OK, so we all know that sugar doesn't cause cavities, germs do. When I overhear oral health-care providers discuss the cause of decay with their patients/clients, I get the distinct impression that the provider made it painfully clear sugar is the culprit. I hear about the numerous spoonfuls of sugar there are in soft drinks, candy bars, a serving of breakfast cereal, or whatever. The conversations between professionals usually become heated when discussing the Mountain Dew caries we see painfully often in early adolescents, "It's all the sugar in the Dew," I hear them say.
I recently talked with a pediatric dentist about hidden sugars, and how the primary product is marketed. Take kid's cereals - they are a perfect example. Eight-year old kids shopping with their parents find their buddy Capt'n Crunch right in front of their face. Cheerios are on the bottom shelf along with Wheaties. They're not frosted, in the lingo of the marketing department, but they do contain sugar.
Pour a bowl of any cereal, frosted or not, or even a bowl of sugar. Then immerse a tooth into it and watch what happens. Stand back. Back up further. Vacuum the living room, go pick up some dry cleaning. Come back in a month, and you will find the flies have found your experiment, but the tooth is unchanged.
What am I saying? Are you ready?
Marketing causes cavities.
Roll your eyes back down. Let's take my favorite example of misdirected focus - Mountain Dew - red or yellow. Let's talk about the kid first. He and his pals are taking a break from video games to watch a little TV. The TV owner is channel-surfing and lands on a channel where a distance shot shows two lines of dust rising from the desert. One line of dust is closing the gap. Drums in the background are building on the tension. The group of dudes in the commercial are watching another dude on a bike crossing the African plain chasing after a cheetah, the fastest land animal. The cycle dude tackles the cat, wrestles with it, jams his arm down its throat, and withdraws his can of Dew. The dude trio relax, the tension over, their friend regained his prize, and they celebrate by dumping a can of Dew into their open gullet. The tribal drumming changes into some kickin' rock music and a tooth-pierced can of Mountain Dew is proof that the event actually happened.
The kids in the room are realizing the physical manifestations of an adrenaline rush from the intense mini-drama unfolding before their eyes. Their eyes are glued to the box; muscles are frozen as saliva drips from the corners of their mouths. Their hearts are racing - until the next commercial about a women's feminine hygiene product comes on and the channel-surfing resumes.
The stage is set. The emotion targeted by the marketing department was hit; the kids felt exhilarated while exposed to the punch line, "Do the Dew." This adrenaline rush happens multiple times daily. The commercials alter the emotional state, then deliver a punch line. In the February 2000 issue of Egopower Magazine, Shamus Brown lists the emotion chain for this commercial as: intrigue, anticipation, excitement, fun, and friendship. Anthony Robbins talks about state manipulation in his programs. He teaches people to change their own state to achieve goals, because it works. The Mountain Dew marketing firm knows it works too. Look at their sales numbers! Better yet, look at the trade magazines to see exactly how it works.
The kid is primed for having a beverage of choice, beer (the commercials with breasts). But he'll put up with Mountain Dew until he's older. There is no counter commercial, with or without emotion (or breasts), to tell him to remove the plaque from his teeth. When he ends up in our chair, we see bottle mouth. Cervical decay is evident in various stages of development on all of his anterior teeth under a millimeter of plaque. We bring out a mirror and say, "Look what all that sugar is doing to your teeth." Ta da!
The real sequence of events is:
- Emotion-altering commercial
- Taste of the product
- Agreeable taste leads to other purchases
- Caffeine affects the nervous system/emotions*
- Caffeine is addictive*
- XYZ product is no longer a choice; it's a requirement*
- Beverage has a low pH*
- Decay-causing bacteria are acidophilic
- Combination of frequent sugar intake and plaque equals decay
- No compelling reason to remove plaque = rampant decay
(*In the case of soda pop)
Let's put this into a different realm, one that early adolescents can relate to and accept. How about granting permission with a set of soda drinking rules?
- Drink it fast
- Rinse with tap water (source of fl) afterwards
- Chew gum with Recaldent™ in it
- Brush teeth twice a day until all the stuff that looks like paste is off
- Use a high concentration fluoride once daily
- Have fluoride applied professionally four times a year
- Have a dental check up four times a year
- Use a power brush
- Start a savings account to pay for all the fillings
- Use a straw
Ten little rules. All positive, I might add (except number nine, maybe). The sequence of events is more complicated than blaming sugar. The different acids in this brew also are contributing to the decay. Explaining market targeting along with brushing instruction is a lot more instructive. We'll be giving our young patients some advice about life that reaches much further than their teeth. If education is done improperly, these kids become embarrassed. In the future, they will face a difficult decision: Change their ways, or avoid ever coming to the dentist office again. They will take the path of least resistance.
Tolerance of opinion is one of the hallmarks of the educated. We must respect the decisions our patients make. Our job is to congenially share knowledge with the head in our lap.
Shirley Gutkowski, RDH, BSDH, has been a full time practicing dental hygienist in Madison, Wis., since 1986. Ms. Gutkowski is published in print and on Internet sites, and speaks to groups through Cross Links Presentations. She can be contacted at [email protected].