By Dr. Linda Vidone

Dental Director, Delta Dental of Massachusetts

When reflecting back on your teenage years, you may think of embarrassing physical afflictions like acne, braces, sweat ... We don't need to elaborate, you get the point.

But have you ever thought of cavities or tooth decay? There are plenty of seemingly harmless or discreet activities teens do that affect their oral health and may lead to infections, painful toothaches or even life-threatening complications.

Keep clicking as Dr. Linda Vidone explains what to be on the watch for as a parent...

1. Bulimia

The eating disorder bulimia usually surfaces in the teenage years. In addition to wreaking physical and emotional havoc, it is quite common for bulimia to cause widespread tooth decay. The problems arise when bulimics binge on high-carb foods. The sugars in these foods weaken and erode tooth enamel and feed plaque-causing bacteria. Purging then exposes weakened tooth enamel to stomach acid, which dissolves tooth enamel and further contributes to tooth decay.

It's no surprise that a long-time sufferer of bulimia will probably need to have dental repair work done frequently and repeatedly, especially on teeth that are exposed to harsh stomach acid in purging.

If you or anyone you know suffers from bulimia, seek medical help immediately.

2. Drinking Bottled Water

Teens drink bottled water for various reasons - a convenient means of hydration in school or on the sports field.


But bottled water may not have an adequate amount of fluoride, a natural mineral that helps prevent tooth decay and promotes overall oral health. Fluoride can occur naturally in source waters used for bottling or it can be added.

If teens are not drinking bottled water with fluoride, they should make sure to brush with fluoride toothpaste and talk to their dentist about regular fluoride varnish applications.

3. Chewing Tobacco

Whether it's a way to discreetly get nicotine or because they think it's safer than cigarettes, some teens chew or dip smokeless tobacco. But teens should be forewarned -- chewing tobacco can cause serious oral health problems, as well as general health problems.

Chewing tobacco contains grit and sand that scratches teeth and wears down enamel. It also causes permanent damage to gum tissue and supporting bone structure, which leads to loosened teeth that can be permanently lost. Increased tooth decay from sugars in the tobacco, as well as tooth discoloration and bad breath are also caused by chewing tobacco. And the most frightening of all - oral cancer, is much more prevalent among users than non-users.

4. Citrus Juice & Sports Drinks

Citrus juices and sports drinks can do serious damage to teeth. And it's not the sugar - it's acid. The citric and ascorbic acid in most sports drinks and citrus juices eats away at enamel. Teens oftentimes fall victim to enamel erosion since they tend to drink lots of these drinks. This can especially pose a problem to those teens that tend to sip and swish drinks in their mouths.

Teens should know that water is an adequate rehydration drink for most activities, but if they drink a citrus juice or sports drink, they should drink it quickly so it does not linger in the mouth. If possible, they should rinse their mouths with water afterward.

5. Mouth Jewelry

While piercing the lip, tongue or cheeks may be attractive to some (or unattractive, however you look at it), it can lead to severe complications. After all, there are more bacteria in the mouth than humans on the earth. This enormous amount of bacteria oftentimes enters the opening of the piercing and leads to painful infections.

The jewelry itself can also be an issue. If it damages the gum through frequent contact, gum disease can develop, as well as receding gums that can never grow back. One dental study suggests that nearly 50 percent of those with mouth jewelry have at least one chipped tooth.

6. Ice Breaker

It may sound strange, but teens may crunch on ice to stave off hunger if they're on a diet or need to skip a meal due to a busy schedule. Some may also chew it as a nervous habit, reacting to school-, family- or relationship-related stress.

The truth is that chewing ice, as harmless as it may seem, can lead to microfractures in teeth. These microfractures, which can be seen under an intense light, act as canals for bacteria to enter and linger - leading to cavities. They also increase the chances of these teeth fracturing.

7. Bleachorexia

Teens are inundated with images of celebrities with Chicklet-white teeth and seemingly perfect smiles. As a result, many teens have turned to bleaching their teeth to achieve that "perfect" smile. But many simply don't know when to stop.

Over-bleaching can erode the teeth, leaving a transparency on the edges of the teeth and breaking down the tooth's enamel. This makes teeth overly sensitive to hot and cold foods and drinks. It also can make teeth glow under a black light, similar to the Friends episode in which Ross over-bleaches his teeth.

Remember that bleaching is temporary and should only be done when following the manufacturers guidelines.