More enthusiasm than skill. (Yes, that is a horse you can see out the window.)
My son Jacob is a bit of a neat freak. I mean, for a four year old. Sure, there are Legos strewn across the floor most of the time and his bed has a giant pile of trucks on it. But he likes to clean. What he really likes is the idea of cleaning. He likes the cool tools you can use to clean (vaccum cleaners, sink sprayers) and he likes to hang clean pans up on their hooks in the kitchen.
So this morning he came up to me asking me to put soap in the dishwasher. At first I was a little worried at what I would find, but I was pleasantly surprised to find that he had simply put a glass in the dishwasher. He was ready to turn the dishwasher on and wanted me to help. So we proceeded to finish filling the dishwasher and started it. Then, he asked to help with the hand wash dishes.
Naturally, he dragged a chair into the kitchen so he could be right in the middle of the action. We filled the sink with soapy water (extra bubbles, of course) and dove into the pots and pans.
Like I said, the kid likes to clean. He grabbed a dishcloth and scrubbed with feeling! He was covered in bubbles and smiling, but the dishes weren’t really that clean. He missed the tougher spots. The pans were still pretty greasy. His little four year old hands didn’t quite have the manual dexterity that was necessary to get the job done. What he lacked in skill he made up with in enthusiasm, yet at the end of the exercise, I had to clean where he had missed.
Now, I’m flashing back to a conversation I had with a mom about her 7 year old boy’s brushing habits. When I examined him I could see that his gums were pretty irritated and April told me that he had a lot of plaque on his molar teeth. Mom told me that she has him brush twice a day most days. The I asked her the question:
“Would you let him do the dishes by himself?”
She looked at me like was crazy. “Well, no,” she said.
I explained that he wasn’t quite ready to brush his teeth on his own. I use this analogy with most of the parents in my practice. Brushing teeth isn’t brain surgery, but it does need a certain amount of dexterity and attention to detail to get the job done right. Furthermore, a parent standing over a child looking directly at the surface that they are brushing (using the previously described “loving headlock” technique) is going to remove plaque and debris much better than the child can alone. 99% of the time you’ll find a clean mouth doesn’t get cavities, so it’s important that the job gets done well. When it’s a child, it’s less important who does the job.
She’s adorable, but would you let her do your dishes?
I think it’s great that Jacob wants to wash dishes and I’m glad that he does it! It’s just that he’s not ready to do it solo. Some kids are probably conscientious enough to wash the dishes at 7 or 8. Some kids probably shouldn’t be allowed to wash dishes at age 16! The parents definitely know them best and should make the judgement. I think the same goes for brushing teeth. If you’re a parent, you need to ask yourself the question. If they aren’t ready to do the dishes on their own, they aren’t ready to brush their teeth without supervision.
Did you find this post soapy clean? Did it make you ask the question? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
I’ve been seeing lots of kids at the office lately. For whatever reason, the few weeks before Halloween tend to be full of kids at Mead Family Dental. I’m not sure how that works, but I’m actually kind of glad. It’s a great time to remind kids and their parents how they need to be taking care of their teeth. Unfortunately, I’ve seen a lot of kids with cavities lately which frustrates me a lot. I used to get frustrated with the kids and I now realize that’s a silly strategy. How often do I see a child at my office? Usually twice in a year or maybe a couple more times if they actually need to have cavities addressed. That’s not very much at all.
So who do I need to talk to? Mom and Dad. They’re with their children every single day and that’s who needs to hear my lecture. So, if you’re a parent I have three important things that you need to read.
It’s not normal for kids to get cavities: Cavities are not inevitable! Most communities have fluoridated water supplies which give kids great start toward a cavity free future. Along with this, a healthy diet and good habits can and will prevent tooth decay. In most cases, when kids get cavities it’s because of poor diet or poor habits. Clean teeth don’t get cavities!
Kids that develop cavities will become adults that get cavities: If you, as a parent, accept your child’s tooth decay you are creating a standard. If a parent isn’t bothered by a child’s tooth decay, why should the child be? This will lead to further apathy and will make creating good dental hygiene habits that much more difficult. Parents…do not accept tooth decay in your children. If you can keep your child cavity free until they reach their late teens, you will have given them an amazing gift. Kids that reach that age without cavities are much less likely to experience decay in the future.
You should brush your kids’ teeth until they are 1o years old or older: No exceptions. You need to brush your child’s teeth. Your six year old may be brilliant. Maybe even a child prodigy in a lot of ways but they won’t get their teeth as clean as you will. Who do you think gets your teeth cleaner…you in your mirror or a dental hygienist? Obviously, the hygienist can do a better job because they can see every single surface that needs cleaning. And that is why you need to brush your child’s teeth.
I’m O.K. with you and your child “sharing” the responsibility of cleaning their teeth, but you need to brush them first. And completely. Here’s how:
Get yourself an inexpensive electric toothbrush. We’re fans of Captain America and Iron Man at my house.
Grab their beautiful little head tightly between your non-dominant arm and your body
Make sure they open wide. Help them tip their head in such a way that you can see each surface of each tooth. If necessary, you can prop their mouth open or retract their lips with the fingers of your non-dominant hand.
Use a fluoride toothpaste as soon as the child can rinse and spit (around 3 or so). There are many non-fluoridated alternatives for children that might still swallow toothpaste.
Gently brush each surface of each tooth with your dominant hand. Make sure you can see the brush clean each surface!
Have them rinse with water and spit out the excess. If you’re doing it right, especially with an electric toothbrush, there will be a lot of foamy excess.
Once you’ve finished, let the child go through the same motions if they like. How long should you brush your children’s teeth? It may be different for each child. A rule of thumb might be that if you trust your child to wash dishes without you checking the results, you may be able to let them brush their teeth unaided. As much as you want your child to be confident and independent, you really cannot trust that they’re getting their teeth completely clean until they’re older! I see many 15 year olds (or even adults) that cannot or will not clean their teeth effectively. Why should an 8 year old be able to handle it any better? The difference is, that 8 year old is your responsibility as a parent!
Kids rely on their parents for almost everything. Keeping their teeth clean and healthy is no different. You can give your children the gift of a healthy mouth and teeth. But there’s some work that goes along with it. You’re going to have to get your hands dirty. Regular dental office visits are a small part of the puzzle, but frankly the dentist has little influence. Your child’s diet and dental hygiene is a choice you make as a parent. Every. Single. Day. Are you up to the challenge? Your little peanut is counting on you!
Did you find this post harsh? Did it make you feel guilty? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
Yesterday ABC played a story in their “Hidden America” series entitled “Do Dentists Turn Children Away.” It’s an emotional piece, for sure. It features many adorable low income kids in various states of dental distress and it levels some pretty serious charges at government and the dental community. Chris Cuomo, the story’s reporter, ended the story with, “…we went after them 5 years ago, it didn’t get done. This time we will not rest. This is unacceptable.” Diane Sawyer replied “And what about the good dentistsout there that want to help the 60% [of children on Medicaid without a dentist] who are living their lives right now and can’t wait…” Chris Cuomo went on to mention that some dentists are “doing the right thing…” The take home message I get from this report is that “dentists don’t care about poor kids.”
This report comes on the heels of ABC’s coverage of “dental x-rays causing brain tumors.” It seems that dentists are getting all kinds of help from ABC news to tarnish our images this month! Like we needed it! So why won’t dentists take care of these needy kids? Is it that they don’t care? Or maybe they’re just unwilling to make less money while helping poor people. Either way, dentists are clearly bad guys.
I can only speak for myself. I’ve discussed this with other dentists often and most tend to agree with my perspective, though. I do take limited amounts of Michigan’s version of Medicaid dental coverage for kids/adolescents/young adults. Why don’t I take more? Here’s a few of those reasons:
limited services: This is probably the main reason that I’m hesitant to get more involved with these programs. I have a toolbox that I bring with me when I treat patients. (Not literally…I actually have an office!) I have a lot of different treatments to offer for different dental problems. Some of these tools work better in some situations, some work better for others. In extensive problems, some of these just aren’t workable. One of the things that frustrates me is that Medicaid will pay for a root canal procedure to save a tooth, but they will not allow you to restore the tooth appropriately after the root canal treatment! A lot of teeth that end up requiring a root canal have lost a lot of tooth structure. A filling is inadequate for these teeth, but that’s what is covered. If I go ahead and do what I feel as appropriate, the program will not cover it and it becomes the patient’s responsibility. Most patients aren’t willing or able to pay for the appropriate treamtent. So, my toolbox gets much smaller for patients using these programs.
limited payment: The fees that the Medicaid programs pay are low. That’s what everyone knows. The news programs always say this, but they never dig any deeper than that. To be specific, Healthy Kids dental in Michigan reimburses my office at about 50% of my regular fee. People hear this and think that dental offices make 50% less when they see kids on the Healthy Kids program. That’s not accurate. Most dental offices are small businesses run to make a profit. A dental office needs to collect a certain amount of money just to pay rent, utilities, equipment costs, employees…the basics. This is called overhead, and every business has it. You need to average a certain number of dollars for each unit of time in order to keep the doors open. If you don’t average this amount, the office doesn’t make a profit. Some offices can change their overhead structure by working more quickly, seeing more patients, using less expensive materials or paying their employees less to make up this difference. I won’t do that. I don’t want to have to change the way I treat patients to be able to participate with the program. My patients expect amazing service and a certain atmosphere and I’m not willing to sacrifice that. You may think that makes me a snob, but I think my patients appreciate it. So, when I see Healthy Kids patients, I’m working for free. The good news is, overhead is figured on an average, so I’m willing to take a loss on some patients. But as I mentioned before, I limit the number of patients I will see on the program.
ethical traps: Medicaid programs give each provider dentist a particular menu of procedures and their associated codes that are covered benefits. It could be tempting for a dentist to “overuse” a code that they wouldn’t normally charge separately for. I’m not saying that it’s wrong to do so and I’m not saying that it is common. All I’m saying is the that the temptation to “overcode” can be there.
All kids deserve healthy teeth!
dental prevention: Most dental diseases, especially in children are 100% preventable. These programs are at their absolute best when they are used for prevention: specifically early childhood examination and education of good dietary and brushing habits. Unfortunately, most people end up in need of these services after a child has problems, often really bad problems. The horse is already out of the barn at that point. These programs become much less helpful for those patients, and they will often need extensive care that can only be handled by pediatric dentists.
This is where I’m coming from. I’m not sure it would be a satisfying answer for Diane Sawyer. It’s a lot better TV when you can point the finger of blame at a particular group, especially when a lot of folks are pretty anxious about that group in the first place. The news media plays a story that riles people up, and then they forget about it. In the mean time, people look at dentists as greedy and uncaring. If you feel like dentists aren’t doing good things for poor kids, you need to ask yourself: in the same position, would you be willing to work for free? How much work would you be willing to do for free?
The Michigan Dental Association will be sponsoring it’s first Mission of Mercy in June of 2013. These amazing events allow Michigan dentists to see around 2000 patients in a weekend for no charge. Next year’s Mission of Mercy will be held on campus at Saginaw Valley State University. I’m planning on being a part of the 2013 MOM. I think this kind of event is an effective way to help people who might otherwise not be able to get dental care. So Diane Sawyer might have it wrong about dentists!
Did you find this post frustrating? Thought provoking? Angering? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.
I see it all the time. A look of concern on a mom’s face while their child is having their teeth cleaned. “Are there cavities?” they wonder. “Will they need braces?” Wouldn’t it be nice if you could relax in our comfortable waiting room knowing that your kid is going to have a brilliant dental check up? Here’s some things you can do to give your kids a really good shot at dental health!
Be a great example: Your kids see and hear everything that you do. And they somehow always repeat what you’ve said at incredibly bad times (think “daddy doesn’t like Grandma’s cooking” at Thanksgiving dinner). So they see how you take care of your teeth, too. They notice if you brush and floss often, or not. They’ll see you chew sugarless gum after meals and will probably want some, too!
Get your teeth fixed: tooth decay and gum disease are a bacterial infections. They are transmitted in a similar fashion to a cold. The bugs that cause tooth decay are almost always transmitted from mother to child, although anyone who is a prominent care provider (dads, grandparents) can also transmit them. What I’m saying is that your kids will have your bugs. What determines what kind of bugs you have? People who have lots of cavities, particularly lots of untreated cavities will have nastier bugs. So, if you’ve got a history of lots of cavities or you have work that you need to have done, you probably have nastier cavity bugs. And you’ll probably transmit them to your kids. The moral of the story…have your teeth fixed and your kids will have healthier teeth.
Bring ’em in early, and often: The American Academy of Pediatric Dentistry (AAPD) recommends “first visit by first birthday.” Practically speaking, you should bring them in once they have their first tooth. And they should be checked every year after that until they start having their teeth cleaned, which is usually around the age of 4. Having a dentist look at your child’s teeth often can help find problems while they’re small. Since baby teeth are actually more susceptible to cavities than adult teeth, this is pretty important.
You brush their teeth, then let them brush their teeth: It’s great to raise independent children. It’s great that they want to take care of themselves. But you need to brush their teeth. An adult should brush first, then the kiddo brushes second. Parents, you’ll need to brush with a firm hold on your little cherub’s head. And you need to retract (pull apart) their lips with the hand that you’re holding their head with so that you can see the surfaces of their teeth. As one pediatric dentist once told me, “if you can’t see what you’re brushing, you’re not brushing it well.” Once you’ve scrubbed all the surfaces, then let the child have a chance to do the same thing. How long until they’re old enough to brush on their own? Well, my oldest is 4 years old and I’m thinking it’s going to be 6 more years of me using the “loving headlock” on him.
No bottles in bed!
Don’t put a baby down with a bottle: Don’t get in the habit of putting your baby down with a bottle. Once they get used to it, it’s much more difficult to break the habit, so don’t do it! Even if you’re giving them formula or breast milk, there are still sugars in them that can be turned into acid by cavity bugs. Pediatric dentists often times call the massive tooth decay found in very young children “baby bottle tooth decay” for a reason. If you have to put a baby to bed with a bottle, use only water!
Reduce the juice: When you think of fruit juice you think of “wholesome” and “healthy.” When I think of fruit juice I think “tons of sugar” and “high acid content.” Kids should have limited fruit juice intake. It’s really tough on teeth and almost always has a lot of added sugar. I know it goes against how fruit juice is marketed, but it’s true. Eating fruit = great! Drinking fruit juice = really bad for teeth. If you want to give your kids juice, do it at meal times…not snack time!
If you do these things the risk factors for cavities and other dental problems can be reduced significantly! So when you’re waiting for your baby to have their cleaning finished you can sit back, relax and know you’ve done your job. Ahhhh! Doesn’t that feel better?
Did you find this post helpful? Informative? Bone headed? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.