cavities in children

Parents flip the lip

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I drafted this post some time ago but held back. I didn’t want parents to think I am criticizing them. I understand how many times throughout a child’s life that parenting can be difficult. I don’t want to add to any external pressure, but reading an article yesterday that “the federal government is spending a million dollars to send five chartered plane loads of Nunavut children to the hospital in Churchill, Man., for dental surgery”  pushed me into sharing this. That coupled with the fact that after discussing this with a patient of mine she stated “I wish you would tell all parents this”. This is my attempt to reach more parents.

Dental decay is preventable

Granted there is an access to care issue for these Nunavut children in this media report, but that wouldn’t explain the situation in other areas of Canada. There is no shortage of tooth decay and dental treatment being carried out in Calgary by pediatric dentists.

Parents – please flip the top lip up and have a look at your baby’s teeth. Do this often, and realize that brown spots are not normal. Flip the lip when you brush. Their tight little lips prevent thorough plaque removal. Often it is far easier to brush the side of their teeth that the tongue touches when they open wide for this task, than to brush the surface covered by their lips.

Take your child to a dental health care provider by age 1 year (6 months after 1st tooth erupts). Yes, it is a short apt if nothing is wrong, but a very important appointment. Don’t wait until there is a problem, or until age 3 years old. Do they have the appropriate number of teeth for their age? Are they tongue tied? Is their lip tied? Are you struggling to clean their teeth? Are you confused about toothpaste that is age appropriate?  This is only a fraction of what could be reviewed and discussed at this first visit. Regulated dental healthcare workers are required to attend continuing education. That phrase “when we know better, we do better” applies. Therefore, what was reviewed at your older child’s exam 9 years ago maybe be quite different than what is reviewed today with a much younger child.

Wipe off baby teeth with a washcloth or baby toothbrush

Don’t lay a baby down with any liquid other than water

Don’t let a child sip for extended times from a sippy cup – think if it this way – every time they take a sip of apple juice (even diluted) a 20 minute acid attack takes place in their mouth (approximately). If they are sipping from their sippy cup intermittently for 1.5 hours (length of a kids movie) that is almost 2 hours of acid attack

Why fruit juice?….  Why not water?

When the time is right – Have Dental Sealants Placed

I am a parent and trust me there was a period of time that it took myself and my husband to hold our son down so that we could brush his teeth –  he was about 2.5 years old when he began to hate having his teeth brushed. I mean hate it. Of course, we hated doing it just as much.   Me: ” It’s your turn”;  my husband: “No, it’s your turn”  – and usually it would take 2 of us to do it. I would put my thumb in my son’s mouth toward the back baby molars- where when he bit down it wasn’t with any amount of force. Then while my thumb was there, we could get his teeth brushed. He couldn’t close completely so I could maneuver a toothbrush around. The thumb technique sometimes allowed me to do it without help from a second adult. This nightly battle went on for about 6 months- then he was over it. He began to want to “do it himself” of course, but the deal was – he had a turn then an adult had a turn. This event takes minutes, not hours – get it done – get it over with.

Children DO NOT have the dexterity to brush and floss well enough until age 10. If you don’t believe me, have them “do it themselves”, then put disclosing liquid on their teeth. The liquid that turns plaque bacteria purple or red. You will then understand how a child who “brushes everyday” still gets cavities. They aren’t brushing well enough to remove the majority of plaque. It’s not their fault, it’s not that they aren’t trying. They don’t have the co-ordination. Sometimes once “disclosed” – it is quite evident that they are right or left handed and they have missed an entire quadrant of their mouth. Not just one or two teeth, but 5 or 6 teeth. They have spent the time in the bathroom and they report the deed is done, but an adult really needs to assist.

As far as flossing on their own? seriously? there are many adults who don’t even feel the need of this 1-2 minute activity warrants doing. A child left to their own devices may use a floss pick or floss and get a percentage of the spaces. If you actually watch them, they get one spot, skip 2 spots and so on. If this part of home care is a nightmare- consider a child’s waterpik flosser or GumChucks (much easier for a parent to use on a child).  Those tight spaces are where many cavities form.

Give some thought to yourself – did you ever have cavities? if so at what age did you have the most dental treatment? If you have never had decay – fantastic. Congratulations. You won’t have to spend time and money over your life having the dental fillings placed when you were a child drilled out and replaced several times over. Once a tooth has been cut with a dental drill and a filling placed, it is destined for future dental treatment. Fillings don’t last forever, especially the white resin fillings. All of this can be PREVENTED.

As a dental hygienist, my children are not immune to tooth decay, so I knew it had to be done, and I considered it a chore. It is important to me that I prevent what I know can be prevented. Why was I then cursed with a child who hated having his teeth brushed?

I know why. I was a dental assistant before I became a dental hygienist. I assisted a dentist with operating room privileges. We treated children under general anesthesia in a hospital. It was difficult to see such small, young children laying on an operating table – their feet going nowhere near the foot of the bed, and their eyelids taped shut during the procedure.This was not a children’s hospital – so these were adult hospital beds.  Usually, treatment involved several injections of anesthetic, pulpotomies (this is basically the equivalent to a root canal treatment but on a baby tooth), stainless steel crowns cemented to hold intact what was left of the decayed teeth, several fillings, and some extractions if the teeth were so badly decayed. As I suctioned and watched eyelids try to flutter I cast judgment on these children’s parents. In my mind I questioned to myself – “who would let their children’s teeth become decayed like this, and why don’t parents brush their kids teeth?”   This is why my son gave me grief – and of course, that is when I realized just how difficult it is to carry out dental home care at times. Often it’s not that brushing isn’t happening, it’s that it isn’t happening well. Today’s typical diet is inducive to dental decay. Let your children, or your grandchildren or any children you know be the exception.

So I sympathize with new parents, parents of multiple kids, tired and overworked parents – but please, as tired as you are, please get through this chore at night before bed – at least, and monitor what it is in contact with their teeth throughout the day. Do what you feel is in the best interest of your child.

Early Childhood Cavities – why be concerned?

Feds spend $1M to fly Inuit children south for dental surgery

Cavities on the increase for kids

Sedatives Cited in Toddler’s Dental Office Death 

Anesthesia in young kids may carry developmental risks

If you live in Calgary or Claresholm, bring your kiddies in for a no charge first visit.

If you have young children at home, or children who you feel would do better in their home environment – a mobile dental hygienist is a great option – they bring their equipment to you.

Autism In The Dental Hygiene Chair

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autism ribbonApril is Autism Awareness month, and this week is National Dental Hygienists week, so I decide to blog about both. I dedicate this blog post to my friend Allison and all families who know Autism and Aspergers well. During my time as a dental hygienist I have been exposed to clients of all ages and backgrounds including those with unique needs. After recently meeting Allison I became aware that I did not have any experience with autistic children.

How is that possible? Did I in fact treat autistic children but didn’t know it? Would a parent not indicate that on a medical chart? Could I treat clients in a city with a population of 1 million and not see 1 autistic child when the stats from Centers for Disease Control and Prevention (CDC) identify that 1 in 88 children is diagnosed with autism? Was I so oblivious that I may have chalked up a child’s behaviour to “high maintenece” when really it was typical behaviour of an autistic child?

I don’t know the answer. I knew that after reading Allison’s blog post “Life with Liam“, about an orthodontic appointment for her 9 year old son that I was certain I may not know how to make a dental hygiene visit for an autistic child a positive one, an experience that both child and caregiver look forward to as opposed to viewing it as one more necessary but unpleasant life task. This was disturbing to me because I sincerely want to make dental hygiene visits a great, educational experience for both children and their caregivers. It is with children I feel hygienists have the opportunity to make the greatest impact – sharing  preventative dentistry knowledge – ensuring a life of “no drilling & filling”.

Of course I studied “special needs” in dental school, but how much could I recall of dealing with autism? not much. I was feeling very inadequate with my limited knowledge of the unique challenges associated with dental hygiene home care, best time of day for dental hygiene appointments, and management in the clinic. I was also certain my dated knowledge wouldn’t hold a candle to the reality of today for these families. Continuing education throughout life is a reality.

I have since learned that Autism is a general term, and there are various functioning levels – each individual is just that –INDIVIDUAL.  Autism Speaks Canada has an informative website and states that “Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. They include autistic disorder, Rett syndrome, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome. ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. ”

It is best for the caregiver to outline the functioning level of the child (where they are on the spectrum)- as well as details about sensory issues that may arise and discuss how to best handle them when at a dental hygiene appointment. If this conversation can happen prior to the child’s appointment that would be best. The dental hygienist will welcome any information that can facilitate an enjoyable visit. You know your child best, and know what sensory stimuli could be avoided or reduced. A dental hygiene clinic can have some advantages in terms of sensory stimuli when compared to a traditional dental clinic. There will be no dental drilling noises, smell of root canal mediciments, or dental materials like monomer being used in a hygiene clinic. Lighting may be an issue, so best to discuss this ahead of time. Caregivers can practice a visit at home before going to the clinic so the child has some familiarity with what may happen – practicing laying back, looking in the mouth, and counting teeth.

From the dental hygienists perspective be prepared to book a longer appointment so it isn’t rushed, the child has the time needed, you can answer all of the caregivers questions, and you can review techniques for oral home care. Repetition and routine can be very reassuring for autistic children. Establishing a relationship with one particular dental hygienist, rather than seeing someone different each visit can achieve this. Like appointments with all children, what works one day may not work the next, so be prepared with knowledge and do not hesitate to ask for recommendations from caregivers, and have patience. The first appointment may end up being a familiarity time, and perhaps no treatment carried out. Stretch your mind and skills and grow with the child & family.

Are you a dental hygienist looking for a resource to use? Dental hygienist and mother, Karen Raposa devoted six years of her life to writing “Treating the Dental Patient with a Developmental Disorder”. She cited her autistic son as her inspiration for writing the book. This book shares information on how to provide dental health services for patients with developmental disorders. You will also find the best information comes directly from parents and caregivers. Keep an open mind…. we are always learning.

A Truly Happy Visit

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At Lifetime Smiles Dental Hygiene Clinic, we want your child’s first dental experience to be a positive one. Our Hygienist’s intuitive nature, guides how much is accomplished in this first visit. We call this first visit the “happy visit”, this appointment is to gain your child’s confidence and trust. Each child is truly unique, we will carry out different hygiene treatments with each child depending on how comfortable your child is. Treatment is never forced, as finishing everything is not the goal.  The goal of the “Happy Visit” is to keep your child happy throughout this experience and share information with parents or guardians on how best to take care of teeth at this age. We encourage parents to stay in the room, or if you feel your child will do best without you, that is your choice. You know your child best.

 

What happens at a Happy Visit?  

First, we want to show your child the chair they will be sitting in, how is goes up and down, back and forward. We will show your child the gadgets connected to the chair such as the air/water syringe and the suction (aka Mr. Thirsty). It is very important for your child to see that the tools that we will use are simply to count your child’s teeth, which always proves to be a lot of fun. Next we will apply the disclosing solution, this is our plaque finder. Once this purple odorless and tasteless liquid is painted on the teeth, we can together, with a mirror in hand, evaluate where the plaque bacteria is “hiding”. After this is done, we have an opportunity to show both child and parent/s the proper brush technique and how to eliminate more of the plaque bacteria in the future. Polishing may come next which further eliminates plaque on the teeth and always makes for a few giggles. Our polisher is a cordless version which has proven very helpful for those children not interested in sitting the chair- and prefer sitting on Mom or Dad`s lap. It  looks like an electric toothbrush which children are able to relate to. If age appropriate, and deemed necessary, fluoride (aka, tooth vitamin) can then be painted on, put into trays, or applied in the form of a mouth rinse. Lastly of course, the best part of the appointment, that well-earned prize, and picking out a new toothbrush!

 It is important for children to be seen by a Registered Dental Hygienist at an early age, to promote a less harmful population of oral bacteria and prevent tooth decay, and connect your family with other required dental or healthcare professionals, such as dentists, pediatric dentists,general physicians, and more.  Today there are many dental hygiene treatments available to ensure a lifetime of “no cavities”. This is what we want for each child.  At Lifetime Smiles Dental Hygiene Clinic we believe that cost of preventative treatment should not be a barrier to the beginning of  healthy teeth and habits for children – if cost is an issue ask us about options in Calgary. There are plans that assist with dental cleanings for children, and if these do not apply we see children under age 3 for their first “Happy Visit” at no cost.  Truly a “Happy Visit”

Call us (403)457-2044 to discuss your child`s first dental cleaning

Signed, SEALED, & Delivered : For Children & Adults

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Seal Out Tooth Decay before It Happens!

How can you prevent yourself or your children from getting cavities? it’s easy SEAL THEM OUT… with Sealants!

Do you remember why your dental hygienist or dentist put sealants or more commonly known as “white coats”, “clear paint” or “protective paint” on your back teeth when you were younger? Has your dental hygienist or dentist recommended having them placed? If so, you might be asking; what are sealants anyway?

The main and most important reason for getting sealants is to avoid tooth decay. They are thin, plastic coatings painted on the chewing surfaces of the back teeth… because our back teeth are primarily used for chewing; the chewing surfaces are rough and uneven surfaces with pits and grooves. Toothbrush bristles cannot get into the tiny pits and grooves of these teeth so germs and food can get stuck for a long time causing a cavity to form if not prevented.

Sealants are put on in dentists’ offices, dental hygiene clinics, and sometimes in schools. They are painted on as a liquid and quickly harden to form a shield over the tooth. A special light is often used to “cure” the liquid.

 

Do you know if you have any sealants now? Are they in good condition? Do you or your children need sealants?

Visiting your dental hygienist and/or dentist can help determine and exam when, and on whom will need sealants. Going in for your regular dental cleanings and check-ups will let us and YOU informed.

 

Having sealants placed on teeth before they decay will also save time and money in the long run by avoiding fillings,root canal treatment, and  crowns (also called caps) used to fix decayed teeth. Sealants are simple and painless and can last many years!!

Some dental insurance plans cover the cost of sealants. Check your dental health care booklet or call your insurance company for details!

 

What else can you do to protect against decay?

Yep, you guessed it… with proper oral hygiene care of daily tooth brushing and flossing which can help prevent tooth decay. Pit and fissure sealants are most commonly placed on molar teeth. These back teeth are harder to get at, especially with toothbrush they need the extra protection to keep the germs out! That is why sealants cover the chewing surfaces of the back teeth and help making our daily routine of proper oral home care a bit easier.

Call us to ask questions about preventative sealants- we are happy to share information to prevent tooth decay! (403)457-2044

test saliva and prevent dental cavities…who knew?

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Saliva, aka SPIT – is very important. Your may have even been complimented at your dental cleaning appointment by your dental hygienist on your saliva. It usually goes something like this:

dental hygienist “wow, you have a lot of saliva”   

patient (who is now wondering is that good or bad) “what does that mean?”

Saliva is very important :

– helps to wash food particles off the teeth and surfaces inside the oral cavity

– contains antibacterial components – comes in handy when babies are putting everything in their mouths

– contains minerals that can help repair tooth enamel that has started to break down

– helps to buffer acids and restore neutral pH when you’ve consumed foods that have created an acidic environment

– can be tested for presence of drugs in the body

-Japan’s Keio University and University of California, have been working on developing saliva testing technology that can detect pancreatic cancer, breast cancer and oral cancer

– dental hygienists can perform saliva testing in the clinic to determine if there is a high level of the strains of bacteria that play a role in the initiation of dental decay

Lifetime Smiles Dental Hygiene clinic in efforts to assist in preventing dental decay can perform saliva testing. If it is determined that you are at a high risk (large population of decay causing bacteria), recommendations can be made to help change amounts of bacteria and treat the infection.   Yes, dental decay is caused by bacteria and is a bacterial infection. Dental decay is the most common chronic infection of early childhood.

Should an adult be concerned? yes, as dental decay is the leading cause of tooth loss in adults.

Prescribed medications and other health problems can decrease the amount of saliva produced, or dimish the neutralizing properties, thus creating a higher risk of dental decay.

Discuss this with your dental hygienist or other dental providers. Dental hygienists love to assist in prevention, as I have indicated in previous blogs, dental hygienists love to talk “prevention”.

 

Home is where the heart is….and the toothpaste, and the floss..

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 I guess you could say a life of good dental hygiene starts at home. More specifically it starts with young children at home. That means parents, listen up. You have the power to provide your child with the tools and habits that can lead to a cavity free life. That’s right…no cavities. 

Kids love “cavity-free dental check ups“. It means no appointments requiring sleepy juice (freezing by injection with a needle) for a dental filling. No watching them after a dental appointment to ensure they don’t chew on their cheeks because they can’t feel it.

What?  Your kid loves to go to the dentist and doesn’t mind any of this?   That’s good because if they have a filling as a child, chances are that filling will need to be replaced more than one time in the future. When it is replaced, more natural tooth structure is lost, and every time this tooth is treated there is risk to the nerve in the tooth. What does that mean? This means the nerve could become damaged and root canal treatment required.  Then what? After a tooth has had  root canal treatment it is recommended that a crown be placed. It doesn’t end there, as a crown doesn’t last forever.  

But the good news is, you can spend a few minutes each day helping to prevent cavities. Dental hygienists  recommend toothbrushing for 2-3 minutes. Thus the timer on electric toothbrushes is 2 minutes long.  So, 3 times a day at 2 minutes = 6 minutes per child. More if they snack often. Piece of cake right?

 Now in reality, and having children of my own I know it is not 6 minutes per child. When my son was 2 -3 yrs old , it was 6 minutes of brushing and 10 minutes for my husband and I to hold him down. Thank goodness that stage didn’t last forever, as it was not something we looked forward to each day. 

This difficult stage I believed was pay back. Prior to having children I was a dental assistant and helped place fillings in children’s teeth. I once worked in a hospital setting with a dentist that placed many fillings, extracted decayed baby teeth, and placed stainless steel crowns on children’s teeth. Due to the amount of dentistry they required, and their young age, they were treated under general anesthesia in the OR. I remember thinking “why doesn’t someone just brush these kids teeth?”. Then I had children.

You can have the best intentions and limit sugary snacks, but essentially most foods can contribute to cavities. Fruit for example, contains natural sugars that supply bacteria in the mouth with fuel. The bacteria release acids, and the acids break down enamel, causing a cavity. Fermentable carbohydrates as well as sugars in children’s medicines are also fuel for bacteria. Bacteria love it, but tooth enamel doesn’t. 

Teeth need to be cleaned properly of food particles after eating to prevent or cut short this “acid attack”. One’s own saliva can neutralize the acid after approximately 20 minutes.  If a child is snacking frequently add up the minutes per day an acid attack is occurring to their teeth. In other words, for children that have a sippy cup – water is a great choice for drinking throughout the day, otherwise their teeth could be exposed to acids for a majority of the day.

 Children love to exhibit their independence at an early age, and despite their best negotiating don’t give in and let them brush their teeth “by themselves”. Don’t break down even if they use the puppy dog eyes…stand firm. If really young, they are likely only chewing the toothbrush, but that good let them have “a turn”, then its “parents turn”. Children do not have the manual dexterity to reach all the surfaces throughly. Thus, parents need to help until they are 8 or 9 years old.

Flossing is another story, they really can’t master this technique until they are 10 or 11 years old. I know I have seen some adults in the dental chair who haven’t mastered their own flossing despite their own self confessed once a week attempts for 30 years , so seriously, can your children do it?     Plastic floss handles are a great tool for both parents and children.

So if you have been at a loss because you thought that  brushing EVERY night was all that was required for your children, and yet they have had a cavity, consider how often they are snacking, and how many minutes their teeth could be under acid attack.

Remember to prevent children from getting a cavity (also called tooth decay) one must :

– brush and floss after eating   (only brushing at night  2 – 3 hours after last eating doesn’t cut it)

– adults need to help with toothbrushing until age 8 -9 yrs old

– adults need to help with flossing until 10-11 yrs old

Often children are taking medications, or using inhalers for medical conditions that can create a higher risk for cavities, if this is the case, ask for suggestions from your dental hygienist….. dental hygienists love to talk “prevention”….

Free Oral Health Care checks for babies 6 months to a year old in Calgary

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Healthy Mouth, Healthy Child is a non-profit charitable organization dedicated to eradicating Early Childhood Caries (ECC), the most common of childhood chronic diseases. Our purpose is to conduct research, teach prevention, and promote diagnosis and treatment of ECC world wide.

A FREE Infant Oral Health CHECK: for babies 6 months to a year old, was held on Sat. July 24, 10 am to 2 pm, Southcentre, Centre Court, Calgary.67 infants were seen at the event. Besides the free assessment parents were given information, infant gum wipes, toothbrushes, toothpaste and Vitamin D samples.The Society would like to thank the three pediatric specialists and the two general dentists as well as hygienists and assistants for their time, which was volunteered.The Society would also like to thank Henry Schein Arcona and Dr. Georgie Rosenbaum for their donations of products for the “loot bags.”Baby Bottle Decay can lead to all sorts of problems — health, development and behavior — in babies, children and adults. Remember, if we can identify Baby Bottle Decay early enough, at ages 6 months to a year, we can easily stop it from ever being a problem in your baby’s life.Society for a Healthy Mouth Healthy Child (Alberta) is a non- profit, charitable society focused on the oral health of children. We’re trying to get the word out about Baby Bottle Decay — what Dentists call “Early Childhood Caries” or “ECC”.

Another FREE Infant Oral Health CHECK:

for babies 6 months to a year old is
planned for the late fall

see website for more information

 

 *Sept 29,2010 Update – see article on Healthy Child featured in Calgary Herald http://www.calgaryherald.com/health/Dental+disease+plagues+Calgary+children/3532635/story.html