Parents: Don't Forget Your Own Oral Health

As a parent you are always trying the do the best for your child and their oral health. Making sure they brush and floss, avoiding sugary foods and taking them to the dentist for regular checkups. Praise yourself for those efforts, but some of the most important things you can do for your child’s oral health begins with taking care of your own dental needs.

The quality of your child’s oral health starts before they are even born. There is a strong association between periodontal disease (gum and bone infection), preterm delivery, and low birth weight infants. Periodontal disease is one of the most common silent infections; many people have no idea they have it. Women with gum disease are six times more likely to deliver prematurely. If you are pregnant, and it has been longer than six months since your last visit, especially if you have any problems such as a toothache or bleeding gums, schedule a visit with your dentist. Although it is preferable to have any dental problems treated prior to pregnancy, there are safe times during your pregnancy to obtain necessary treatment.

Once the child is born, it is important to make sure that both the mother and other primary caregiver’s mouths are healthy. It is critical to your child’s risk for cavities. People often say “I got my Mom’s bad teeth,” when they have a lifetime full of dealing with tooth decay. What you really should be saying is “I’ve got my Mom’s bad bacteria.” Most children acquire the bacteria (Streptococcus mutans) causing cavities from their parents or caregivers soon after birth. This is referred to as “vertical transmission.” It may occur from kissing the baby on the mouth, cooling off or sampling food, cleaning a pacifier off in mouth for the child etc. Cavities are a preventable infectious disease!

To ensure your child has a great start, begin by taking care of your own oral health. Get regular checkups and cleanings, and take care of any cavities in your own mouth. This will decrease the amount of Streptococcus mutans (the bacteria causing cavities). Additionally, it may be beneficial to use certain mouth rinses and/or chew gum containing xylitol to decrease and change the type of bacteria present in your mouth.

The key here is: a healthy parent helps lead to a healthy child. Leading by example is a powerful motivator. Don’t ignore yourself; your kids will thank you.

Morgan

Resources
M. John Novak, BDS, LDS, PhD, Perio and Pregancy is there a link? Dimensions of DENTAL HYGIENE, Oct 2010 34-36.
Oral Healthcare During Pregnancy: A Summary of Practice Guidelines. http://www.mchoralhealth.org
Washington State Department of Health, Community and Family Health, Maternal and Child Health Oral Health Program, (360) 236-3507.

Why We Do What We Do

I recently had the honor of having a really nice article written about my office and published in the November issue of the Wenatchee Valley Business World. Anytime something is written for publication there is always the wonder of will they get it right? Will my words be changed?, or will they get what I am trying to say?

After reading the article I sat back and took a moment to reflect on it. I was actually pretty amazed. It summed up for me what I have worked so hard all these years to create: a business with a heart for giving and innovation.

I love children. I love they way they laugh, the joy they bring into the room, their smiles. They have given me more belly laughs in the last fourteen years than I can count. I can never repay the gifts they have given me. So I say thank you to all of you who have supported me, and the wonderful team at Children’s Dentistry of Wenatchee. It was really nice to see that it is understood ……..why we do what we do……..

Make Work Play

Fun is contagious. You learn that from children. One giggles and laughs and it has a ripple effect on the other kids and pretty soon EVERYONE is laughing. One of our Core Values is: Make Work Play. Work is work and takes up a lot of our lives, but work and play don’t have to be mutually exclusive. If you are having fun and creating positive moments, it’s not so much like work – it’s more like play. Play allows you to find pockets of joy in the day. It also brings out a sense of fun and creativity. Our fun and positivity spill over to our patients and parents. We often hear, “You ladies have a lot of fun here” or “I wish my office was like this.”

I’m really thankful to have a supportive staff who, even on hard days, manage to laugh and smile. I’m also appreciative of the fact that my patients make me laugh out loud on a daily basis by something they say, do, or just by being themselves.

Who wants to look forward to full time drudgery? We sure don’t and neither should you. Today is Wacky Wednesday Costume Day at the office and as you can see by the photos we are “Making Work Play” in an over the top way with Halloween coming up. I encourage you bring some “play” to your day. Start with a Smile.

Dr. Cara

Hygienist's Role

What is the role of the dental hygienist in a children’s dental office?

Dental hygienists are licensed health care professionals focusing on preventative oral health. Traditionally the role of the dental hygienist is to evaluate and gather information about each patient through x-rays and exams. Next, it usually involves a plan for treating any periodontal (gum and bone) condition, by cleaning the teeth and helping the patient maintain good oral habits. The hygienist’s most important role is patient education, teaching patients and parents how to prevent cavities and other dental diseases.

In many children’s dental offices the hygienist is often counted on to help out with restorative procedures. This usually includes giving local anesthetic and placing fillings. One difference between an adult and children’s practice is the hygienist may be more involved with the restorative treatment of children. This varies based on the state, but hygienists in Washington are trained in expanded duties.

Becoming a hygienist requires about 4 years of school, including 2 years in dental hygiene school. In Washington State, additional training is given beyond the scope of traditional dental hygiene. Hygienists are taught how to administer local anesthesia and to place and carve restorations (fillings). Clinical and written board examinations are required to demonstrate competency in these areas.

At Children’s Dentistry of Wenatchee the hygienist spends a good portion of the day administering anesthesia for patients and placing the fillings after Dr. Cara has prepared a tooth for restoration. Your child will typically get a “hygiene check” during a cleaning visit to scale off any calculus (a.k.a. tartar) as well as get oral health recommendations. During this time the hygienist will evaluate each child’s mouth for areas that need improvement, and always make sure to praise good work. The assistants are very involved in patient education and checkups. Working closely with the assistants to make sure that each child has an enjoyable experience is key to the success of your child’s visit.

Above all else the hygienist is a coach helping to instill lifelong healthy habits. By connecting with children at a young age dental problems cannot only be treated, but kids will be given knowledge as a preventative tool. Hygienists are a great resource on oral health. So bring your smile and questions to your next visit!

Morgan

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The Best Toothbrush for Your Child

There are so many to choose from. What is the best tooth brush for my child?

We are often asked for “the best” toothbrush recommendation. I have only one toothbrush that I strongly believe will make a difference in the oral health of your child and that is the Sonicare. Sonicare For Kids is specifically designed to help parents teach their child (ages 4-10) to brush, then help them transition their child to independent brushing.
Parents often ask if the “spin” type brushes available in stores at a lower price will do the same thing. The answer is NO. The carefully researched and patented sonic combination of approximately 31,000 brush strokes per minute and the specific reach of the brush head as it sweeps back and forth are what create Sonicare’s unique “beyond the bristles” cleaning action. Most power toothbrushes have either a different stroke frequency or bristle amplitude and do not have the same powerful, yet remarkably gentle fluid activity as Sonicare.

When children come into the practice 99% of the time I am able to identify by looking at their gum tissue and overall dental health whether or not they are Sonicare users. That was a powerful message and solidified for me as a mother and a dentist that the Sonicare for Kids toothbrush IS the best.

Movitating Kids to Brush

Image via Wikipedia I have a toddler, first grader, and fourth grader at home. How do I motivate them all to brush?

Different age groups learn in different ways. Use the tips below to help your children and motivate them in their lifelong brushing & flossing habit.

Preschool
Preschoolers learn most things through rhythm and rhyme. Make the
brushing experience fun and exciting. Let them know there are little
bugs that we can’t see that live on their teeth, and you have to brush
them away. Make a song out of your teeth brushing time:

There’s a bug on my teeth brush him off
Brush up, brush down, brush you teeth round and round
When you spit the paste in the sink, the bug goes down the drain
There are no more bugs in our teeth  Look smile now so bright

Once you have shown your tots the up and down and round and round flow
of brushing their teeth, give them the brush, “now you try. Once they
get the flow themselves and they move their tiny brushes correctly
make this a very exciting and joyous moment. Celebrate this with
laughter, clapping, and exciting hoorays. Let other family members in
on the celebration as well, have your child show their grandparents or
other family members how awesome they can brush their teeth.

Main points to address:

•Get excited about brushing and even more excited when they brush.
•Make it a fun experience.
•Ask them to show you how well they can brush their teeth.
•Make it a big deal to other family members when they learn how, “Dad
look how great (child’s name) can brush his/her teeth.

Grades K-3rd
Grades K-3rd learn through presentation and repetition. The best way
for young elementary children to learn is through repetition and
presentation. Offer your young children the ability to watch as you
brush your teeth explaining what you are doing every step of the way.
Use creative analogies, “plaque are small bugs in your mouth
eating away at your teeth and the only way to get them out is to
brush.”

You’ll be amazed at how quickly your kids will ask to brush their
teeth and insist on doing so regularly.

Main points to address:

•Be consistent with times of the day to brush.
•Use creative analogies or stories of others who never brushed their
teeth.

Grades 4th-6th
While grades 4th -6th learn through show and tell. There is nothing
more effective than honesty and showing these youngsters what happens
when someone doesn’t brush their teeth. Find pictures of an individual’s
teeth with serious decay or rotten teeth. Use every dental visit
as a way to teach them by asking the dentist for pictures of people
who never brush their teeth. Explain to them, “this is what happens
when people don’t brush their teeth.”

You can also explain the health hazards of not brushing your teeth.
There are plenty of health risks for individuals who don’t brush their
teeth.

Main points to address:

•Be honest about how not brushing decays their teeth and hurts their
health.
•Use pictures offered through your dentist at every visit.
•Ask your dentist to share with your children stories, pictures or
knowledge of the hazards of not brushing their teeth.

Remember....Learning is life long!

Dr. Cara

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Teeth Grinding

My child grinds her teeth so loudly at night it wakes me up! Should I be worried?

Well, even though it may sound like your daughter is chewing on rocks, no you don’t need to worry! Parents will often tell me that it is the most awful sound and it can be…but actually, tooth grinding ( bruxism) is quite common. I have at least one parent a day ask me about it in my children’s dental practice.

The exact cause of grinding is unknown. Dentists don't really know what turns some kids (and not others) into grinders. Tooth grinding in toddlers usually goes away on its own as a child gets used to having teeth.

One side effect of grinding that parents often ask about is the chipping and wearing down of the teeth. I do agree, the teeth can look kind of funky. I see teeth that are slightly chipped to some worn down to the gum line.
Often, as the enamel wears away the teeth flatten out, and the dentin (inside more yellow layer) shows. It does’nt hurt as the pulp (nerve) "scars" back out of the way about as fast as the kid grinds away the tooth structure. By the time you would see real problems due to lost tooth structure, the teeth naturally fall out.

What about a night guard? For toddlers - no. First, it would be impossible to keep it in the mouth, second, you would have to remake it so often due to growth and most importantly - there is no real benefit! Just look at grinding as another milestone as your toddler adjusts to the new teeth they have in their mouths. Although most children out grow it, if your child is still grinding when all of their permanent teeth are in, talk to your dentist. Maybe then it will be time for a night guard. In the mean time a pair of earplugs goes along way!

Dark Tooth

One of my toddlers teeth is changing color, is the tooth dead?

No, the tooth isn’t dead. Parents often express concern because one of their toddler’s teeth has darkened in color. It is a very common thing to see a dark baby tooth because kids are bumping their teeth all the time. That is why they call them toddlers! The color change generally happens two to three weeks after an accident. It's usually a grayish color, sometimes turning almost black and even often lightening back up. Whether the tooth turns dark or not doesn't always depend on the severity of the injury. If it doesn't turn dark after a month, generally you won't have any further problems. It will likely lighten back up. If it doesn't, there still may be no treatment needed other than observation.

If your child does have an accident and bumps their tooth it is always a good idea to have it checked by your dentist rather than waiting for a color change to occur. By doing so, even if nothing is wrong at the time your dentist will have a baseline to go from if the health of the tooth changes in the future. Rarely, a baby tooth that has been traumatized will abscess and need removal. The primary concern is the protection of the health of the developing permanent tooth and not allowing any infection to spread.

Shark Teeth

My child has two rows of front teeth. Is something wrong?

Well, yes and no. Yes, it needs to be addressed and no, your child is not really a baby shark! It looks strange and does often cause parents concern. I actually see this quite often. The baby teeth have not come out like they were supposed to - it is most common with the lower front teeth when the child is six years old.

In the normal course of events, the permanent tooth slowly dissolves the root of the primary tooth as it comes up underneath. Eventually, there is not much root left, the baby tooth gets loose and falls out. The permanent tooth then comes in where the baby tooth used to be. Well, it just doesn't always happen like that.

If the child doesn't have enough room for the permanent teeth, then the permanent tooth may not come in right up under the baby tooth. Even when there is lots of room, the new tooth may not be able to resorb the baby tooth root fast enough. It then takes the path of least resistance, which is to come in behind the baby tooth. That means there is nothing "pushing" the baby tooth and there may be quite a lot of primary root left.

The good news is the permanent tooth will tend to move forward into the correct position on it's own IF there is nothing in the way and there is enough room. A lot of parents hold out hoping the baby tooth will fall out on it's own. Some children are very aggressive in wiggling their teeth. Some just let them hang there! This can create a not so nice plaque trap, which leads to red and irritated gum tissue.

Often the retained baby teeth need to be taken out. This may involve making more room by removing the adjacent baby teeth or making the baby teeth more slender by "disking" them. If the new tooth hasn't come in very much (you haven't waited too long), then the new tooth will slowly move forward. This takes a few weeks or months. The tongue is a strong muscle and with the pressure it applies you may be surprised how quickly these teeth move into a better position!

Independent Brushing

My toddler wants to brush her own teeth, what do I do?

There is one very important point to be made here. No matter how talented your toddler is, they cannot EFFECTIVELY brush their teeth by themselves. Children don’t develop the muscular control and skill required for good brushing until sometime between the ages of 5 and 7. Until then they need your physical help each and every time.

That being said, start with your toddler modeling you as you brush your teeth. At this stage of the game most little ones want be just like mommy and daddy. Give your toddler their own toothbrush dampened with water and just a touch of toothpaste. They will do more sucking than brushing so reserve that small pea sized amount of fluoridated toothpaste for the time that you are actually doing the cleaning. Using a team approach is a win for both of you. Decide with your toddler if they are going to brush first or second. This gives them the freedom to choose and you the control of a thorough brushing.

A good way to get all of the tooth surfaces clean is the “AAHHSS” and the “EEEES” method. Have your toddler open wide and say “AAHHHHH” to get the top surfaces and insides of the teeth. To brush the sides of the teeth ask your toddler to bite together and say “EEEEEEE”. This loosens up the cheek musculature and allows you effectively clean the outsides of the teeth.

Now for the fun part! Perhaps your toddler wants nothing to do with you brushing their teeth. I remember my oldest daughter, Olivia often (actually quite often) having a fit at brushing time. I was a tired young mother trying to talk her into opening her mouth. Well that got me zippo and so yes, I would hold her down to brush and yes we both survived.

As a professional I understood that the mouth is a personal space. As a mom all I wanted was to avoid a battle with my daughter. What I believe and what I tell parents is all you can do is your best. You know that you love your child. You know that brushing in the morning and evening is important. However, you get to pick your battles and if you miss a night of brushing once in awhile it won’t be the end of the world.

I promise both you and your child will make it though this challenge. I like the analogy of putting an uncooperative toddler in a car seat. Just because they don’t want to do it doesn’t mean you don’t give them a gentle push and buckle them up! Remember, I had a very strong willed toddler and brushing was a battle. She is now 14, brushes her teeth regularly and is not traumatized by “my mommy loves you method!” Happy Brushing!

To Seal or Not to Seal?

My dentist suggested sealants on my child’s teeth. What are they & are they really necessary?

Great question! As a mom and dentist I believe that all options that will help prevent cavities are worth learning more about. The chewing surface of your child’s permanent teeth are covered with deep grooves (referred to as pits and fissures). Food particles accumulate in these grooves, come in contact with bacteria and lactic acid is released. This lactic acid destroys tooth enamel which leads to cavities.

A sealant is a protective coating between the lactic acids and the tooth enamel.
Sealants themselves are a polymer resin brushed on the chewing surface of your child’s teeth. They are bonded to the surface of teeth with an ultra violet light. Sealants are preventive dentistry for the biting surfaces of teeth. They are painless and easy to apply.

Are sealants necessary? Let me put it this way. Removing an appendix is necessary. Sealants are a choice. However, I strongly I they are a benefit. I chose to place them on all four of my own children’s teeth. I have seen too many unprotected teeth come in without sealants and in place are big cavities!