dr. Shah to determine how to address it.




why do adults seek orthodontic treatment?


Orthodontic treatment can benefit adults as well




Jan 11, 2025


The decision to pursue orthodontic treatment is influenced by a variety of reasons. Here are a few reasons to consider:

Improved Aesthetics: Enhance your smile and boost self-confidence


Correcting Bite Issues (malocclusion): Correcting problems like overbites, underbites, crossbites, or open bites that can affect chewing and jaw function


Crowded teeth: Addressing overcrowded teeth which can be difficult to clean and may lead to tooth decay


Preventing Wear and Tear: Protect your teeth from excessive wear and tear


Enhanced Oral Health: Improve oral hygiene and reduce the risk of gum disease


Increased Comfort: Alleviate pain or discomfort associated with misaligned teeth


Preparation for other dental work: Align your bite before restorative procedures like crowns or veneers


Addressing Relapse: Correct any shifting of teeth that may have occurred after previous orthodontic treatment



Dr. Shah's Blog - just some Food For THoUGHT



TOPICS EXPLORED: Nutrition, Growth & Development, Pediatric Dentistry, Orthodontics and Other interesting topics and ideas



Child GROWTh & DEVELOPMENT


Definition, Similarities, Differences, Principle and Influences






Dec 28, 2024


Growth refers to measurable increases in a child's physical size, such as height, weight, head circumference, and body mass index (BMI).


Development, on the other hand, refers to an increase in complexity and sophistication. It involves a continuous progression where children acquire more refined knowledge, behaviors, and skills. While the general sequence of development is similar for all children, the rate at which they progress varies significantly.


Growth:

• During the first year of life, infants experience rapid growth, typically gaining 10 inches in length and tripling their birth weight.

• Growth slows considerably in the following years, with toddlers typically growing 5 inches per year.

• From ages 2-3 to puberty, growth continues at a steadier rate of 2-3 inches per year.

• Puberty marks a significant growth spurt, with girls generally entering puberty between 8 and 13 years of age and boys between 10 and 15 years of age.


Similarities in Growth:

• Cephalocaudal Trend: Growth follows a head-to-toe pattern. Infants gain control over their head and neck before their arms and legs.

• Proximodistal Trend: Growth proceeds from the center of the body outward. Infants gain control of their trunk before their limbs, and their arms before their hands and fingers.

• Early Brain Development: At birth, the brain, heart, and spinal cord are fully functioning, providing the foundation for growth and development.

• Muscular Development: Arm and leg muscles develop before the finer muscles in the hands and feet.


Differences in Growth:

• Children exhibit significant individual differences in growth rates. Some children are taller, shorter, heavier, or lighter than others.

• These variations are entirely normal.

• Factors such as genetics, nutrition, sleep, and exercise significantly influence growth patterns.

• Growth is not always linear. Children experience periods of rapid growth (growth spurts) followed by periods of slower growth.

• It's crucial to help children understand and accept these natural variations in growth.


Principles of Child Development:

1. Developmental Sequence is Similar for All: While the pace may vary, the general order of developmental milestones is consistent across children.

2. Development Proceeds from General to Specific: Children develop broad skills before mastering specific ones. For example, they learn to grasp objects before they can precisely manipulate small objects.

3. Development is Continuous: Development is an ongoing process that builds upon previously acquired skills and knowledge.

4. Development Proceeds at Different Rates: Children develop at their own unique pace. Some children may reach milestones earlier than others, and this is perfectly normal.

5. All Areas of Development are Interrelated: Physical, cognitive, social-emotional, and language development are interconnected and influence each other.


Experiences and Environmental Influences on Brain Development:

Every interaction and experience a child has significantly impacts their brain development and learning. These include:

• Responsive Caregiving: Meeting a child's needs promptly and sensitively fosters secure attachment and emotional well-being.

• Safe and Stimulating Environments: Providing a safe, nurturing, and stimulating environment with opportunities for exploration, play, and learning.

• Early Childhood Education: High-quality early childhood programs can significantly enhance cognitive, social, and emotional development.

• Nutrition and Health: Adequate nutrition, regular exercise, and good health are essential for optimal brain development.

• Stress and Trauma: Adverse childhood experiences, such as stress and trauma, can have a significant negative impact on brain development.


By understanding these principles and providing a nurturing and supportive environment, we can help children reach their full potential.


Speak with Dr. Shah to learn more!



You are what you eat


Importance of paying attention to what we eat




Dec 26, 2024


In a literal sense, I think we all can agree that it's true that 'you are what you eat'. Nutrients from the foods we eat provide the foundation of the structure, function, and wholeness of every little cell in our body, from the skin and hair to the muscles, bones, digestive and immune systems.


Nutrients

The nutrients from food are the basis for the structure and function of every cell in the body. The food we eat is broken down into nutritional building blocks, absorbed into the bloodstream, and reassembled into the body's cells, tissues, and enzymes.


Mood

Food can impact mood in many ways. For example, food affects gut health, which influences the production of neurotransmitters. Ninety percent of serotonin receptors, which regulate mood, are located in the gut.


Cells, hormones, and behavior

The food we eat becomes cells that produce hormones and control activities, emotions, and behavior.

Speak with Dr. Shah to learn more!



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