In the good old days, dentists and physicians did not suggest children visit the dentist until they were 5 or 6 years old. Gradually, these recommendations have become more evidence based and currently, all major dental and medical organizations recommend the age 1 dental visit.
One of the most important aspects of an early dental visit is to focus on prevention of Early Childhood Caries (ECC). Yet, there is much more involved and for good reason. Let's look at the two phases of the infant oral health exam.
When the parent/caregiver brings their infant to our office, we review the medical history and also the parent's dental and social history. We understand that there is a very high correlation between parent's oral health and past dental disease and transmission to their child. This information is part of our caries risk assessment because if parents or siblings are at high risk, the infant should also be considered as such. We then review the causes of caries and prevention that partially includes breast/bottle feeding, diet counseling with emphasis on frequency (especially juices), toothpaste/fluoride, and any other guidance on growth or development issues like teething and oral habits such as thumb/finger sucking or pacifier use. Then we make sure to touch on trauma prevention and what to do if a child has a dental emergency. Finally, we welcome the parent to their new "dental home" and encourage them to call us with their questions and make sure they understand that we are available for their child 24/7 for emergency care.
We are not done yet! We still need to examine the infant. We tell the parent their child is going to cry, much like going to the pediatrician. We then ask the parent to face us (knee to knee) with the child facing them and lay the child's head in the doctors lap. Now, we demonstrate how to brush their teeth, do our examination and decide if we want to place fluoride varnish on the teeth depending on the caries risk evaluation we have just performed. We sit the infant up and place in mom/dads loving hands for a hug and ask if there are any further questions.
The infant's first visit may sound like a big deal, but think about what we have accomplished. We have educated the parent about dental disease, prevention, oral habits, and trauma. We have examined the child to make sure there are no signs of disease. We have established the child's new dental home where his/her oral health is managed in a comprehensive, continuously accessible, coordinated and family-centered way by a licensed, board certified dentist.
Monday, December 21, 2009
Tuesday, September 29, 2009
What have we been up to?
Hello Everyone,
This September was the Arizona Academy of Pediatric Dentistry's Fall meeting. I am currently the Secretary/Treasurer for the academy and arranged for internationally known, Dr. Kevin Donly to speak to our members. Dr. Chaet also gave a presentation on new technologies for restoration.
Dr. Julie, Lesley and myself traveled to Sedona and presented an educational poster to the American Academy of Pediatrics Arizona Chapter. This meeting was the Arizona AAP's annual convention. Our presentation included educational information on infant oral hygiene and fluoride varnish applications. The doctors were well received and look forward to attending the meeting again next year. Here we are with Dr. Ron Fischler, who is the President for the Arizona AAP.
This past April, I was joined by Dr. Feinberg, Nancy and Lisa at the Doll House's Safety Saturday. The Doll House is a toy store located in the Promenade at Scottsdale Road and Frank Lloyd Wright. Police cruisers, fire trucks and kids were in abundance. Fire properly checked and buckled car seats for parents, while APDO gave out toothbrushes, stickers and toys.
This is Dr. Tim. I am one of the pediatric dentists at Affiliated Pediatric Dentistry and Orthodontics. Welcome to our Blog. I want to share with you some exciting things we have been up to the past year.
This September was the Arizona Academy of Pediatric Dentistry's Fall meeting. I am currently the Secretary/Treasurer for the academy and arranged for internationally known, Dr. Kevin Donly to speak to our members. Dr. Chaet also gave a presentation on new technologies for restoration.
Dr. Chaet recently spoke with the family practitioner residents at Scottsdale Healthcare Osborn. He spoke with them about the importance of baby oral health and fluoride varnish. The residence valued his presentation so much that he has been asked to come back to speak again.
In June, I drove to Tucson and met with a number of Arizona Academy of Pediatric Dentistry members. We had dinner and discussed many issues relevant to improving the oral health care of children in Arizona.
Dr. Julie, Lesley and myself traveled to Sedona and presented an educational poster to the American Academy of Pediatrics Arizona Chapter. This meeting was the Arizona AAP's annual convention. Our presentation included educational information on infant oral hygiene and fluoride varnish applications. The doctors were well received and look forward to attending the meeting again next year. Here we are with Dr. Ron Fischler, who is the President for the Arizona AAP.This past April, I was joined by Dr. Feinberg, Nancy and Lisa at the Doll House's Safety Saturday. The Doll House is a toy store located in the Promenade at Scottsdale Road and Frank Lloyd Wright. Police cruisers, fire trucks and kids were in abundance. Fire properly checked and buckled car seats for parents, while APDO gave out toothbrushes, stickers and toys. Our lead assistant, Nancy, painted children's faces. Do you like the sun on my face?
Halloween 2008 spooked Dr. Julie, Lisa and myself. We were hanging out at Desert Sun's Fall Festival. I lurked behind the bean bag toss. We gave prizes to pixie hollow fairies, zombies, robots and more. I am the one dressed as Cat in the Hat. My daughter Ally was Cinderella. Nancy's husband Doug, made our tooth shaped board. While Nancy sewed together Star Wars bean bags for the toss.
Monday, September 28, 2009
When and Why should I bring my child to the dentist?
When should I bring my child to the dentist is a frequent question asked by parents to their health care providers such as pediatricians, family practice physicians, and dentists. The typical answer is "around 3 or 4 years of age" or "when little Billy or Susie can sit in the dental chair." However, if your Billy or Susie develops cavities at 18 months of age, perhaps these were not the best answers. The appropriate reply is when your infant's teeth start erupting between 6 months to 1 year of age.
The reason for such an early dental visit is simple-PREVENTION. Dental disease is very common in young children, 5 times more common than asthma. The Centers for Disease Control and Prevention says that 40% of the population of children entering kindergarten has cavities.
Everyone knows that sugar "causes" cavities, but why do some children get cavities and others, who eat similar diets, do not? The partial answer begins by understanding that all of us have a normal, healthy relationship with the flora (bacteria) that is on our bodies and in our mouths. This flora is important to our very existence and in the case of infants; it begins to be established in the mouth when the first tooth starts erupting. The mother is the source for the flora approximately 71% of the time in the dental population and 88% of the time in breastfed infants.
It has been recognized that high levels of cavities fun in families and are passed down from mother to child. Yet, it is not as simple as that since we all know the story of the child in the family that does "everything wrong" and never has a cavity, while your "perfect brush and eater" has lots of cavities. The reason is that not everyone's bacteria are created equal. Some children have fairly harmless flora while others have bacteria that consistently produce higher levels of of acid (when exposed to sugary foods) that dissolve the outer enamel of the tooth.
Another important variable when discussing cavity potential is the fact that the formation of the cavity is determined by many factors. For example, diet, oral hygiene, fluoride exposure, salivary glands, etc. will play a role in cavity activity. Modification of a child's diet, better tooth brushing and flossing, and optimal exposure to fluoride may help prevent cavities by reducing the more active acid producing bacteria.
It can now be seen why early dental visits are important to help prevent cavities because the process starts as soon as teeth erupt. The only way to help a parent prevent cavities in their infant and toddlers is to discuss the mothers past dental history, review the cavity producing process, and offer preventative suggestions.
The reason for such an early dental visit is simple-PREVENTION. Dental disease is very common in young children, 5 times more common than asthma. The Centers for Disease Control and Prevention says that 40% of the population of children entering kindergarten has cavities.
Everyone knows that sugar "causes" cavities, but why do some children get cavities and others, who eat similar diets, do not? The partial answer begins by understanding that all of us have a normal, healthy relationship with the flora (bacteria) that is on our bodies and in our mouths. This flora is important to our very existence and in the case of infants; it begins to be established in the mouth when the first tooth starts erupting. The mother is the source for the flora approximately 71% of the time in the dental population and 88% of the time in breastfed infants.
It has been recognized that high levels of cavities fun in families and are passed down from mother to child. Yet, it is not as simple as that since we all know the story of the child in the family that does "everything wrong" and never has a cavity, while your "perfect brush and eater" has lots of cavities. The reason is that not everyone's bacteria are created equal. Some children have fairly harmless flora while others have bacteria that consistently produce higher levels of of acid (when exposed to sugary foods) that dissolve the outer enamel of the tooth.
Another important variable when discussing cavity potential is the fact that the formation of the cavity is determined by many factors. For example, diet, oral hygiene, fluoride exposure, salivary glands, etc. will play a role in cavity activity. Modification of a child's diet, better tooth brushing and flossing, and optimal exposure to fluoride may help prevent cavities by reducing the more active acid producing bacteria.
It can now be seen why early dental visits are important to help prevent cavities because the process starts as soon as teeth erupt. The only way to help a parent prevent cavities in their infant and toddlers is to discuss the mothers past dental history, review the cavity producing process, and offer preventative suggestions.
Wednesday, August 26, 2009
Braces 101: Adult Treatment- What are my options?
A growing population of patients in many orthodontic practices consists of the 18 years and older crowd. Orthodontic treatment has become more accessible and palatable in recent years due to the variety of options for treatment that exist. Some may have never had treatment at all; and some may have had years of braces as a child or an adolescent with many more years since having not worn retainers. Problems may be slight or dramatic and a variety of treatment options may exist given new research and technology.
Adult Orthodontic Challenges
The greatest obstacle for the adult patient to overcome is the level of acceptability of orthodontic treatment in the workplace or social setting. Any adult entering treatment must be comfortable to interact with their peers while showing some type of orthodontic appliance while they speak. Nowadays, this is not a big obstacle. Orthodontic treatment has become wildly acceptable in adult circles.
A challenge present for all orthodontic patients is hygiene, although it is a social challenge in many adult situations. Adolescent patients generally can get by with poor hygiene in social situations, while adults have pressure to keep their teeth sparkling clean. Extra time must be spent in the mirror after meals to ensure that nothing unsightly is left on their braces or teeth before continuing on with their day.
Braces
Adults entering the orthodontic office generally seek the most cosmetic, efficient and hassle-free type of treatment that will address their chief concern. Although other options may exist, braces are usually the most predictable way to move teeth to their final destination and achieve the best possible results. Braces can be silver, gold or clear. Modern braces are small and applied directly to the tooth surface with few or no metal bands. Braces allow a three-dimensional grip on the tooth which allows the orthodontist full control of all tooth movement.
Length of treatment can vary based on the difficulty level of the case. Simple cases can be as short as a few months, while very difficult cases can take up to or more than two years to complete. New advances in orthodontics are helping to shorten this treatment time dramatically. Technology has allowed orthodontist to have custom braces and/or wires fabricated by robots to make treatment more efficient and increase precision of tooth movement. Shorter treatment time sometimes makes traditional braces a more realistic option for adult patients.
Proper diagnosis and treatment planning are essential to determine the possible options that will meet the needs of each individual. Multiple options may exist with different potential outcomes. Be sure to ask questions and have a thorough understanding of the information presented to you. The more you understand, the better you will feel about the decision you will make.
Adult Orthodontic Challenges
The greatest obstacle for the adult patient to overcome is the level of acceptability of orthodontic treatment in the workplace or social setting. Any adult entering treatment must be comfortable to interact with their peers while showing some type of orthodontic appliance while they speak. Nowadays, this is not a big obstacle. Orthodontic treatment has become wildly acceptable in adult circles.
A challenge present for all orthodontic patients is hygiene, although it is a social challenge in many adult situations. Adolescent patients generally can get by with poor hygiene in social situations, while adults have pressure to keep their teeth sparkling clean. Extra time must be spent in the mirror after meals to ensure that nothing unsightly is left on their braces or teeth before continuing on with their day.
Braces
Adults entering the orthodontic office generally seek the most cosmetic, efficient and hassle-free type of treatment that will address their chief concern. Although other options may exist, braces are usually the most predictable way to move teeth to their final destination and achieve the best possible results. Braces can be silver, gold or clear. Modern braces are small and applied directly to the tooth surface with few or no metal bands. Braces allow a three-dimensional grip on the tooth which allows the orthodontist full control of all tooth movement.
Length of treatment can vary based on the difficulty level of the case. Simple cases can be as short as a few months, while very difficult cases can take up to or more than two years to complete. New advances in orthodontics are helping to shorten this treatment time dramatically. Technology has allowed orthodontist to have custom braces and/or wires fabricated by robots to make treatment more efficient and increase precision of tooth movement. Shorter treatment time sometimes makes traditional braces a more realistic option for adult patients.
Aligners
Individuals with mild to moderate orthodontic needs may be candidates for aligners to move their teeth to correct crowding or other bite issues. This type of treatment involves a series of clear plastic retainers that will move teeth progressively over time. Excellent compliance is essential to treatment success. The aligners must be worn full time in order to produce proper tooth movement. Aligner treatment is a good option when braces are not an acceptable option for an adult patient. Ask your doctor to determine if you may be a candidate for this option and whether it can properly address your treatment goals.Proper diagnosis and treatment planning are essential to determine the possible options that will meet the needs of each individual. Multiple options may exist with different potential outcomes. Be sure to ask questions and have a thorough understanding of the information presented to you. The more you understand, the better you will feel about the decision you will make.
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