Welcome to Children’s Dental Health Month!
February is Children’s Dental Health Month. Nordent hopes you are looking forward to educating children and families on the best oral health practices and nutrition for dental health. Children need to have the best and most positive dental experience to ensure a fondness for a lifetime of dental visits. We want to help eliminate stress and apprehension for clinicians, patients and their families. The best way to accomplish this is starting early. Let’s begin the preventive education with all of our expecting patients. Take a few moments to discuss the benefits of early examination. Suggest a first visit when the first tooth erupts or by the first birthday. This is the AAPD (1) recommendation. Offering full home care instructions will set the stage for excellent health and compliance.
Get Into Position
The first appointment is education focused, but it should also be fun and informative! It’s what we do best. Keep it low key and positive, offering lots of praise and direction to both parent and child! First appointment “knee-to-knee” examinations tend to be the most successful. Have the parent hold their child with the child’s legs wrapped around their waist and the head by their knees. This allows you to be knee-to-knee with the parent and with full access to the child’s head and neck.
Examine all soft tissues, check for potential tongue and lip ties, eruption pattern anomalies, and assess the teeth. Use the Tell-Show-Do method. Tell what you are planning to do. Show the tools (mirror, explorer, etc.) required. Do what you told them. Try counting the parent’s fingers, then the child’s fingers gently with the back end of a Nordent explorer, then enter the mouth. This pattern instills confidence in the parent that their child is completely comfortable, even if they may be crying or squirming about. During this entire experience discuss what you are seeing, what you expect to see, and discuss any potential issues found and possible treatment options.
Next, get that super soft infant brush out. Do a full toothbrush demonstration in the child’s mouth, so that it can be easily recreated. Allow the parent to take the brush and practice with you. Now they can confidently create a plaque-free mouth at home. How can we expect a parent to brush if we have not given them the tools and knowledge?
The “BOIT” Method
For brushing simplicity teach the BOIT method, which is simple and easily reproducible. BOIT = bumpy, outside, inside, tongue. Start by wetting the brush and applying a rice sized portion of paste/gel, or just water if sensory issues are noted. This can be increased to a “pea” sized amount at age 3.
Start in the upper right and brush all occlusal maxillary teeth. Next, drop to the mandibular left and brush all occlusal mandibular teeth. This creates one full circle of the bumpy (occlusal) biting surface. By brushing the bumpy/occlusal first you have spread the toothpaste, ensuring all surfaces have adequate time in contact with the fluoride. Next brush the the outsides (facial). These are the “parts you see when you smile.” Starting in maxillary right and ending in mandibular right, brush the facial surfaces. Next, using the same pattern, brush the insides (lingual). These are the “parts your tongue feels”. This pattern makes three complete circles. Bumpy/occlusal, outsides/facial, and insides/lingual. Last, to complete the BOIT method, instruct them to brush the tongue.
A cloth may be used to wipe away excess saliva and paste until expectorating can be successful. Don’t forget to try different flavors to add fun and increase interest in brushing.
Chat and Prophy
Base the appointment flow and treatment on the behavior and comfort of both parent and child. If the appointment is progressing nicely, and time allows, demonstrate use of the prophy angle. Again, use the Tell-Show-Do method. Let parent and child listen to the sound, feel the rubber cup on a finger and possibly on the teeth if the child allows. Try to gently polish with a bit of prophy paste after allowing both parent and child to smell it. Apply a fluoride varnish sparingly at the conclusion of the appointment.
Education On Sugars
Explain the importance of primary teeth as not being simply “practice teeth.” They are necessary for speech, eating and future permanent dentition eruption. Discuss hidden sugars, and adverse reactions from sleeping with a bottle or sippy style cup. Many parents believe that if a product is labeled “organic” or “non-GMO,” it is healthy and not a dental issue. Clearly, we know this is far from true as it relates to tooth decay. Stress water as being the only beverage allowed between meals.
Discuss carbohydrates and sugars and how they relate to tooth decay. This is easiest to do with some common food packages, perhaps a yogurt and 100% fruit juice. Point to the carbohydrates, explaining that four grams of sugar equals one teaspoon of sugar. Showing the package and the volume of sugar is extremely effective! Point out that sticky raisins, candies and granolas adhere to the bumpy surfaces and how this causes increased tooth decay by sticking sugars to the teeth.
Knowledge To Keep
Offer a written pamphlet or sheet outlining the BOIT method, brushing frequency, and basic nutrition with examples. Give them a reminder for a 6 month return visit, or sooner as needed. Offer lavish praise for bringing the child to you for treatment and a sincere thank you for putting their trust in you. Creating a “happy visit” sets parent and child up for a successful dental experience, and eases potential apprehension moving forward.
Nordent believes the most important aspect of an initial appointment is a confident education in children’s dental health. Establishing this confidence in the dental office team and a feeling of comradery sets everyone up for success! As dental professionals, we have the ability to help our youngest patients have the best experience and make dentistry joyful- a win for all. Have a great children’s dental health month!
- http://www.mychildrensteeth.org/education/ Copyright@2012-2021 AAPD mychildrensteeth.org