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A Hidden Epidemic- Central Appalachia’s "Dental Crisis" Revealed

By February 17, 2009

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A recent report by Diane Sawyer seen on ABC's 20/20 February 13, 2009, exposed an alarming realization regarding the rate of tooth decay in the innocent children that call Kentucky's central Appalachia mountains their home. It is the opinion of many dentists in the area that Mountain Dew is the leading cause of rampent tooth decay found in the mouths of children in the area. This type of decay in children will potentially lead to toothlessness as an adult. Referred to as "an epidemic" when it comes to toothlessness, this particular region of the United States has been found to have one in ten people without any natural teeth. "Mountain Dew Mouth" as it has been aptly named by dentists, is caused by the abundance of acid found in the popular soda. A 20 oz bottle of Mountain Dew contains 19 teaspoons of sugar and 93 milligrams of caffeine. Dentists do agree that any soda will cause acid erosion in the teeth, but Dr. Edwin Smith revealed to Diane Sawyer that Mountain Dew is "unique," adding "it has a lot of sugar and a lot of acid." Dr. Smith, founder of “Kids First Dental“ provides school-based, free dental care, in a mobile dental office that brings the dental office directly to 16 eastern Kentucky counties.

We know that sugar is the fuel that feeds the bacteria that forms plaque on the teeth causing tooth decay, but why is soda identified as being responsible for this excessive tooth decay, especially in children? I was alarmed to learn from the report that soda is put into baby bottles and “sippy” cups in place of milk, or even water, and that soda namely Mountain Dew is sipped constantly throughout the day "bathing" the teeth in sugar, and is carried around in large bottles at school especially during lunch time. Dr. Moore-Martin, a dentist, believes that "people are addicted to Mountain Dew," a "terrible" reality for many people in the area.

I am fully and compassionately aware that poverty is a realization for many people, more notably the families documented in the report. What I do not understand is how the use of soda in this manner is justified; by anyone, including parents of young children? Milk certainly does not cost a fortune, in fact where I live a case of 12 soda cans costs more than a gallon of milk. Don't get me wrong, milk used irresponsibly in a bottle or sippy cup will cause rampant tooth decay, but at least there is a nutritional value in milk that is essential to growing little bodies. I do, however, strongly believe it is the responsibility of the company that produces the soda, to educate people on their products and its intended use. Perhaps placing a label that clearly indicates the recommended daily limit and age restrictions of each product will prompt people to reconsider how soda is used as a beverage. That being said, it is ultimately the hope of dentists and dental professionals alike that by educating parents and caregivers on the importance of brushing and flossing, providing a well balanced diet, and remembering that healthy baby teeth are a vital necessity for children, will one day reduce the rate of this type of decay and cause a drop in the number of toothless people in the United States as a whole.

If you would like more information on ways you can help the “Children of the Mountains” ABC News has a list of charities that are in place, ready to accept your donation.

April 2, 2009 at 10:37 pm
(1) Jennifer McKee says:

This phenomenon is not unique to Kentucky. I work as a volunteer in a (mostly) church-supported free dental clinic in Western NC — the Blue Ridge Mountains. The dentists there have been pulling the teeth they could not rescue for years. Our clinic is unique in that it attempts to rescue salvageable teeth — most just pull them all.
“Mountain Dew mouth” is a commonly used phrase in our clinic, not dissimilar in appearance from “meth-mouth”. It’s nothing new, just new to the airwaves.
I would like to see the “list of charities” link in this article rehabilitated, for I would surely add our little NC mountain clinic to that list, and there must be many others.
Incidentally, I’ve heard that Pepsi-Co is now donating to Dr. Smith. …pitifully meager mitigation for the damage done.

January 30, 2010 at 10:33 am
(2) Jennifer McKee says:

The Blue Ridge Free Dental Clinic in Cashiers, NC, continues to address this problem, using all-volunteer dentists, and funded entirely by grants and contributions. The Clinic also participates with the local Rotary Club to teach prevention to school-age children and provide free screenings.
The need is ongoing in Appalachia. Here is the website: http://www.blueridgefreedentalclinic.org.

February 7, 2010 at 7:56 am
(3) Kids Dentist says:

Thanks for shedding light on this topic of Mountain Dew and dental tooth decay. Many people are completely unaware of the devestating effects this sody can have on their dental health. Mountain Dew Mouth is a real phenomenon and parents must ensure their kids are limiting their intake of this high-sugar soda.

June 27, 2010 at 9:13 pm
(4) Toronto Dentist in Etobicoke says:

Making the company responsible for the dental damage isn’t going to happen.

Educating is worthwhile but it has limited impact on those that need it most. Besides, even well-educated people will still make bad choices.

Free dentistry helps keep the children from suffering, so they can go on to become suffering young adults.

The bottom line is life isn’t fair. Some people are going to get a very lousy deal. We’re all going to die sometime and some of us sooner than others.

Remember in Dickens Christmas Carol – the 2 wailing children beneath the ghost of Christmas Present’s robes? “This boy is Ignorance. This girl is Want. Beware them both, and all of their degree, but most of all beware this boy, for on his brow I see that written which is Doom, unless the writing be erased.”

Dickens was warning that today’s hungry victims become tomorrows violence and tragedies.

Joe Bulger DDS
Visit my dental blog – Toronto Dentist Smile Blog

July 6, 2010 at 4:25 pm
(5) Oscar Valenzuela, D.D.S. says:

I would like to address the comments of Dr Bulger:

You make an interesting point. Adults make bad decisions, and rightly, should bear the brunt of those decisions. But to dismiss the pain of children, then (dripping in sarcasm) say that we are all going to die…is really absurd. You seem to be pretty self-absorbed, as in… “I got mine…go get yours.”
Perhaps you also agree with Scrooges comments when asked if he would like to make a contribution to the “poor and destitute..” He asks if the prisons and workhouses are still in good working order, because his taxes pay for them. He is told that they are, but the conditions are so deplorable, the poor would rather die.
To this, Scrooge replies “If they would rather die, they had better do it and decrease the surplus population.”
Is this what you would like to happen to the poor of this (and your) country? Then, at least you wouldn’t have to worry about them.
My guess is that you do your own type of charity work, so I won’t get too frustrated with your remarks. But you should consider carefully your words when speaking of the poor, especially poor children. It is clear that they don’t have an advocate in you, but there are others who believe that they are the most vulnerable, and should be cared for as if they were our own.
I pray you didn’t mean to be so harsh, but I couldn’t let this go by without saying something.

Oscar Valenzuela, D.D.S.
(sorry–I don’t have a dental blog)

August 27, 2010 at 6:03 pm
(6) Toronto Dentists Etobicoke says:

Wow, I must have been feeling poetic that day. Charles Dickens? I must have been sucking on too much Mountain Dew.

Anyways, despite modern advances, there’s always going to be an ill-kept, mostly-illiterate component of our society. Should the State assume stewardship of the needs of such people, or let their teeth rot?

Tough question. I would be concerned that ramping up State care would only encourage more State dependence.

Joe :D

September 26, 2010 at 8:13 pm
(7) Hip says:

New Virus Causes Sudden Increase in Tooth Decay
There is a respiratory virus going around that causes sudden periodontal problems (ie, RECEDING GUM LINE), and the very sudden appearance of many DENTAL CAVITIES in the mouth, even in people with excellent oral hygiene habits. 

This new virus may be responsible for this tooth decay epidemic, at least in part.

I caught this virus, and my previously perfect oral health plummeted within a matter of months. Many friends and family members who also caught the same virus had exactly the same sudden onset of dental caries and peritonitis. 
For more info on this virus, see here: http://chronicsorethroat.wordpress.com/

Or google “Chronic Sore Throat / Mood Virus”
Mechanism Of Tooth Decay Caused by this Virus
The mechanism for tooth decay caused by this new virus is probably connected to its immunosuppressive nature, which thus allows oral bacteria to proliferate more, and thereby create dental cavities and erode the gum line, leading to periodontitis. Also this viral infection may increase levels of matrix metalloproteinases such as MMP-9, or neutrophil elastase, which can undermine gum connective tissue, thus further promoting periodontitis.

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