Friday, August 1, 2014

Nurse Jen blogs about dental care

I have two daughters, 6 and 9. They brush their teeth regularly, don't overindulge on sugar, and floss once in awhile. They've always received glowing reviews from their dentist for their oral hygiene. I'm not against x-rays, but because of this positive feedback I opposed our pediatric dentist's gentle suggestion for annual x-rays. I remember Googling it in the waiting room and I found a 2012 study published in CANCER associating yearly or more frequent dental x-rays to an increased risk of developing meningioma, the most commonly diagnosed brain tumor. I made my best parenting decision and waited two years for more x-rays (they still went in for the recommended cleanings every six months.) Despite more glowing praise for the appearance of my kids' teeth on the outside, they both had cavities to fill!

This prompted me to pay closer attention to my kids' teeth ....and do a little more research on the subject. Following are my findings, along with some advice from Dr. Claudia Masouredis (our respected pediatric dentist.)

Did you know your child can actually 'catch' cavity causing bacteria by sharing a spoon with you? If you (or any other care provider or friend of your child) is prone to cavities, protect your child and do not share utensils, toothbrushes or anything else that goes in the mouth.

Everyone in your family should take good care of their teeth. Set a good example and let your child see you brushing twice a day and flossing every day. Begin wiping away bacteria from your child's gums before their first tooth even erupts. When teeth are present, gently scrub them with a clean toothbrush (no toothpaste.) Kids as young as age 2 or 3 can begin to use toothpaste when brushing, under supervision. *Ask your dentist when they can start using toothpaste with fluoride (we want to make sure they are old enough not to swallow the toothpaste first.) SF water is fluoridated so they are getting beneficial levels of fluoride if they drink tap water.

The American Dental Association recommends that parents take their child to a dentist no later than his or her first birthday. This gives the dentist a chance to look for early problems with your child's teeth. Pediatric dentists specialize in treating children's dental health. You and your child's dentist should review important information about diet, bottles, tooth brushing and fluoride use. Visiting the dentist from a young age will help your child become comfortable with his or her dentist. It also establishes the good habit of regular dental check-ups. Children who were born prematurely or weighed very little at birth and/or who have ongoing special health care needs are at a higher risk of developing cavities. Enamel hypoplasia or a weaker enamel coating of the primary teeth has been correlated with pre-term infants. These children have a higher rate of dental decay from having this weaker enamel.

As your child's permanent teeth grow in, the dentist can help seal out decay by applying a thin wash of resin to the back teeth, where most chewing occurs. Known as a sealant, this protective coating keeps bacteria from settling in the hard-to-reach crevices of the molars. In addition, I learned that electric toothbrushes are far more effective and are worth the cost if they help prevent cavities. Most also have the added benefit of having built-in timers to encourage longer brushing!

When it is time for x-rays, ask your dentist if they use high speed or digital imaging, which has less radiation. As part of the ADA's recommendations to minimize radiation exposure, the ADA encourages the use of abdominal shielding (e.g., protective aprons) and thyroid collars on all patients. In addition, the ADA recommends that dentists use E or F speed film, the two fastest film speeds available, or a digital x -ray. (AADP)

Dental x-rays are valuable in helping dentists detect and treat oral health problems at an early stage. Many oral diseases can't be detected on the basis of a visual and physical examination alone, and dental x-rays are valuable in providing information about a patient's oral health such as early-stage cavities, gum diseases, infections or some types of tumors. In particular, when teeth are very close together it is impossible to determine if there is active decay on those surfaces of the teeth without an x-ray. How often dental xrays should be taken depends on the patient's oral health condition, age, risk for disease and any signs and symptoms of oral disease that the patient might be experiencing (AADP.) For example, a child with a history of past cavities and is between 0 to 6 years may require x-rays every 6 months depending on their oral hygiene and diet.

If they do end up getting cavities (despite your best efforts) the National Institutes of Health reminds us that new materials mean pediatric dentists have more filling and repair options than ever. Silver amalgam has become a less attractive dental restorative material for restoration of primary teeth. After many decades of scientific and nonscientific controversy, use of silver amalgam for primary teeth is waning, not because of its mercury content but because dentistry has come up with more suitable materials such as composite resin. Tooth-colored resins are also more attractive. Our pediatric dentist does not have any silver left in her office, I urge you to ask for the newer composite resin materials. A filling done with composite resin preserves more healthy tooth structure as only decayed areas need to be removed - metal requires a lock and key design which can result in the unnecessary removal of more tooth structure.

I learned from my lesson (several visits and hundreds of dollars later) and now my kids and I ALL floss almost
every night. As with most parenting decisions, you do your best and remain flexible.....and try not to beat yourself up over your missteps.  

Nurse Judy adds... 
*Check with your dentist for their toothpaste recommendations.Many will start your baby off from the start with a tiny amount of gentle paste that does contain fluoride 
Below is the link to my post from last year. 


  1. Thanks you for sharing such great information about About dentee

  2. Good post. Regular dental checkup for children should be mandatory.

    Dental Care for Kids