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

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