It's 2:30...Time To Go To The Dentist

I am sure you remember the childhood joke - Someone would ask you, "What time is it?" You would reply, "It's 2:30...time to go to the dentist!" Laughter would ensue on your part followed by the explanation for the dim-witted, "It's 2:30...tooth hurt-y (with a slow enunciation) ...get it?"

Well, this time came for my own children just the other day, and luckily not because of a toothache. It was time for their bi-annual visit to the pediatric dentist for some routine maintenance on their pearly whites. They have seen the dentist every six months since the time when I still counted their age in months. One might think that after 9+ years of regular trips to the dentist with them, it would be no big deal...right? Then why do I have a sense of dread over a little dental prophylaxis? Why do my palms get sweaty as my children are taken to the back office? Will they misbehave and bite someone? Are they experiencing any discomfort or psychological damage? Why do I feel guilty that maybe I brushed off the brushing a few times since their last visit? Are the hygienists judging my parenting abilities by the number of cavities they find? And, of course, what is it all going to cost me?

I realize that this angst is deeply seeded in me. It does not arise from prior personal experience with long, painful dental procedures, as I have had none, except the usual orthodontics during my formative years of adolescence. I do fear my own visits to the dentist. I just loathe the dentist, nothing personal. Fortunately, my children must have some paternally-inherited immunity to the dental chair jitters. They are not concerned by the poking and prodding in their little mouths, but instead, by what color of toothbrush they will receive. I am amazed by this, particularly with my son. He has so much silver in mouth that we refer it to as his "grill". We have spent thousands of dollars and many grueling hours under the influence of Valium to get his teeth filled, crowned, or extracted. Despite all the years of proper dental care, he has endured more than a lifetime of dental procedures for any one person. We hope that one day these carious baby teeth make way for healthier, stronger grown-up teeth. I know my son is not alone in his experiences at the dentist, as there is usually at least one other child zoned out from Valium in the waiting room. In my practice, I have seen many children who have required general anesthesia for the major work that is required to stop the disease of dental caries. Sometimes there are medical conditions that predispose a child to "bad teeth" as with my son. There can be genetic causes too. However, the vast majority of dental disease in young children is completely preventable.
 
According to the U.S. Preventative Services Task Force, it is estimated that 20% of children aged 2 to 5 years and about 50% of children aged 5 to 9 years have experienced dental caries. Both the American Academy of Pediatrics and the American Academy of Pediatric Dentists recommend the first dental visit within 6 months of the first baby tooth eruption or by 12 months of age, whichever occurs first. However, only one-third of children aged 2 to 4 years have ever been to the dentist. Oral health is directly linked to general health and dental caries is the most common oral disease in children. Dental caries is an infectious disease - a chronic process that destroys teeth by the interactions of normal mouth bacteria and the food sugars that stick to the teeth. Both the AAP and AAPD firmly believe that early dental care and parental education would significantly reduce the incidence and long-term consequences of this disease. Other preventative measures for oral health include: 

• Breastfeed your baby for at least the first year of life and beyond, if both mom and baby desire. It is best to wean to a regular cup when the time comes.
• Clean your baby's gums and teeth twice a day. Plain water on a soft cloth or a small soft toothbrush works just fine.
• Fluoridated toothpaste can be used with a soft toothbrush once your child can "spit" (often between 2 and 3 years of age). Use a small pea-sized amount and always supervise children when using toothpaste - it can be toxic if ingested.
  
• Never put your child to sleep with a bottle or sippy cup. Not only is it a choking risk, it can cause "Baby Bottle Mouth", a severe form of dental caries. Water in a bottle before bed is acceptable.
• Encourage your child to eat fruit and limit fruit juice (100% only) to no more than 4 oz a day.
• Children do not need carbonated beverages, sweet tea or other sweetened drinks containing high-fructose corn syrup. There is nothing of nutritional value in these drinks.
  
• Limit sugary drinks and foods to mealtimes. Water may be offered between meals as desired.

If you have questions about your child's dental health, please contact your child's health care provider or a pediatric dentist. Here are a couple of helpful links.          

http://www.aapd.org/parents/

http://www.aap.org/commpeds/dochs/oralhealth/audience-families.cfm

© Copyright The Baby Squad, LLC, All right reserved.

Let 'Em Play Just Put 'Em in Bubble Wrap First

Baseball, football, basketball, soccer - if you are a parent of a child older than 4 years, you have probably had an encounter with one or all of these sports. Football season is in full swing this time of year - from a friendly backyard game to flag or full-on tackle. I have never been a huge fan of football - pro, college, or otherwise - and my son shares my opinion on the sport too. Recently, he quite confidently told me that "football is boring" and he was just going to "swim until he beats Michael Phelps' records". I admire that goal but part of me feels as if he is missing a fundamental slice of boyhood with his disinterest in "ball" sports. Of course, the other part of me is relieved as his risk of injury is miniscule with swimming compared to the other sports. Maybe I would feel differently if football was his passion. I wonder about other moms, sitting on the sidelines, watching their beloved children being tackled to the ground with bone-breaking force. How do they do it? Are their hearts in their throats the whole game? How do they restrain themselves from running on the field to protect their son from the chaotic roughness of tackle football. Well, my friend has a son who is quite an athlete - he lives and breathes ball sports year round. The family has spent countless hours at practices and games. Last week, my friend's son was injured during a football game. He was grabbed around the collar and thrown to the ground by another 9 year old. Despite all of the proper protective equipment, he suffered an elbow fracture and a bruised liver. His injuries were significant enough to warrant avoidance of all sports, including gym class, until the Spring. Time will tell if surgery is needed to repair the fracture in his arm. His liver is resilient and will mend without intervention. Until then, he will support his team from the bench while his mother is thinking of creative ways to camouflage the bubble wrap under his clothing. Not the place any parent wants their child to be, but it will be the reality at some point in most young athletes' careers.

Injuries occur everyday in the sports world. According to Safe Kids USA, over 3.5 million children ages 14 and under receive medical care for sports injuries each year. Fortunately, fatal injuries from sports activities are uncommon. Baseball has the highest rate of fatal injuries with 3 to 4 children killed each year, most likely from a traumatic brain injury. Contact sports carry higher rates of non-fatal injury. One study from Safe Kids USA found that 28% of football players (ages 5 to 14 years) have been injured playing the sport. In 2002, 187,000+ young football players were treated in hospital emergency rooms for their injuries. Countless others were treated in physician offices and clinics that go unreported. This same report indicated that 62% of sports injuries occur during organized practices rather than games, and that about one-third of parents do not utilize the same level of safety precautions for practices as they do for games. Why is this and how do we change it to make our young athletes safer?

First, we need to raise awareness and parents need to understand that children are not just little adults. They are more at risk for injury because they are less coordinated, less accurate, have slower reaction times and possess a poor judgment of danger and risk. Sports injury risk is related more to the child's developmental stage than age or weight. Girls are more likely to be injured at younger ages, but by puberty, boys are more frequently injured and usually with more severity. Developing tendons and ligaments are most commonly injured, and bony injury is less likely. However, caution must be taken because injury to the growth plate of immature bones can be serious.

The American Academy of Pediatrics recommends these sports injury prevention tips:

• Wear the right gear. Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will protect them from performing more dangerous or risky activities.
• Strengthen muscles. Conditioning exercises before games and during practice strengthens muscles used in play.
• Increase flexibility. Stretching exercises before and after games or practice can increase flexibility.
• Use the proper technique. This should be reinforced during the playing season.
• Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.
• Play safe. Strict rules against headfirst sliding (baseball and softball), spearing (football), and body checking (ice hockey) should be enforced.
• Stop the activity if there is pain.
• Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing
  

Please visit www.aap.org or www.usa.safekids.org for additional information.