Q&A with Dr. Martha Ann Keels of Duke Pediatric Dentistry

by Administrator 28. February 2012 16:01

February is National Children's Dental Health Month! And there is no time better than the present to highlight the importance of oral health and developing good habits at an early age. The Partnership was able to track down Martha Keels, DDS of Duke Pediatric Dentistry for a Q&A on this very important topic. Thank you Dr. Keels for lending us your expertise!

Q: What is preventive dental care and why is it so important?

It saves money! Dental treatment is expensive.
Children can take great pride in saying “I am cavity-free!”
Prevention helps you stay on the path to being cavity free and hopefully avoid having a needle shot and a drill in your mouth!

Q: What dental routine is suggested for infants whose teeth have yet to arrive?

Get the baby accustomed to having their mouth wiped even before the teeth arrive. Before or after the bath, use a clean washcloth and wipe the gums.
This also gets parents and caregivers in the habit of checking the mouth every day.
Make oral hygiene part of the child’s everyday routine!

Q: At what age should children get their first dental cleaning?
Children should have a “dental home” by age one. Typically, children have 8 teeth by then and the dentist or the dental staff can review with you and demonstrate how to properly clean these teeth. This is usually done sitting knee to knee with the dentist and not in the dental chair.

Q: What can parents/children expect during their first visit to the dentist?

Review of the families’ (both parents) dental history and the child’s medical history
Thorough mouth exam – pathology, cavities, saliva
Demonstration on proper teeth cleaning – brushing and flossing
Discuss appropriate type of toothpaste and fluoride needs
Review of the diet – avoid juice, keep WATER in the bottle or sippy cup, avoid sticky candy and foods. Avoid any food labeled SOUR --- sour candy is very acidic and burns holes in the teeth
Discussion about how to handle any habits like pacifier or digit sucking
Discussion about how to handle any dental injuries – what to do and who to call
Leave knowing what your child’s caries risk is – high, medium or low

Q: What is the most common excuse parents and caregivers make for not seeking preventive dental care early enough?
Parents are often afraid their child will cry or be disruptive in the dental office, so they want to wait until the child is better behaving. Dentists are very comfortable with a crying child. It is normal for children to be scared or anxious, but typically, after we spend some time with the child and gain their trust, the child relaxes. Don’t avoid getting good information about how to care for your child.
Another reason would simply be the cost. But prevention in much cheaper than treatment! One small filling can be over $200 – OUCH!

Q: What are the long-term problems that arise from improper dental care early on?

Studies show that if dental caries is left untreated, children do more poorly in school as they can be distracted by discomfort or pain.
If you lose a baby tooth too early, then the teeth shift around and permanent teeth do not erupt nicely, which can lead to more crooked teeth.
If the teeth have to be restored with silver crowns, then the child has to live with silver versus natural white for several years. The last baby molars do not fall out until age 12.

Q: What are the main culprits for tooth decay in young children?

Eating my worry foods --- dried fruit (raisins, craisins), fruit roll-ups, fruit chews, skittles, starbursts, gummies, gummy vitamins, cereal bars and granola bars. And, NOT FLOSSING --- these foods get stuck between the 8 molars and then you get the 8 chewing cavities.
Holding juice, sports drinks, lemonade or soda in the mouth – slow swallowing or drinking an acidic beverage before bed.

Q: What is the critical connection between preventive dental care and success in school for children?
Dr. Stephanie Jackson’s study showed there were more missed school days due to cavities as well as poorer school performance for children with cavities. Healthy smiles and successful lives go hand in hand.

Data from the Office of Disease Prevention and Health Promotion indicates that early tooth loss caused by dental decay can result in failure to thrive, impaired speech development, absence from and inability to concentrate in school, and reduced self-esteem.

Resources for parents and children
» Handout for parents on preventive dental care for toddlers
» Coloring sheet for children, developed by the American Dental Association.