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Your Toddler

Thumb Sucking

2.00 to read

I admit it – I was a thumb sucker for way too long. My thumb and mouth didn’t part company until I was in first grade. The fear of getting caught during a sleepover at a friend’s house was enough for me to finally call it quits.

It’s normal for babies and toddlers to suck their thumbs. Babies are born with the urge to suck as part of their survival. They also use it as a way to soothe themselves when they feel hungry, afraid, restless, sleepy or bored. Toddlers carry on that natural instinct as they find their way in the world.

By the time children are around four-years-old they’ve typically stopped sucking their thumb and found replacements for self-soothing. Occasionally, children (like myself) will continue to suck their thumb out of habit.

Some experts say that if a child is still sucking their thumb by the age of six, they may be doing so because of emotional distress such as anxiety.

Thumb sucking isn’t a problem under the age of four, but if a child continues- with great intensity- after five or six years old, they could be setting themselves up for dental or speech problems.

Prolonged thumb sucking may cause their teeth to become improperly aligned (malocclusion) or push their teeth outward. If the thumb sucking stops, the teeth most likely will align correctly, but the longer the sucking continues the more likely orthodontic treatment will be needed.

Extended thumb sucking may also cause speech issues such as lisping, inability to say Ts and Ds, and pushing the tongue out when talking. A speech therapist may be needed to help correct these problems.

How do you help your child stop sucking their thumb? It takes a lot of patience.

One place to begin is to pay attention to what triggers the thumb sucking. Does your little one start when they are bored, sleepy, or unsure about something? Redirecting can help. Busy hands help keep thumbs from going into the mouth. Give your child a large stuffed animal to wrap their arms around or have them help hold the book when you are reading to them. Offer a squeezable rubber ball or finger puppets to grasp when they are watching TV.  The key is to offer an alternative at the times you notice they are the most likely to want to suck their thumb.

Ask your child to not suck their thumb in public and gently remind them when you see them doing it. Let them suck their thumb at home, but start the process of being self-aware in public. Kids often unconsciously slip their thumb into their mouth. A reminder helps them notice what they are doing.

You can also start talking to your child about why it’s time to give some thought to stopping. In age-appropriate language explain how thumb sucking is okay for younger children, but as children get older they learn how to stop. Ask them questions like “Do you see (insert name of an older child or adult here) sucking his or her thumb?” They’ll think about it more and start to decide whether they want to continue. It’s a process that takes time.

Punishing or shaming your child is absolutely the wrong method to address thumb sucking. This approach not only doesn’t work, but also lowers a child self-value and can create an even stronger desire to thumb suck. It’s like quitting anything you’re doing that may not be good for you in the long run- the worse someone tries to make you feel about it- the more you want to do it (think overeating, smoking, drinking.)

You can also talk to your pediatrician or family doctor for his or her suggestions on how to help your child. For older children, behavioral therapy may be beneficial.

There are products that are nasty tasting that can be swabbed on your child’s thumb, but some experts think that approach is cruel and more like a punishment than a humane way to help a child outgrow a natural inclination.

Most kids will simply quit sucking their thumb when they are good and ready. Helping your child reach that point may require patience and creativity, but in time his or her thumb will cease to be a constant comfort companion.

Sources: http://children.webmd.com/tc/thumb-sucking-topic-overview

Your Teen

Are Energy Drinks Rotting Your Teen’s Teeth?

2:00 to read

A lot of parents know that too many high sugar sodas are not only hazardous to their child’s waistline and health, but they can also cause cavities. But what about the energy drinks teens are gulping down? A new study suggests those drinks could be stripping the enamel right off their teeth.   

In a study published in the May/June issue of General Dentistry, researchers have looked for the first time at the effects of energy drinks on teeth. It turns out there's often a lot of citric acid in the drinks.

To give drinks a long shelf life and to enhance flavors, preservatives are added. It’s the preservatives that are very good at stripping the enamel off of teeth.

Dentists are especially worried about teens. 30 to 50 percent are now drinking energy and sports drinks and losing enamel. Once it's gone, teeth are more prone to cavities and more likely to decay.

"We are well aware of the damage that sugar does in the mouth and in the whole body — the role it can play in obesity, diabetes, etc," says Poonam Jain, an associate professor in the School of Dental Medicine at Southern Illinois University, Edwardsville, and the lead author of the study. "But the average consumer is not very well aware that acid does all kinds of damage, too."

To measure just how energy and sports drinks affect teeth, the researchers looked at the fluoride levels, pH, and something called "titratable acidity" of 13 sports drinks and nine energy drinks, including Gatorade and Red Bull.

The researchers then measured how much enamel the drinks took off teeth, dousing sliced-up molars in a petri dish with the beverages for 15 minutes, followed by artificial saliva for two hours. This was repeated four times a day for five days.

The researchers found that teeth lost enamel with exposure to both kinds of drinks, but energy drinks took off a lot more enamel than sports drinks.

Drink labels list citric acid in the ingredients, but they don’t have to show the precise amount.

The American Beverage Association (ABA) was quick to respond to the study.  

"It is irresponsible to blame foods, beverages or any other single factor for enamel loss and tooth decay (dental caries or cavities)," the ABA said in a statement responding to Jain's paper. "Science tells us that individual susceptibility to both dental cavities and tooth erosion varies depending on a person's dental hygiene behavior, lifestyle, total diet and genetic make-up."

"This study was not conducted on humans and in no way mirrors reality," the ABA noted in its statement. "People do not keep any kind of liquid in their mouths for 15 minute intervals over five day periods. Thus, the findings of this paper simply cannot be applied to real life situations."

Jain is concerned about health effects beyond cavities. She says consuming a lot of citric acid can lead to loss of bone mass and kidney stones. "This has become a big concern because people are drinking more of these drinks and less milk," she says.

Dentist Dr. Jennifer Bone, spokesperson for Academy of General Dentistry, the organization that publishes the journal, said in the statement that teens and adults should curb their intake of these types of drinks. If they're going to drink one anyway, she recommends they chew sugar-free gum or rinse their mouth with water after drinking the beverage.

"Both tactics increase saliva flow, which naturally helps to return the acidity levels in the mouth to normal," Bone said.

Sources: http://www.cbsnews.com/sections/health/main204.shtml?tag=hdr;cnav

http://www.npr.org/blogs/health

Your Baby

Baby's First Tooth!

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child.After all the crying, and teething fits, midnight trips to the crib, and endless time soothing and rubbing gums.... it’s finally here. Baby’s first tooth!  It’s also time to start thinking about your child’s dental health, and baby’s first visit to the Dentist.

It is generally recommended that an infant sees a dentist by the age of 1 or within 6 months after his or her first tooth comes in.

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child. The average age for continuing visits is about 2 to 2.5 years old depending on your child’s dental heredity and overall health. Many dentists like to see children every 6 months to build up the child's comfort and confidence level in visiting the dentist, to monitor the development of the teeth, and promptly treat any developing problems. What Happens at the First Dental Visit? The first dental visit is usually short and involves very little treatment. This visit gives your child an opportunity to meet the dentist in a non-threatening and friendly way. Some dentists may ask the parent to sit in the dental chair and hold their child during the examination. The parent may also be asked to wait in the reception area during part of the visit so that a relationship can be built between your child and your dentist. During the exam, your dentist should check all of your child's existing teeth for decay, examine your child's bite, and look for any potential problems with the gums, jaw, and oral tissues. If indicated, the dentist or hygienist will clean any teeth and assess the need for fluoride. He or she will also educate parents about oral health basics for children and discuss dental developmental issues and answer any questions. Topics your dentist may discuss with you might include: 1. Good oral hygiene practices for your child's teeth and gums and cavity prevention 2. Fluoride needs 3. Oral habits such as thumb sucking, tongue thrusting, lip sucking. 4.  Developmental milestones 5. Teething 6. Proper nutrition You will be asked to complete medical and health information forms concerning the child during the first visit. Come prepared with the necessary information. What's the Difference Between a Pediatric Dentist and a Regular Dentist? A pediatric dentist has at least two additional years of training beyond dental school. The additional training focuses on management and treatment of a child's developing teeth, child behavior, physical growth and development, and the special needs of children's dentistry. Although either type of dentist is capable of addressing your child's oral health care needs, a pediatric dentist, his or her staff, and even the office décor are all geared to care for children and to put them at ease. If your child has special needs, care from a pediatric dentist should be considered. Ask your dentist or your child's doctor what he or she recommends for your child. When Should Children Get Their First Dental X-Ray? There are no hard-and-fast rules for when to start dental X-rays. Some children who may be at higher risk for dental problems. Children prone to baby bottle tooth decay or those with cleft lip or palate should have X-rays taken earlier than others. Usually, most children will have had X-rays taken by the age of 5 or 6. As children begin to get their adult teeth around the age of 6, X-rays play an important role in helping your dentist. X-rays allow your dentist to see if all of the adult teeth are growing in the jaw, to look for bite problems and to determine if teeth are clean and healthy. Once a child’s diet includes anything besides breast-milk or baby formula, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Daily Dose

The Right Water For Formula?

A new parent asked me the other day if they could use concentrated or powdered your-baby formula that needed to be mixed with water.A new parent asked me the other day if they could use concentrated or powdered baby formula that needed to be mixed with water. That brought to mind the need to discuss fluoride and its importance in developing teeth.

Over the past 40 years, tooth decay in young children had been decreasing. Recent studies show that the trend is reversing and we are once again dealing with tooth decay in young children’s teeth. I had written in a previous column about “early childhood caries” as it related to prolonged bottle use, but early cavities may also be related to inadequate fluoride consumption. Fluoride is a natural mineral that protects and strengthens teeth from developing cavities. Infants’ teeth are developing and will be stronger and more resistant to cavities if they have been exposed to fluoride. Fluoride is found in drinking water we usually get from drinking water from the faucet in our homes. If the community water supply has greater than 0.6 ppm (you can check on this by checking with public health officials in your city) and you use tap water routinely then your infants and children are getting adequate fluoride and will not need supplements. The issue is that many families are drinking bottled water or use home filtration systems. In this case your infant may not receive the fluoride that they need. We don’t often think about fluoride and drinking water, but I am amazed at how many families are concerned about using tap water. We pay a water bill each month to provide water to our homes, one of the advantages of the modern age. This water is tested, protected and ensured to be safe, and on top of that has fluoride added at the correct amounts to ensure proper dental protection. So why do so many of us buy bottled water? At the same time it has been pointed out that plastic water bottles are filling up landfills, and polluting our environment. Who would have thought to invest in water that comes in bottles, not me. Sounds crazy. Why buy special “nursery water” which is costly and not eco friendly? So, why do we parents try to complicate things that don’t need to be complicated? Be thrifty and use the water you pay for out of the faucet. It is safer to mix formula with tap water, which provides adequate fluoride for those developing teeth, than using fluoride drops or supplements that may be forgotten or mis-measured. Along with protecting new teeth you will be protecting the environment, a “two-fer” for your baby. I am also going to practice what I preach and have stopped buying bottled water. I am now using a re-usable bottle for my daily workouts, filled with good old-fashioned tap water! That’s your daily dose, we’ll chat again tomorrow. Send your question to Dr. Sue!

Daily Dose

Baby's 1st Tooth

Dr. Sue answers an email whwn will my baby cur her first tooth?I received an iPhone App email from Lilli who was concerned that her son was almost one year of age, and had not cut a tooth yet.  I remember having the same feeling when our middle son had not cut a tooth at 15 months of age and my mother kept reminding me of “toothless” children.

Of course, our first son cut his first tooth at about 7 months of age, so despite trying NOT to compare them, of course I was.  Upon reviewing the literature I was thrilled to find out that there is a wide variation in dental eruption among babies and very few cases of children who never developed teeth! The first teeth to erupt are typically the lower central (middle) incisors, usually somewhere around 6 months of age, although just like many things in child development there may be those who have teeth earlier and those who will not cut a tooth until after their first birthday.  Girls typically cut their teeth before boys (just like pubertal development). Teeth usually erupt in pairs with the two lower central incisors being the first to erupt, then followed by the upper two central incisors and then the upper lateral incisors. Most children will have their full set of “baby teeth” by the age of three years. Personally, I would not worry about it, and not having teeth should not prevent your child from eating finger foods either.  It is wonderful to have a few extra months of that sweet baby breath (teeth make for bad breath) and you don’t have to worry about tooth brushing. It is still a good idea to give your child a toothbrush that they can begin experimenting with if only to brush the gums! That's your daily dose.  We'll chat again tomorrow

Your Baby

Breastfeeding May Improve Infant’s Dental Development.

2:00

Infants that breastfeed exclusively or predominately for their first three to six months of life are less likely to develop any kind of dental misalignment later on according to a new study.

The researchers, led by Karen Peres at the University of Adelaide in Australia, tracked just over 1,300 children for five years, including how much they breast-fed at 3 months, 1 year and 2 years old.

The children were also monitored for pacifier use.  About forty percent used a pacifier daily for four years.

When the children were 5, the researchers determined which of them had various types of misaligned teeth or jaw conditions, including open bite, cross bite, overbite or a moderate to severe misalignment.

The risk of overbite was one-third lower for those who exclusively breast-fed for three to six months compared to those who didn't, the findings showed. If they breast-fed at least six months or more, the risk of overbite dropped by 44 percent.

Similarly, children who exclusively breast-fed for three months to six months were 41 percent less likely to have moderate to severe misalignment of the teeth. Breast-feeding six months or longer reduced their risk by 72 percent.

The reason breastfeeding might offer protection from dental misalignments is the way it works an infant’s jaws. Breastfeeding involves coordinated tongue and jaw movements that support the normal development of teeth and facial muscles.

Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John's Health Center in Santa Monica, California, agrees that it’s the jaw movement.

"Breast-feeding requires the use of jaw muscles more so than bottle-feeding, so the mechanics of breast-feeding stimulate muscle tone in the jaw," Fisher said.

Open bite, overbite and moderate to severe misalignment were generally less common overall among the children who mostly or exclusively breast-fed. Children who mostly breast-fed but also used pacifiers, however, were slightly more likely to have one of these misalignment issues, the study found.

"Pacifiers are used for non-nutritive sucking but when overused, they can put pressure on the developing jaw and lead to more problems in older children with malocclusion [teeth/jaw misalignment]," Fisher said.

Parents oftentimes depend on the pacifier to help babies relax and self-soothe. The key is moderation of use.

The American Academy of Pediatrics recommends parents consider using a pacifier for an infant's first six months because pacifiers are associated with a reduced risk of sudden infant death syndrome (SIDS).

"Most infants need to suck for comfort or non-nutritive sucking," Fisher said. "Pacifiers can be helpful in the newborn period and even help reduce incidents of SIDS in infants who sleep with them."

Instead, parents should simply limit pacifier use, she said. In addition, pacifiers are not needed past the first six to 12 months, Fisher said, so parents can begin weaning after that time.

Like most studies, the results did not prove cause and effect, but an association.

The findings were published online in the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150615/breast-feeding-may-have-dental-benefits-study-suggests

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