Health Care and Your Kid's Teeth

How was your first experience with a dentist? Was it when you were a child and your Mother took you trembling and shaking into the dental office? Was your first time in the chair one of fear and trepidation because all you heard were horror stories from your friends? Did you have anxiety about what was going to happen because of all the weird looking tools and equipment. Was your dentist a kind and gentle older person, or young and hip? Many people are afraid to go to the dentist, and some of that comes from memories of childhood anxieties when they were getting cavities filled or a cleaning by the dental hygienist. Some of those fears may be well founded if the first visit as a child is not positive, and some continue as phobias because of general experiences that may be very uncomfortable.

Pediatric dentistry is a very specialized field. And dentists who practice that specialty are required to have much more detailed experience and training before they work with children. According to the American Academy of Pediatric Dentistry (AAPD), pediatric dentistry is one of the nine recognized dental specialties of the American Dental Association. Pediatric dentists complete two to three years of additional specialized training (after the required four years of dental school) to prepare them for treating a wide variety of children's dental problems. They are also trained and qualified to care for patients with medical, physical or mental disabilities. The pediatric dentist is a recognized primary oral health care provider and resource for specialty referral. The AAPD has over 7,600 members who work in private offices, clinics and hospital settings and serve as primary care providers for millions of infants, children, adolescents and patients with special health care needs. In addition, these dentists serve as the primary contributors to professional education programs and scholarly works concerning dental care for children.

According to YourDentistryGuide.com, dental caries (tooth decay or cavities) is the most chronic childhood ailment – five times more common than asthma and seven times more common than hay fever. The Centers for Disease Control and Prevention reports that tooth decay is the most chronic disease among children aged five to 17. Oral health problems affecting infants are no less serious. What your children eat affects their teeth. Sugars (found in cake, cookies, candy, milk and juice) and starches (found in pretzels and potato chips) can cause tooth decay. Add to this the fact that it is more difficult to clean babies' and children's teeth and you can see why debris tends to remain in children's teeth, resulting in bacteria growth and, ultimately, tooth decay. And although baby teeth (deciduous or primary teeth) are eventually replaced with permanent teeth, healthy baby teeth are fundamental to a child's overall health and development.

Some babies are born with neonatal teeth (teeth that develop in the first month) that require dental hygiene or a visit to the dentist for their removal, according to YourDentistryGuide.com. At least one baby tooth erupts by six months of age. And, yes, it requires cleaning. From six months to 24 months, children begin teething in earnest, indicated by irritability, biting on objects, drooling and ear pulling. As a parent, you can help teething progress by using strategies such as massaging your child's gums, offering a chilled teething ring or cold, wet washcloth and asking your dentist for a teething ointment recommendation. By three years of age, most if not all baby teeth have erupted. Soon after four years, spaces for permanent teeth begin to appear as the jaw, supporting bone structure and facial bones begin to grow. From six to 12, it is typical for your child to have both baby teeth and permanent teeth in their mouth. More details can be found at this site: http://www.yourdentistryguide.com/children/.

It is very important to maintain the health of the primary teeth, according to Dentistry4Kids.com. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

Tooth brushing is one of the most important tasks for good oral health as well. According to Dentistry4Kids.com, many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use. Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.

The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. According to Dentistry4Kids.com, research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy. Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother’s should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:
--Visit your dentist regularly.
--Brush and floss on a daily basis to reduce bacterial plaque.
--Proper diet, with the reduction of beverages and foods high in sugar & starch.
--Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
--Don’t share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
--Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

You can make the first visit to the dentist enjoyable and positive, according to Dentistry4Kids.com. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better. It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child. A huge amount of material is available on this website that can assist you to find out much more about how to take care of your children's dental needs: http://www.dentists4kids.com/parents/dentaltopics/.

A huge number of children don't get to see a dentist. According to the California Society of Pediatric Dentistry, having any form of dental insurance significantly increases the odds of seeing a dentist on a regular basis — 54% of privately insured children and 27% of publicly insured children had seen the dentist in the last six months, compared to 12% of children without dental coverage. With all the information available to the general public about the importance of visiting a dentist on a regular basis, there are millions of children who still have not had dental treatment. Researchers found that Latino and African American children across all types of insurance were less likely than Asian American and white children to have visited the dentist in the prior six months. Similarly, Latino and African American children in public insurance programs, including Medicaid and the Children's Health Insurance Program (CHIP), went to the dentist less often than white and Asian American children with the same insurance coverage.

According to FirstEval.com, regarding new federal legislation, i.e. health care reform – for dentists, it looks like it may have the biggest impact on pediatric dentistry (up to age 21) as all Americans under age 21 will either have to have or will be provided with dental coverage. So, that could mean a big flood of kids coming to dental offices when this goes in effect. Yet, these new patients may not be high-paying, or, the reimbursement rates for these children may not be on the high side. But, it could mean a big increase in volume of patients. And, the result may even mean new patients who have never been to a dentist before. As well, as of 2014, Medicaid coverage will greatly expand. In some states, this will include dental coverage, and in some states it won’t. Each state will determine its own set of standards for “comprehensive care for adults” that may or may not include dental coverage. In states where it DOES, this could mean another flood of patients to the dental market. The problem is, that as of today, states haven’t yet decided what these standards of care are yet – this is yet to be determined. But, this could probably be fairly easily predicted, based on a state’s current Medicaid coverage – i.e. (for example purposes only) let’s say that Texas provides rather “restrictive” benefits to its Medicaid recipients currently, while Vermont Medicaid recipients enjoy many more benefits and coverage. Medicaid is one of those programs that the federal government funds by giving a pot of money to states, and then states decide how to dole it out, meeting some minimum standards set by the feds. So Medicaid coverage varies from state to state.

According to Lexology.com, the recently enacted Patient Protection and Affordable Care Act (PPACA), often described as “sweeping” in terms of its impact on insurance and medical care, will also bring changes to dentistry. Few, however, would characterize the law’s immediate impact on the dental profession as “sweeping.” Some aspects of preliminary versions of the legislation that many experts believed could have hurt dentistry were eliminated or modified in the final version of the law, easing those concerns, but the package will have important repercussions for dentistry, particularly pediatric dentistry, in both the near and long term. Beginning in 2014, most US citizens and legal residents will be required to carry a minimum level of health insurance, referred to in PPACA as “minimum essential coverage,” or pay a penalty. Dental benefits are not specifically required as part of the minimum essential coverage which individuals must maintain, but all policies offered to individuals through the state-run Exchanges and in the individual and small insurance market outside of the state-run Exchanges will be required to cover pediatric oral care. PPACA will provide tax credits to low-income individuals and families to purchase insurance through the Exchanges. A “Qualified health benefit plan” is an insurance plan that provides “qualified coverage” for an “essential benefits package,” which includes pediatric oral care for children up to 21 years of age. The final version of PPACA expressly provides that stand-alone dental plans are permitted to operate in the Exchanges, either separately or in conjunction with qualified health plans if the dental plan provides pediatric dental benefits meeting the requirements of PPACA.

Dental care can be expensive, and many families do not go to the dentist because of the cost for pediatric care for their children. Unfortunately, this lack of treatment causes major dental and health care issues for any child who has not been on a dental care plan or seen a pediatric specialist. If you have dental insurance that includes pediatric care, then use it. Budget the monies to take your kids to the dentist before they suffer massive cavities, oral disease, or worse. Pediatric dental care is the first step in preventing serious health issues. If dental insurance is not provided as an employee option at your job, consider purchasing it on your own with affordable plans through qualified insurance carriers and your insurance agent. If your budget is too tight to afford insurance, then a great way to save money and get your kids great dental care is with a discount dental plan. Companies in the market place, such as Careington International (http://www.careington.com/), provide access to pediatric specialists nationwide through these plans for just a nominal monthly membership fee. You buy a membership and visit participating dentists, receiving a discount at the time of service from 20% to 60% on most procedures. And the entire family is automatically included.

Your kids need good teeth. Make sure they visit the dentist at least once a year if not more often. If your children miss the dentist, it could be much more costly for you as a parent with additional medical bills when they get sick. And, the Tooth Fairy will be there much more often, making a sizeable dent in someone's bank account.

Until next time. Let me know what you think.