Saturday, 2 July 2016

Healthy Children Radio: Your Teen's Beautiful Smile and Fresh Breath

Adriana Segura DDS, MS, FAAP answers hot questions such as:
  • How can parents help teens bring a healthy smile into adulthood?
  • Does what they eat matter?
  • What is fluoride varnish, and what does it do for kids?
  • Why are x-rays needed, and how often should they be done?
  • When your child needs braces, what are the options?
Dr. Segura is a professor in the Department of Comprehensive Dentistry and the Department of Pediatrics at the University of Texas Health Science Center at San Antonio (UTHSCSA) and is currently the Associate Dean of Student Affairs.

Good Reasons to Smile

A healthy mouth and teeth are an important part of a child’s wellness. So when should a child go in for his first dental exam? What’s the best way to take care of a baby’s teeth? How can you build good dental habits with your children, regardless of their ages? Here’s what you need to know.
Do you remember learning how to take care of your teeth as a child? Perhaps there was an upbeat rhyme that kept you on task when brushing, or maybe cartoon images of milk come to mind. Maybe you’re old enough to remember those red tablets that, once chewed, showed where you missed brushing. Though this time marked a turning point in your independence, the road to your oral health began much sooner.
Even babies’ mouths can develop a buildup of damaging bacteria along the gums, a problem that can be preventing by wiping them with a soft, damp cloth after feedings. Some of the advice pediatricians include in a total wellness plan also speaks to keeping baby’s mouth and teeth healthy. Nutritional needs come into play. And for all the advice you might have received about helping your child sleep by putting her to bed with a bottle, this is perhaps the biggest contributor to preventable decay and early cavities.
“In our clinic at Duke Children’s Hospital, we see children under age 3 every week with significant tooth decay. Restoring these teeth to a healthy state is not only emotionally challenging for the child but a major financial burden to the family,” says Martha Ann Keels, DDS, Ph.D., a pediatric dentist in Durham, N.C., who treats baby bottle tooth decay.  Getting Dental Help
Healthy teeth are crucial for speaking and for chewing solid food. Whether you’re in the midst of the long nights that might accompany infant teething or your child has a full set of pearly whites, it’s a good idea to brush up on just what to do next.
And according to Dr. Keels, there’s now consensus among four major national entities all recommending that children should have an oral health risk assessment by their first birthday.
A child’s first trips to a pediatric dentist can give parents good guidance for taking care of a child’s teeth, gums, and mouth. It’s a good time to find out how to encourage your child to be proactive about dental hygiene, and get answers to your questions about everything from feeding to using pacifiers.
The dentist also will explain how to spot potential problems, such as the white chalky spots that indicate dental caries, an early dental disease. According to Dr. Keels, caries is the most common problem diagnosed in young patients. “Parents need to know that the white spot lesions are reversible — they can be re-mineralized with a combination of remedies, such as diet changes and fluoride varnish,” explains Dr. Keels. “If the white spot is left unattended, it may quickly advance into an irreversible cavity.”Peace of Mind
Even for adults who haven’t been faithful in getting their own routine checkups, parents often want what’s best for their children, and this includes getting appropriate dental care. Adding a dental professional as a resource to your support system can provide ongoing peace of mind for your entire family.
Dr. Keels relates her experience of examining a 12-month-old for the first time on a recent morning. Later that same day, the child fell and pushed her teeth up into her gums.
“It is not uncommon for a toddler to fall and have dental trauma when learning to walk. In the scenario where the child already has a dental home at age one, that family knows where to go for help,” says Dr. Keels. “In the scenario where they have not seen a dentist yet, it will be doubly stressful to find a provider.”

Finding the Right Dentist

David M. Krol, M.D., FAAP, associate professor and chair of pediatrics at University of Toledo College of Medicine, says that he “wholeheartedly” supports an oral health risk assessment by one year of age. It’s the best way to build knowledge about how to care for a child’s teeth, and to build the good habits that are key to prevention, he says. “This is the ideal, as children will hopefully be connecting with a dental home before they need any serious intervention and can develop a strong and positive relationship with a dentist,” Dr. Krol points out.
Experts suggest that you approach locating a pediatric dentist with the same seriousness and energy you invested when finding a primary care physician. Obtain names of area pediatric dentists from trusted friends, professionals, and health organizations. Your child’s existing pediatrician, along with your own research on the Internet and through your dental insurance provider, can serve as solid starting points, too.
Dr. Krol advises parents to ask themselves some simple questions after selecting a pediatric dentist for a first-year visit, such “How does the dentist interact with children? Will they see the same dentist each time they come in?” Most importantly, he points out, parents should not underestimate their own comfort level when committing to a regular dental provider.

The Exam: What to Expect

Almost all pediatric dentists will perform a thorough exam of the mouth and teeth while the child is comfortably situated on the parent’s tap. Using a lap pillow as a prop, some dentists may have the child lean back onto the pillow while holding his parent’s hands.
As further comfort to hesitant moms and dads, Dr. Keels says, “I reassure parents that it is completely normal for the child to get upset with having to lean backwards, but that the exam is very quick and the toddlers quickly recover once the child is allowed to sit up.”
If you’re at all worried about the prospects of a squirmy baby or rambunctious toddler in a quiet office setting, you’re not alone. It might help to remember that you are seeking the expertise of a professional whose career is dedicated to working with kids. A pediatric dentist receives an additional two to three years of specialized training over that of a non-specialized dentist. And while maintaining a toy-filled waiting room might not be necessary to obtaining credentials, it most certainly is the norm.

The Golden Rules for Raising Cavity-free Kids

  • Support good dental health by taking care of your child’s gums and teeth on a daily basis. Once the child is old enough to “do it by herself,” continue monitoring daily habits and self-care.
  • Be selective about any type of beverage you put in your child’s bottle or sippy cup besides water. Remember, dentists often refer to juice and soda as “liquid candy.”
  • Keep a bottle or sippy cup away from your child’s naptime and nighttime slumbers. Liquids tend to stick to the teeth because the mouth is drier during sleep.
  • Reward children with hugs, stickers, and toys instead of desserts and candy. Sugary foods leave behind a sticky coating that converts to harmful bacteria and enamel-eating acid. But if you feel compelled to give your child an occasional sweet, choose one that melts rapidly instead of gummy candy.
  • Serve up calcium-rich foods such as yogurt, cheese, and milk, along with plenty of vitamin-heavy vegetables to help your child maintain strong, healthy teeth. Build good habits early by giving your child healthy treats in place of sweets at snack time.
  • Talk to your child’s pediatrician or dentist about the appropriate amount of fluoride your child needs.

Fluorosis Facts: Information Parents & Caregivers

Fluoride is an important mineral for all children. Our mouths contain bacteria that combine with sugars in the foods we eat and the beverages we drink. The acid that is produced harms tooth enamel and damages teeth. Fluoride protects the teeth and can even help reverse early signs of decay. But the increased availability of fluoride today has resulted in more of something called dental fluorosis.

What is Dental Fluorosis?

Dental fluorosis is a change in the appearance of the tooth's enamel surface. The most common types do not affect the function of the tooth and don't cause pain.
Most dental fluorosis is either very mild or mild. Mild forms of fluorosis appear as white, lacy markings on the tooth's enamel and are difficult to see with the untrained eye.
Fewer instances of fluorosis are categorized as moderate. Moderate fluorosis looks just like mild but covers more of the tooth.
In rare cases, fluorosis is described as severe. When fluorosis is severe, the enamel may have pitting and brown spots.

What Causes Dental Fluorosis?

Dental fluorosis is caused by consuming too much fluoride over the period of time when teeth are forming but before they appear in the mouth. This takes place before 8 years of age. To avoid this possibility, supervise brushing so that children do not use too much toothpaste, mouthwash, or mouthrinse and learn to spit, not swallow.

How Much Fluoride Should My Child Have to Protect His Teeth Without the Risk of Fluorosis?

Children who consume a typical diet, drink fluoridated water, and use fluoridated dental products properly will get the fluoride they need for healthy teeth. It is not necessary to monitor water or food consumption since your child ingests low levels of fluoride from these sources. Parents will want to ensure that children do not swallow toothpaste or mouthrinse, which contain more concentrated amounts of this important mineral.

How Do I Know if My Child Has Dental Fluorosis?

Since there are many possible causes of changes in the appearance of the teeth, you may want to see a dental professional to have the teeth checked for fluorosis or other issues. The American Academy of Pediatrics recommends that all children begin regular visits to the dentist by their first birthday. Ask your pediatrician's office if they offer referrals.

Sources of Fluoride

  • Beverages, including fluoridated tap water
  • Foods processed with fluoridated water
  • Toothpaste and other oral care products
  • Topical fluoride & dietary supplements

How Do I Protect My Child's Teeth without Causing Fluorosis?

Here are three things you can do:

1.       Follow these guidelines on the proper use of dental products such as toothpaste. Children under the age of 6 should avoid the use of mouthwash and mouthrinse. 
  • Children younger than age 3 should use a "smear" of toothpaste containing fluoride.
  • Limit tooth brushing to 2 times a day for this age group.
  • Children aged 3-6 years should use a slightly larger, "pea-sized" amount of toothpaste containing fluoride.
  • Supervise and help young children with tooth brushing. Since most young children will instinctively swallow water, they should be encouraged to spit out excess toothpaste, but not rinse with water.
  • Keep all dental products out of the reach of young children to avoid accidental ingestion.
2.       Determine whether your primary source of water is fluoridated.
  • For information on local water systems see the CDC My Water's Fluoride.
  • For information on well water, see Private Well Water & Fluoride.
  • Most bottled water in the U.S. does not contain an optimal level of fluoride.
  • If your water is not fluoridated, speak to your child's doctor or dentist about ways to ensure your family is getting enough fluoride from other sources.
3.       Start regular visits to the dentist by your child's first birthday. If you do not have a dentist yet, your child's doctor can refer you to a dental home. He can also check her teeth, talk to you about taking care of her oral health, and make sure she is getting enough fluoride.

What about Infant Formula?

According to the American Dental Association, it is safe to mix infant formula with fluoridated water.

Not All Sugars are Sweet!

Starchy foods, including snacks kids like such as pretzels, crackers, and chips, contain sugars, and sugar contributes to tooth decay!
Limit sweet and salty snacks, and offer water instead of sweetened beverages like soda pop and juice.