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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
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DENTAL HEALTH AGES ONE THROUGH SIX

37% of American children have NOT had a dental visit 
before starting school!**

Regular check ups can help protect your child's teeth from decay
Preventive care such as cleanings and fluoride treatment
 provide your child with "smile" insurance. 

"Despite the great advances in caries research over the past few decades, 
dental decay remains the major infectious disease that affects
 children worldwide
," *

Children's teeth are the most susceptible to cavities during the first two years after their eruption!

    The front four teeth usually erupt first around the age of 6 months. Most children have a full set of 20 primary teeth by the time they are three years old.  Baby teeth are just as important as permanent teeth---for speaking, chewing, appearance and to hold space for permanent teeth.

New recommendation by American Academy of Pediatrics and Academy of General Dentistry: Infants who are at high risk for tooth decay should see their family dentist between 6-12 months.***

Dental caries are transmitted vertically from mother to child!

Bacterial causing bacteria is transmitted from mom to baby

Children with tooth decay in their primary dentition are nearly three times more likely to have decay in their permanent teeth.

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Trying following these tips for good dental health:

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When the first tooth erupts brush it with water.

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After the age of 2 use a pea size amount of fluoride toothpaste twice a day.  

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Supervise their cleaning to ensure that a good job is done and that they do not shallow any of the toothpaste.  Teach them how to spit the remaining toothpaste out. Do not rinse after brushing. It is important that you brush their teeth until the age of 7 to 9 once a day because you are able to clean their teeth better than your child.  During this period it is recommended that you brush their teeth at night  and then they can brush their teeth in the morning and other times of the day.


Click here to view brushing and flossing videos for kids
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Flossing should start as soon as two teeth touch around the age of 2 to 2 1/2.    Cleaning between the teeth is important because it removes bacteria laden plaque where a toothbrush cannot reach. You can floss your child's teeth by having your child kneel in front of you with their head on your lap.  Not only does this improve oral hygiene, but your child gets use to someone working in their mouth. (from Pat RDH).  By  around the ages between 6-8  they can floss their own teeth.

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Choose health snacks.   The odds of experiencing cavities in  primary teeth  were significantly greater in children who did not eat breakfast daily or ate fewer than five servings of fruit and vegetables per day.  Young children with poor eating habits are more likely to experience caries.^^

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Prolonged usage of a pacifier can cause increased ear infections from sucking and/or an open bite.

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Bedtime is the most important time to brush.

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If your child falls and cuts his or her lip, use something cold, such as a Popsicle.  They will like the treat and it will reduce swelling at the same time.

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See your dentist by the age of one for a well baby checkup.  Schedule appointments early in the day but avoid naptime

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Professionally applied fluoride: The cavity prevention benefits from professionally applied fluoride treatments are directly related to how many times it is applied.

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As  permanent molars appear dental sealants may be placed to protect the chewing surfaces from decay.

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Change your child's toothbrush every two months and after the child has been sick.

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Avoid chewable vitamins that list sugar as the first ingredient.

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If your child is sick toothpaste should be placed on the brush via a cotton swab or clean finger to avoid contaminating the toothpaste tube.

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If your child likes to chew on toothbrushes, have one for them to chew on and one to use for cleaning their teeth.  The reason for this is that chewing on the bristles will make it difficult for the toothbrush to clean their teeth.

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To arrest incipient lesions in children with significant cavity activity it is recommended that the child receives four to five topical fluoride treatments within a period of four to six weeks.*

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If your child has a high risk for cavities ask your dentist about this program: Pulse with Chlorhexidine for a week, then three weeks with Fluoride and/or carbamide peroxide.  Best application is with trays.

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Black spots on teeth may be caused by cavities, iron build up or staining.

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Check Your Child's Brushing

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A fluoride varnish should be applied to the teeth of all children under six who have had decay instead of fluoride gel applied in foam trays. Fluoride “varnish” isn’t a real varnish with fluoride in it.  Rather, it is fluoride applied as a coating that sticks to teeth for hours after it is applied.  The teeth have a much longer time to absorb the fluoride, which also has an anti-bacterial effect.   

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Fluoride rinses are recommended for home use in decay-prone children once a child is old enough to spit out (rather than swallow) the rinse. 

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Children under age three should be encouraged to brush their teeth with a moist toothbrush remember no toothpaste before the age of three because they might swallow too much fluoride.  Parents should be brushing their children’s teeth with a very small smear of toothpaste on a baby toothbrush using a pea-sized amount of toothpaste for children age three to five.   

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Listerine has introduced Agent Cool Blue© mouth rinse.  It has a chemical in it that identifies the bacterial buildup that we call plaque.   

Here’s how it works:  after brushing (and, for those old enough to do it,  flossing), you rinse with Agent Cool Blue.  Any area you missed will show a blue stain.  Brush and floss away the stain, and you get the areas you were missing.   If you suspect that your child is trying to pull a fast one on you by brushing quickly and poorly,  a surprise post-brushing inspection with Agent Cool Blue will reveal the truth.

Best Predictors of Cavities In Preschool and School Aged Children

Clinical evidence has proven that having cavities in baby teeth is the most significant single predictor of having more cavities in the future.*

 

Children with tooth decay in their baby teeth are nearly three times more likely to have decay in their permanent teeth.^

If all first molars have cavities, then there is a high probability that the second molars will also get cavities.*

Oral health care for children is the cornerstone for adult oral health!~

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Updates                             

 

CDC released a report in May showing that, while Americans of all ages continue to experience improved oral health, the rate of tooth decay increased among children aged 2-5 from 24% to 28% over approximately 10 years between 1994 and 2004. The report, "Trends in Oral Health Status: United States, 1988-1994 and 1999-2004," noted several racial and ethnic disparities. Thirty-one percent of Mexican American children aged 6 to 11 had experienced decay in their permanent teeth, compared with 19% of non-Hispanic white children. There were also disparities along economic lines. Three times as many children aged 6-11 (12%) from families with incomes below the federal poverty line had untreated tooth decay, compared with children from families with incomes above poverty (4%). ADA org 5/07
 

Amoxicillin and tooth enamel defects

Dental fluorosis, a result of exposure to excessive fluoride during enamel formation,  is one of the most common defects seen in permanent teeth.  The clinical signs range from barely noticeable white flecks, to pits and brown stains.  Amoxicillin is one of the most common antibiotics used among pediatric patients, mainly for treatment of otitis media---infection  of the middle ear.   A recent study in the Archives of Pediatrics and Adolescent Medicine linked the use of amoxicillin with the presence of fluorosis in permanent teeth. 

The use of amoxicillin during early infancy showed a strong correlation with fluorosis defects on the permanent teeth that come in earliest---the six year molars and the two front teeth.  The longer a child used the amoxicillin , the greater the risk that dental fluorosis would develop.

Amoxicillin use from three to six months doubled the risk of dental fluorosis. Doctors have more choices in the treatment of pediatric ear infections. If you have an infant will certainly want to discuss this issue with your child’s pediatrician.

 

Childhood Obesity + Pediatric Dentistry

About 15% of children and adolescents ages 6-19 are obese. Pediatric dentists have an important role in fighting the rapid increase in childhood obesity. They must also heighten their staff's awareness by relying on the recently adopted American Academy of Pediatric Dentistry Policy on Dietary Recommendations for Infants, Children and Adolescents. The policy suggests that "the first three years of life may lay the groundwork for obesity," and that dentists bear responsibility for educating parents.

(Source: July/Aug 2005 Pediatric Dentistry) Author: William F. Vann, Jr, Thomas J. Bouwens, Antonio S.  Braithwaite, Jessica Y. Lee
Title: The Childhood Obesity Epidemic: A Role for Pediatric Dentists

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Infant Antibiotic Use Linked To Later Dental Problems

Infants who are given the antibiotic amoxicillin are at an increased risk of dental problems later in life, University of Iowa researcherssuggest. Amoxicillin is one of the most common antibiotics used among children, for conditions such as middle ear infections.

The BBC reports that the researchers say the drug appears to be linked to enamel damage in permanent teeth. Enamel defects can showclinical signs ranging from barely noticeable white flecks, to pits and brown stains.

The study found that the more children took the drug, the more teeth were affected, but a UK expert said it was more likely the diseases themselves had caused the damage, rather than the drug. The researchers followed 579 infants from birth until they were 32 months old, using questionnaires every three to four months to gather information on fluoride intake and amoxicillin use.

By the age of one, three-quarters of the subjects had used amoxicillin. By 32 months, 91% had used amoxicillin. It was found that amoxicillin use from three to six months doubled the risk of dental fluorosis. This condition is usually linked to exposure toexcess levels of fluoride in which the normal maturation of dental enamel is blocked due to disruption of the ameloblasts - the cellswhich produce the enamel.

Writing in Archives of Pediatrics and Adolescent Medicine, the team led by Dr Liang Hong, said, `The results of our study show that amoxicillin use during early infancy seems to be linked to dental fluorosis on both permanent first molars and maxillary central incisors. Duration of amoxicillin use was related to the number of early-erupting permanent teeth with fluorosis.'

`Amoxicillin use in infancy could carry some heretofore undocumented risk to the developing teeth. While the results of this one study do not warrant recommendations to cease use of amoxicillin early in life, they do further highlight the need to use antibiotics judiciously, particularly during infancy.'

Dr Paula Waterhouse, a dental paediatrician at the University of Newcastle, took issue with the research findings. She said research had shown that problems with enamel maturation were more likely in children who suffer from infections. She told the BBC News website, `My feeling is that despite in-depth statistical analyses it is likely to be the illness itself which is causing the developmental defects in enamel.'


Monday 3rd October 2005 cited smile-on.com

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http://www.brianpalmerdds.com/sids_otitis.htm Great website on ear infections and SIDS

Cavity prevention tips for pre-school age children
 

Providing proper care and oral hygiene during preschool years can mean a lifetime of good oral healthChildren who develop cavities in their baby teeth are more likely to develop cavities as an adult. So how can a parent determine if their child is at risk for cavities? It all begins with that first trip to the dentist.

The first dental visit should include an exam to determine if the child is at low, moderate or high risk for cavities and will help decide which oral hygiene program best suits them. The dentist will be able to explain to the parent how often the child should be brushing as well as provide flossing instructions for the child.

Brushing should begin when the first tooth erupts and parents should be in charge of a child's brushing until the child is able to tie his or her shoes or write their own name clearly-usually five or six years of age.  Children whose parents are prone to cavities and tooth decay need to be extra careful because of genetic predisposition to tooth decay.

Children at high risk for cavities should be discouraged from eating starchy snacks such as crackers and chips. In fact, one good way to determine if a snack is good for a child is to check their teeth 20 minutes after consumption. If the teeth are still filled with food, the snack should be discontinued.

Regardless of what food is eaten, regular efforts have to be made to clean the teeth before decay can begin. This means things like brushing, flossing, rinsing after snacks and using non-sugary beverages in bottles or sippy cups. Even if your child is not at risk, it is always good to routine dental check-ups and to limit your child's intake of sugary foods.Essentially all children are at risk to some extent or another, so the same basic principles apply-control of exposure of cavity-inducing food and through cleaning of the teeth. Even if decay is a low risk for an individual child they can still develop gingivitis or other problems if home care is inadequate.

 January/February issue of General Dentistry, clinical, peer-reviewed journal of the Academy of General Dentistry (AGD)2005
 

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Toymaker Hasbro Inc. plans to turn jawbones into headphones to try to tune out tooth decay.

The company announced Friday it's launching ''Tooth Tunes,'' a toothbrush that transmits music through the jawbone to the ear when its bristles touch teeth.

The battery-operated toothbrush contains a tiny microchip that stores the song. When the user presses a button and starts brushing, sound vibrations pass through the tooth, to the jawbone and into the inner ear. The song plays for two minutes, the amount of time dentists recommend people spend brushing their teeth.

The Pawtucket-based company will offer the product, priced under $10, starting in September nationwide.

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Dental caries: a transmissible bacterial infection

According to Kathy Phipps, PhD, under normal circumstances of diet and challenge, children become permanently colonized with mutans streptococci between the middle of the second year and the end of the third year of life, during a  window of infectivity. Despite a long-held belief that mutans streptococci require teeth for persistent oral colonization, recent studies have demonstrated that the bacteria can colonize the mouths of  infants who have no teeth, particularly in the furrows of the tongue. The primary sources of caries-causing bacteria in infants are their mothers. The higher the level of maternal mutans streptococcal infection, the higher the percentage of children who become infected.  By shifting the focus to the bacterial nature of the disease, we will be able to more effectively prevent and treat dental caries. UDA Action, newsletter of the Utah Dental Association, May/June 2004

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Caries in Primary Teeth Predict Future Decay

 Children with tooth decay in their primary dentition are nearly three times more likely to have decay in their permanent teeth, according to an eight-year study conducted in China. In 362 Chinese children age 3 to 5 years at the time of the 1992 baseline study, 85 percent who had had caries in their primary molars showed at least one decayed permanent tooth in a follow-up examination in 2000. In contrast, 83 percent of the children who exhibited no caries in their primary teeth remained decay-free until at least age 12. The authors of the study suggest that children with caries in their primary dentition should be considered high-risk cases for decay in permanent teeth, increasing the importance of dental sealants and fluoride treatments for decay prevention. The recommendation is consistent with a recent recommendation from the Centers for Disease Control and  The results of the Chinese study were published in the August 2002 issue of the Journal of Dental Research.

Fluoride Toothpaste Significantly Reduces Childhood Cavities

A review of 50 years of clinical trails (74 studies involving more than 42,000 children under the age of 16)  firmly establishes that in children brushing with toothpaste containing fluoride results in 24% less cavities than does brushing with non fluoridated toothpaste.  This study conferred:

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greater cavity reduction by brushing twice a day or more with fluorided toothpaste than only once a day.

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brushing with toothpaste containing a higher concentration of fluoride is associated with greater reduction in cavities.

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fluorided toothpaste with give greater benefits in  those with higher levels of decayed, missing and filled teeth.

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brushing with fluoride toothpaste provides additional reduction of cavities even if children live in areas with fluoridated water

Fluoride Toothpaste Significantly Reduces Childhood Cavities, pg 44, Dentistry Today 2/03

Dental exams are essential in evaluating dental health

 Child's First Dental Visit Two Years Too Late+
    A survey of U.S. expectant mothers, mothers and primary caregivers reveals that nearly 70% of children begin receiving dental care two years later than the age recommended by pediatric dental experts.

     On average, children first visit a dentist at age three. Dental experts recommend that initial visits occur between the ages of six months and one year, or when the first tooth appears.

Early visits are crucial in:
bulletassessing diet and feeding patterns that may contribute to tooth decay,
bulletdetermining if such preventive measures as fluoride treatments are required 
bulletteaching parents to better understand and care for their child's teeth and gums

We believe that good oral health begins with informed parents.

 

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Association of Amoxicillin Use During Early Childhood With Developmental Tooth Enamel... Hong et al. Arch Pediatr Adolesc Med.2005; 159: 943-948.

Resource:

^^ The Relationship between Healthful Eating Practices and Dental Caries in Children ages 2=5 in the US., Dr. Dye, Shenkin, Dr. Ogden, Dr Marshall, Dr Levy, Dr. Kanellis, J.A.D.A. Vo. 135, pg 55-66. 1/2004
***AGD, AGD Impact,  Nov 2003 pg 7 
*The Oral Care Report, Volume 10, Number 3, 2000 pg 7.
**Dentistry Today March 2001 pg 31.
~Dental Economics, Feb 2001 pg 70
*ADHA Access Extra 2001; Forsyth Institute President and CEO Dominic      P. DePaola, DDS, PhD Sept-Oct
DentalNotes, Winter 2001, page 5.
JADA, Vol 133, February 2002, pg 255.
^Journal of Dental Research, August 2002

Adventures in Parenting" is available free-of-charge by calling the NICHD Information Resource Center at 1-800-370-2943.  It also is available online at www.nichd.nih.gov

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February 06, 2008

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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