Mightee Kids

Teach your kids about their less fortunate friends and help contribute to some great causes!

http://www.mighteekids.com/

Smile Squared Toothbrushes

Check out the story of Smile Squared Toothbrushes:

http://smilesquared.com/story

These toothbrushes can be recycled and are produced from sustainable materials.  Think of all those plastic brushes thrown away in the landfills!  Best of all, for every brush purchased one is donated to a child in need.  Many children in developing countries don't have access to things as basic as a toothbrush.

My daughter Audrey and I have been using them and they're great.  Ask me about them in the office and I'll give you one after your visit!

Dr. Jeremy

Dental X-Rays

A few weeks ago The New York Times published an article titled "Radiation Worries for Children in Dentists' Chairs".  Here's the link:

http://www.nytimes.com/2010/11/23/us/23scan.html

It focuses mainly on the radiation dose from a specific type of imaging device called a Cone Beam Ct Scanner or CBCT and it's potential abuse, but the title and content seem to blur the line between this technology and traditional dental x-rays.  The issue of dental and medical ionizing radiation can be confusing, and there's a lot of passionate and conflicting advice on the internet.  It's difficult to find reliable, unbiased, information on the topic.  I've found useful information at the Health Physics Society website:

http://www.hps.org/publicinformation/ate/cat5.html

The HPS is an independent nonprofit scientific organization devoted to radiation safety.  They're not affiliated with any government or industrial organization or private entity.



As parents, it's our duty to safeguard our children and make sound decisions for them.  It's unreasonable to expect every parent to be an expert on ionizing radiation.  So rather than getting into a technical discussion about radiation, I think it's more valuable to give you the following advice:

1.  Make sure your dentist knows about and practices the ALARA Principle.  ALARA stands for  "As Low As Reasonably Achievable".  ALARA means taking every reasonable effort to minimize the exposure to ionizing radiation.  For example, by reducing exposure times, utilizing shielding, utilizing proper technique, etc...

2.  Understand that dental x-rays should not be taken the same way for every patient.  If your dentist can't articulate to you the reason they are taking a particular x-ray...don't take it.  I don't take an x-ray unless either: 1. the risk of an undiagnosed dental disease outweighs the risk of the x-ray or 2. the x-ray is likely to have clinical implications...meaning that the results will affect treatment.  Children with poor hygiene, a history of trauma, or dental decay will typically require more x-rays than those with good hygiene, no trauma, and no decay.

I hope this helps!

Happy Holidays!

- Dr. Jeremy

Electric vs. Manual Toothbrush, Which is better?

This question comes up often in the office.  The simple answer is:

The one you use most often! 

There seems to be some debate as to whether powered toothbrushes actually clean better than manual brushes.  Virtually everyone agrees, however, that regardless of the type of brush you use, if you brush regularly and properly you will have healthier teeth and gums.

There are advantages and disadvantages to both types of brushes.  Electric brushes can sometimes be better for people with poor manual dexterity and/or motor deficits.  Kids with poor technique could conceivably benefit from the additional motion and 2 minute timers found in many electric brushes.  Manual brushes are less expensive and more portable.  They also don't require an outside power source.  I've found some kids don't like the added stimulation of the electric brushes, while others enjoy the novelty.  Some electric brushes have lights or music that guide kids to brush for a specified amount of time.

Regardless of which type of brush you chose for your kids, make sure that it has a small enough head for their mouth size, and soft bristles.

The take home message is...find a brush that your kids like and make sure they use it!  We'll help you, and them, make sure they're using it right.

- Dr. Jeremy

Cleaning Baby's New Teeth

It's important to begin cleaning our baby's teeth as soon as they come into the mouth.  When Audrey got her first teeth, I found these Spiffies Baby Tooth Wipes to be very handy.  I incorporated them into our bedtime routine.  After she finished her bottle, I would wipe her teeth with these while reading to her.  She really likes them! 

Wiping the teeth with the spiffies helps remove plaque and they're flavored with Xylitol, a naturally occurring sweetener that helps fight the bacteria that causes tooth decay.  Now that she is getting older (she's 14 months now) I'm using a small soft brush, but in a pinch, I'll still use these occasionally.

What's the deal with Fluoride?...Part 3

How should I be giving my child fluoride?

Here in New York City our municipal water is fluoridated, so your child is getting some fluoride if they drink tap water and/or if you cook with it.  In many areas, such as Nassau and Suffolk Counties here in New York and in some areas with well water, there is no fluoride in the water.  The American Academy of Pediatrics and American Academy of Pediatric Dentistry recommend that children in these non-fluoridated areas receive a daily fluoride supplement in the form of a vitamin.  This is a very safe and well established way to prevent tooth decay, and your health care provider can recommend the appropriated dosages for your child which are typically divided into three age groups:  6 months to 3 years, 3 years to 6 years, and 6 years to about 16 years.

It's also recommended that everyone brush twice daily with a fluoridated toothpaste.  For children under the age of two, a thin smear should be used.  For those between ages 2 and 5, a small green pea-sized amount should be used.  Your child will still benefit from using these small amounts, while reducing their risk of developing fluorosis.

You dentist may also recommend an in-office topical fluoride application depending on your home fluoride status, your child's dental hygiene and dental caries risk.  These typically take the form of a tray delivered foam or gel or a brush applied varnish.

I think the take home message for these related posts is that, when used properly, fluoride is an excellent tool for the prevention of tooth decay.  Actual fluoride poisoning is extremely rare and the benefits of using fluoride, as recommended, greatly outweigh the risks.

Best,

Dr. Jeremy

What's the deal with Fluoride?...Part 2

So what exactly is the downside of fluoride?

As with most minerals, vitamins, medications, and even water too much can be harmful.  Children with developing teeth, who ingest too much fluoride over a long period of time, will often develop a condition called fluorosis. 

Fluorosis is a disruption in the development of tooth enamel that often presents as "mottling" or small white spots or streaks in the teeth.  In most cases of fluorosis the discolorations are very subtle and easily remedied.  In rare severe cases the mottling can have a brown, pitted appearance.  This picture represents a patient with a typical form of fluorosis.

Fluoride ingested at extremely high doses can cause a serious or even lethal poisoning.  There are several hundred emergency room admissions each year for fluoride toxicity.  The vast majority of these cases occur in children under the age of 6 and usually result from the ingestion of great quantities of fluoride.  For a typical 3 year old child this would be over one half of an entire tube of toothpaste or about 10 gallons of fluoridated water in one sitting.  For a typical 9 year old child this would be about an entire tube of toothpaste or 20 gallons of fluoridated water at one time.

Next time in Part 3 - How should I be giving Fluoride to my child...