Turning the tide of tooth decay with proper pediatric dental care

| Teaching healthy habits to children now prevents oral health problems later |

MANY OF US EXPECT cavities if we neglect brushing our teeth. But we may not recognize how oral health affects our overall health. “The mouth can be a very dirty place. In a healthy individual, our immune system is able to kind of protect us,” says Dr. Tiffany Chen, co-owner of Bright Smiles in Winter Haven, a dentistry for children and adolescents. “Imagine if you weren’t healthy. … That can lead to a lot of other very serious health issues.”

Learning healthy habits should start at a young age. More than 25 percent of children two to five years old suffered tooth decay in 2011, according to U.S. Centers for Disease Control and Prevention. That percentage climbed to about 50 percent for those 12 to 15, and about 67 percent for those 12 to 19.

“We start teaching the kids to brush their teeth at three,” says Dr. Shirin Yasrebi, a pediatric dentist in Lakeland. “A lot of parents think they can stop helping at six, but that’s when the oral hygiene may not be as good because the child tries to do it alone.”

“At age two and three, children should begin to hold a toothbrush and imitate their parents, but parents should continue to do the brushing until they have the manual dexterity to hold a toothbrush and properly brush all areas of the tooth,” explains Dr. Kenneth Rogers, co-owner of Bright Smiles.

Children also may rush through brushing, skipping some of their teeth. Consequently, Dr. Chen stresses the importance of brushing for two minutes, twice a day.

Many oral diseases are preventable. Yet, both children and adults go without water fluoridation and dental sealants that help prevent decay, CDC officials report. Sixty-seven percent of the population had fluoridated water in 2012; about 33 percent of children between six and 19 years old had the plastic sealants in 2011 to protect molars from cavities.

Pediatric dentists aim to teach children proper dental care early. “Not losing teeth early is going to prevent problems with speech, sleep, self-esteem, and school,” asserts Dr. Chen.

They teach that diet is important. “Avoid particularly sticky candies and soda,” Dr. Rogers advises. “It’s unrealistic to tell parents to never let their child have candy. When they do have sweets, it should be done so in moderation and under parental supervision.” He also stresses brushing and flossing after eating the things that stick to your teeth.

Chocolate is better than hard candy. Drinking a sweet drink all at once is better than sipping it repeatedly. “Chocolate is easier to brush off your teeth. Sticky candies stick in the grooves of the teeth,” Dr. Yasrebi explains. “You just don’t want to have a constant supply of sugar.”

Not everyone is taught proper dental hygiene at the dentist’s office or at home. So some dental practices are sending educators into schools to share important health lessons. Among them are Sharon DuCharme, a dental health educator for Bright Smiles, and Stacey Catalano, a dental health educator for Dr. Yasrebi.

DuCharme visited 4,141 students in 2014, including visits to 27 schools and one summer recreational program. Catalano visits more than 5,000 students annually at schools and daycares.

DuCharme, a former kindergarten teacher, teaches primarily pre-kindergarten through second-graders how they can keep their teeth strong and healthy. She tries to make the lesson fun by bringing along her puppet, Al E. Gator. “Al E. Gator squirts water when the children are good listeners,” she says. “Everywhere I go in the county, I will have children come up to me, saying, ‘I know you! You’re the lady that squirts the water!’ ”

She teaches that taking care of baby or primary teeth and permanent teeth is equally important. She talks about the right kind of toothbrush and when to replace it. “I then demonstrate the proper way to brush and floss on my puppet,” she says. “We discuss to brush at least twice a day, morning and night, and to floss once a day.”

She also teaches about “healthy foods” and “sometimes foods,” stressing they should brush their teeth after eating the sweet, sticky foods rather than waiting until bedtime.

Every year, some 40-plus volunteers work together to provide free dental care at Give Kids a Smile (GKAS) Day, usually in February. The American Dental Association event was held Feb. 6 through Traviss Career Center and the Polk County Dental Association.

Sometimes it’s the only dental care the children receive, says GKAS Coordinator Susan Rexroat. “We also expand this service to the many financially challenged adults as well through the access to dental care clinics throughout the county,” she adds. “The gratitude expressed from the children and the parents is compliment enough that we are able to provide this service year after year to those of our community in need.”


• Take your child to the dentist at age one, as recommended by the American Academy of Pediatrics. Visiting the dentist every six months is advised because baby teeth are smaller and cavities tend to progress quickly, Dr. Chen points out. Parents can be counseled about brushing and diet.

• Don’t put your child to bed with a bottle, or provide sweet drinks to sip all day, advises Dr. Chen. Bad habits can begin with juice in a bottle or sippy cup, then progress to sports drinks at soccer games and caffeinated sodas in high school. She suggests water and white milk for children under six; when children are older, if they choose to have a sweet drink, they are better off drinking it all at once and brushing their teeth afterwards, if possible.

• Brushing your child’s teeth while he or she is lying down is easier until they are age two. Then you can brush while they are standing, suggests Dr. Chen. “It’s a lot easier for you to see, as a parent, what you’re doing. It’s just like wrestling an octopus on some days.”

• Brush teeth in a small circular motion, rather than up and down, to avoid receding gums, Dr. Yasrebi cautions.

• Discontinue pacifiers by age two to avoid disfiguring teeth, Dr. Yasrebi advises.

• End thumb sucking by age four or sooner to avoid projected front teeth, Dr. Yasrebi adds.

• Be sure to use mouth guards when appropriate to avoid sports injuries, Dr. Yasrebi says.

• Xylitol gum is a good alternative to lots of candy or gums with sugar, Dr. Yasrebi adds.


doctor portraits by PEZZIMENTI

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