Can I give my baby cavities by kissing her?

February 7, 2013 By Leave a Comment

February is Children’s Dental Health month.  As I only blog every so often I wrestled with what xylitol-chewing-gumI wanted to share with parents this month.  I thought about stressing the importance of making sure little ones visit the dentist no later than their first birthday.  I also thought about discussing proper use of fluoride supplements and fluoridated toothpaste.  I ultimately decided to take the road less traveled and talk about prevention of cavities prior to eruption of the baby teeth.  Since February is most commonly associated with Valentine’s Day, I immediately thought about kissing.  Unfortunately, for some people kissing one’s baby can put the baby at a higher risk of developing cavities.

Prevention of cavities has a few components.  Some of which I’m sure you’re well aware of such as the physical removal of plaque and food particles by brushing.  Another component of prevention is making the teeth less susceptible to decay with fluoride products.  The least commonly discussed component of the disease process is the role that bacteria play.  I know it sounds odd to the ear to hear cavities referred to as a disease process but that’s in fact what it is.  It’s actually the most common chronic disease of early childhood.  Without boring you with too many microbiological details I’ll just say, just as there is a bacteria that causes strep throat there is another type of strep named Strep Mutans (MS) that causes cavities.

Unfortunately, there are individuals that have higher numbers of and/or more aggressive strains of MS than others.  Those individuals are typically at a higher risk of developing dental decay.  It turns out that even prior to the baby’s teeth coming in the baby already has the EXACT strain of MS the mom has.  This occurs through what’s called vertical transmission.  Vertical transmission occurs when the mom kisses the baby on the mouth.  The bacteria hangs around in the folds of the tongue until the teeth erupt.  Once the teeth erupt the bacteria have some extra things to hang on to.

The good news is there are preventive measures that new mothers can take to reduce the amount of MS levels in their saliva.  Xylitol is a sugar that can be found in many gums and candies.  According to the American Academy of Pediatric Dentistry (AAPD), studies have shown when the mother chews certain types of xylitol containing gum at least two to three times per day it can dramatically reduce the amount of cavity causing bacteria in the child’s mouth by reducing the amount of MS in the mother’s mouth.  In order for maximum efficacy new moms should begin this regimen when their baby is three months old and continue until their child is at least two.  Additionally, the total amount of xylitol per day should range from four to ten grams.  Many of the xylitol containing gums have about 1.7 grams of xylitol per piece.  Be sure to check the label of the brand you purchase to make sure you are getting the proper amount of daily xylitol.

A xylitol regimen isn’t just beneficial for the child but also beneficial for the mother’s oral health.  Additionally just about anyone can use this regimen to utilize the oral health benefits xylitol provides.  Remember, before embarking on a cavity prevention regimen for yourself or your child check with your oral health care provider first to make sure you are on the right track.

Warm regards,

Dr. Lezli

Filed Under: Baby cavities, Chewing Gum, xylitol Tagged With: , , , , , ,

From now until 12/31 Dental Kidz will donate $5 for every new like on its Facebook page to Wynona’s House

November 24, 2012 By Leave a Comment

From now until the end of the year Dental Kidz will donate $5 to Wynona’s House for every new like our Facebook page receives.  Like us at www.facebook.com/dentalkidz. Please go to www.wynonashouse.com to learn more about how this organization is changing the lives of sexually abused children.

I truly believe nothing happens randomly.  A couple of years ago I was researching non-profit organizations on behalf of a mommies’ group that I am a part of.  My purpose was to submit a few non-profit organizations in Essex County that serve the needs of children so that the mothers and children of the mommies’ group can develop a relationship with the organization through community service.  In the process I stumbled upon Wynona’s House located not even three blocks away from my Newark office.  I learned from the website that Wynona’s House is a non-profit organization that serves the needs of sexually and severely physically abused children that reside in Essex County.  I later had a lovely conversation with the Executive Director of Wynona’s House, Keri Logosso.  She invited my husband and me to tour their facilities.  The very next day we visited Wynona’s House and we were moved to tears.  There were pediatricians, mental health providers and a plethora of specialists, all there for one sole purpose; to help these invisible children feel good about themselves not withstanding the abuse they’ve had to endure.

Keri explained to me on average when a child reports sexual abuse they often have to tell, retell and recount the abuse they have endure to five to six different parties prior to getting help.  Typically, when a child reports sexual abuse the focus becomes getting all of the information required to make sure the claim is legitimate and subsequently prosecuting the perpetrator.  What then happens to the victim?  Wynona’s House is the only organization of its kind in Essex County. It reduces the amount of time sexually abused children have to be interviewed.  Children are referred directly from Essex County’s Department of Children and Families (formerly DYFS) or from the police department.  Rather than this vulnerable population having to go to their local police station and having to divulge painful details to police officers that aren’t trained to deal with children, abused children partake in an interview at Wynona’s House given by a specially trained detective in a “play room”.   Watching the interview is a member of the Essex County’s prosecutor’s office and a DYFS worker.   If the child is less than twelve years old, that recorded interview is admissible in court in lieu of them testifying.

Wynona’s House is also a fully functioning mental health and primary health care facility for these abused children.   There are pediatricians and child psychologists on site to provide these children with the comprehensive care they so desperately need.

Since its inception Essex County has found Wynona’s House so integral to the successful rehabilitation of abused children they moved the Essex County Prosecutor’s office directly next to the Wynona’s House building and the construction was completed in such a way that Wynona’s House and the Essex County Prosecutor’s office is one contiguous building.  This partnership with Essex County Prosecutor’s Office distinguishes Wynona’s House from any organization of the like nationally.  Alas, our mommies’ group ultimately selected another amazing non-profit organization that addresses the unique needs of homeless children in Essex County.  However, my heart was forever changed by Wynona’s House.  I subsequently became a board member of the organization.  Please go to www.wynonashouse.com to learn more about how this organization is changing the lives of sexually abused children.

Warm regards,

Dr. Lezli

Filed Under: Uncategorized

Dr. Lezli is now a Diplomate of the American Board of Pediatric Dentistry…..what does that even mean?

November 21, 2012 By Leave a Comment

Hello parents, I’ve been missing in action.  Not without good reasons of course.  In addition to meeting the needs of my family (did I mention my husband and I have five daughters, three of which are under the age of five) and a busy private practice, I was feverishly preparing for my oral board exams, which I took in Dallas during the first week of October.  I received the excellent news yesterday that I am now board certified and am a Diplomate of the American Board of Pediatric Dentistry (ABPD).

I think it’s important for parents and other stake holders in children’s health to understand what the term board certified means as it relates pediatric dentistry.  After dental school, a small percentage (roughly 20%) of dentists go on to receive advanced specialty training in one of the nine specialty areas recognized by the American Dental Association.   An even smaller percentage of dentists go on to receive board certification.

You may have heard of dentistry’s largest group of specialists, our friend the orthodontist.  With the exception of one dental specialty there is a specialty specific board that governs the board certification process.  In my case that board is named the ABPD.

I chose to participate in the board certification process because I saw it as an opportunity.  I saw it as an opportunity to demonstrate two things to my daughters, my patients’ parents and to the public.  In addition to taking the additional step to receive advanced training in pediatric dentistry I wanted to demonstrate that I am committed to and am proficient in the highest standard of care possible.

Here is a brief overview of what the board certification process entails for a pediatric dentist.  For any board certifiable dental specialty, the board certification process usually takes places in two steps.  The board candidate must sit for a written or what the ABPD calls the qualifying exam (QE).  Once the candidate has successfully completed the QE they are eligible and can apply to take the oral clinical exam (OCE).  Unlike most dental specialties where the board permits the candidate to select and submit their own cases for the OCE, the ABPD selects eight cases upon which the candidate will be examined.  Both the QE and OCE are given once a year.  Per the ABPD the purpose of the QE is to provide evidence toward validation of the candidate’s advanced training in pediatric dentistry.  Additionally, the ABPD says the purpose of the OCE is to enable the candidate to demonstrate proficiency in diagnosis, treatment planning, and clinical care.

If the candidate successfully completes both steps they become Diplomates of the American Board of Pediatric Dentistry and are board certified.  In order to maintain board certification status the doctor must pass a written exam every ten years.  The ideal time frame to have this completed is within five years of completing their advanced specialty training.  It isn’t mandatory in dentistry for specialists to become board certified.  Board certification is a completely voluntary process.  If a dentist works at a hospital or has operating room privileges at a hospital that particular institution usually requires that doctor become board certified.

There are many pediatric dentists that may opt out of the board certification process for a myriad of reasons.  The most obvious is that they have attempted unsuccessfully.  However, many pediatric dentists work solely in private practice, never step foot in a hospital and for this reason may choose not to participate in the board certification process.  It is expensive and time-consuming.  According to the ABPD, sixty percent of pediatric dentists are board certified.

While receiving Diplomate status is a huge achievement one should not select a pediatric dentist solely on the basis of whether or not they are board certified.  Choosing a knowledgeable pediatric dentist that will provide your child with quality care is multifaceted.  It is important to note that there are many excellent pediatric dentists that are not board certified.  I myself was one until yesterday!  Have a wonderful Thanksgiving.

Warm regards,

Dr. Lezli

Filed Under: Board Certification, Uncategorized Tagged With: ,

They’re just baby teeth so what’s the big deal?

May 21, 2012 By Leave a Comment

A dear college friend and fellow mom mentioned to me that she was having a conversation with another mom who posed the question that reflects the sentiment of this post’s title.  This is an excellent question and is one that I answer very often.  It’s true that baby teeth will eventually fall out.  However, we have to keep in mind that prior to them falling out they are a part of the body.  They have a nerve supply and a blood supply and everything is connected.  However before I talk about physiology, I need to impress upon you the fact that dental decay is a disease.  Yes, it is a disease.  Its the most common disease of early childhood and is five times more common than asthma.  I’m sure you’ve heard of strep throat.  Well, dental decay is caused by a particular type of strep, not the same type that causes strep throat but it is bacterial in origin.  Also, if your child’s oral cavity due to poor oral hygiene and diet is conducive to allowing these little strep buggers to cause cavities in the baby teeth, unless you modify the diet, hygiene and flora this will be the same oral environment that will be present when the permanent teeth start to erupt.  And guess what? The best predictor of future cavities experience is past cavities experience.

Now that we’ve gotten that out of the way, let’s discuss the exfoliation of baby teeth or in other words when the baby teeth fall out.  The top two front teeth fall out on average when your child is around seven to eight years old.  The baby molars on the top or the bottom won’t fall out until your child at the very least, nine years old.  Let’s think about this.  If you bring your three, four or five year old child to the dentist because you notice a cavity that means the cavity is really large.  If you can see a cavity with your naked eye, it will or has been causing your child pain or discomfort.  If the dentist discovers it during the exam and then determines that the cavity isn’t small enough to remineralize and treatment is required, well….then treatment is required.  If your child is three, four or five years old and cavities are discovered on the front teeth those teeth likely won’t fall out for a few years.  If cavities are discovered on the back teeth depending on what tooth it is you shouldn’t expect your child to lose that tooth until at least nine or ten years old.  Do you really want to leave disease in your child’s mouth for a few years?  Additionally, enamel on baby teeth are much thinner than it is on permanent teeth so cavities get much bigger, much quicker on baby teeth.  These cavities will likely cause pain and infection before they fall out.

This is called cellulitis.  It is the result of an untreated dental infection.  Cellulitis is very serious and has to be treated very aggressively.  It happens because the bacteria spreads from the tooth into other spaces in the body.

Also, the permanent teeth are right behind the baby teeth.  In addition to the pain and infection we previously discussed, bacteria from untreated decay on a baby tooth can travel up to the root and may also cause a white or brown spot or possibly a complete absence on a portion of the enamel of the permanent tooth.  So yes, they are baby teeth and we want to take care of them.  Lastly, and we’ll discuss this in another blog post but there is a direct correlation between severe decay of baby teeth in a child less than six years old and childhood obesity.

Warm regards,

Dr. Lezli

Filed Under: Dental Decay Tagged With:

Has your little one visited the dentist as of yet?

May 11, 2012 By Leave a Comment

Once upon a time the American Academy of Pediatrics (AAP) recommended the parent wait until their child was three years old prior to having their first dental visit.  Empirical evidence subsequently revealed 36 months was far too long to wait before initiating intervention from an oral health care provider.  As a result the American Academy of Pediatric Dentistry (AAPD) followed by the AAP changed their recommendations.  Your little one should establish their dental home around 6 months of age and no later than their 1st birthday.  For many of you I may already be preaching to the choir.  However, there are a good number of really great parents that still think they should wait until the age of 3 to bring their child for their first dental check up.  Additionally, there may be many of you that already know the AAPD’s recommendation but are thinking, “My child doesn’t have all of their teeth yet so why would I bring them to the dentist?”.

Prevention of disease is less invasive and more cost effective than controlling or attempting to cure it.  Yes, dental decay is a disease, we’ll discuss why in another blog post.  Your child’s dentist will guide you on what to anticipate.  During your child’s first check up you should expect to learn about proper use of the bottle, proper use of fluoridated toothpaste, depending on where you live the appropriate use of fluoride supplements, nutritional counseling, the impact of oral health on overall health and wellness, how long is too long to maintain a non-nutritive sucking habit (pacifier, digits), when to floss, etc.

During the first year of life even a well child will visit the pediatrician a number of times.  Naturally, parents may want to defer oral health questions to the primary care physician.  However, the pediatric dentist, not your child’s pediatrician is the most suited to guide you on the best way to optimize your child’s oral health.  Pediatric dentists have received an additional 24 to 36 months of training after dental school to address the unique needs of children.  If you haven’t established a dental home for your child as of yet, take the guess work out of trying to figure out what’s best for your child’s oral health.  Please visit www.aapd.org to find a pediatric dentist in your area.

Warm regards,

Dr. Lezli

Filed Under: Dental Home Tagged With:

Ask Dr. Lezli is back with an easier to remember web address :)

May 10, 2012 By Leave a Comment

If you’ve visited my previous blog you may remember the .blogspot that followed askdrlezli and preceded .com.  Unfortunately, my blog was mistakenly identified and deleted by google as one that sells merchandise.  The good news is Ask Dr. Lezli is back with a much easier to remember web address, www.askdrlezli.com.  I have some down time as I’ve just given birth to our 5th daughter on May 1st.  There are new things that I want to discuss based on questions I’ve been asked regarding “orthodontically correct” pacifiers, “kid’s flossers” and other aspects of pediatric oral health.  However, I would be remiss without reposting some of the basics.  No pediatric oral health blog would be complete without valuable information such as: when your child should first visit the dentist, nutritional information, juice versus soda, etc.  So bear with me if you’ve heard this information before.

Warm regards,

Dr. Lezli

Filed Under: Uncategorized
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