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Keep Calm & Brush On

“An apple a day keeps the doctor away, but brushing your teeth twice a day may keep the dentist at bay.” 

-Dr. Clark

Even in the times of COVID dental care is still super important for your child’s overall health and well-being and February is National Children’s Dental Health Month! 

Did you know dental caries (or cavities) are one of the most common chronic diseases of childhood (5x more common than asthma)? 37% of children ages 2-8 with primary teeth, 21% of children ages 6-11 with permanent teeth, and 58% of adolescents ages 12-19 will have dental caries. 

Dental caries can cause tooth/mouth pain that can affect children’s ability to chew and get the nutrition they need, increase their risk of infection, lead to poor sleep quality, and affect their overall self-esteem. There is also growing evidence that poor oral health can impact other chronic diseases such as cardiovascular disease, lung diseases, and diabetes.

The best way to avoid these problems and others is prevention of dental caries before they start. Here are some tips and tricks on the best ways to accomplish this:

Routine Dental Care

  • The American Academy of Pediatrics (AAP) and the American Dental Association (ADA) recommend all children should see a dentist and establish a dental home by their first birthday or within 6 months of getting their first tooth, whichever is earliest. 
  • Prior to teeth erupting, use a soft wet cloth to clean baby’s gums after feedings
  • Once teeth erupt, the AAP and ADA recommend brushing teeth twice a day for 2 minutes with a fluoride containing toothpaste. For children under 3 – use a small smear (no larger than a grain of rice) of toothpaste. For children over 3 – use a pea sized amount of toothpaste. Help children brush their teeth until they are able to do so themselves, usually around 8-9 years of age.
    • Tip – Some parents tell me teeth brushing time is a battle with their younger children, try making it as fun as possible! Get their favorite cartoon character on the toothbrush, play games while getting ready to brush their teeth, sing songs while brushing for 2 minutes. Encourage younger children to “practice” brushing their own teeth with your supervision as well. 
  • Once able, floss teeth once daily. 
  • After establishing a dental home, visit your dentist every 6 months for routine checkups and cleanings, or as directed by your dentist. 

Preventing Dental Caries is Everyone’s Responsibility

  • Your dental health is equally important in caring for your baby’s dental health. The most common source of transmission of dental cary causing bacteria is from the primary caregiver’s mouth. 
    • Visit your dentist regularly for routine dental checkups and cleanings and brush your teeth twice a day (this also helps set a good example for your children!).
    • Avoid sharing cups, utensils, and putting your baby’s pacifier in your mouth. 
  • Avoid putting your baby to bed or down for naptime with a bottle in their mouth.
  • Limit sugar exposure and foods high in carbohydrates as much as possible as these increase dental caries risk. Instead of sugary drinks, try giving your child water or plain milk. Instead of sugary snacks, try foods such as fresh fruits and vegetables, cheese, nuts, popcorn, or pretzels. 
  • Avoid drinks other than water in a sippy cup between meals.
  • As your child becomes older and starts engaging in sports and other physical activities, discuss prevention of oral injuries with your provider. 
  • As your child gets older and matures, start teaching them to care for their own oral health – one day it will be only their responsibility!

What happens at Your Child’s First Dental Visit?

It may seem odd to take your baby to the dentist when they only have a few teeth, however as discussed above starting preventative care early will set your child up for success in maintaining good oral hygiene. At your first visit your dentist will provide a comprehensive evaluation of your baby’s mouth, gums, and teeth and assess their overall risk for disease. Your dentist will clean your baby’s teeth and provide a cary-preventing fluoride varnish if indicated. Your dentist will also provide anticipatory guidance on how to care for your baby’s teeth at home.

  • Tip – Any dentist will be able to provide these services for your child, but a pediatric dentist will be more experienced treating children and may have fun toys/distractions in their offices and exam rooms to help with any anxiety your child may have. 

These are just a few of the basics about dental care. Each of your child’s well visits with us will also include a general inspection of their teeth. Our office can also recommend and provide fluoride varnishes if needed. Feel free to ask us any questions you may have regarding your child’s dental health as well!

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About the COVID-19 Vaccines…

There are now a few different vaccines available for COVID-19 and two of them have been approved by the FDA for use in the U.S. But what do we know about these vaccines? Are they effective? Are they safe? When will they be available to everyone? Here is some (hopefully) helpful information about the vaccines approved in the U.S.

The only two vaccines currently approved are the Pfizer-BioNTech and Moderna vaccines. Pfizer was approved 12/11/2020 and Moderna was approved 12/18/2020. In comparing the two:

Pfizer-BioNTechModerna
mRNA vaccinemRNA vaccine
Currently approved for ages 16+Currently approved for ages 18+
Given in 2 doses, 21 days apartGiven in 2 doses, 28 days apart
Demonstrated 95% efficacy in trial with >44,000 participantsDemonstrated 94% efficacy in trial with >30,000 participants

What is an mRNA vaccine? How is it different from other vaccines?

  • Many vaccines we traditionally provide for children are either “killed” or “live” versions of the disease they protect against. The body encounters the virus or bacteria and begins building an immune response. The entire virus or bacteria is injected into the body. mRNA vaccines are a newer vaccine variant that provide only one specific part of the virus, in this case the “spike protein”, which the body encounters and starts building an immune response to. mRNA breaks down very quickly in the body after it delivers the instructions to replicate the spike protein to our body. 

This vaccine is brand new, is it safe?

  • The vaccines have been undergoing safety monitoring since the early days of the studies and will continue to be monitored in the trials for at least a 2 year period. The CDC has also set up a patient-reported monitoring program called “V-safe” for patients to report any side effects experienced after receiving the vaccine. The only true contraindication to the vaccine is a history of a severe allergic reaction to any component to the vaccine. As has been reported, a few individuals have experienced allergic reactions after receiving the vaccine. If you have a history of allergic reactions, particularly to any other vaccine, discuss the COVID-19 vaccine with your healthcare provider.

What side effects are there?

  • The most common side effects reported are arm soreness/redness at the injection site, fatigue, fever, chills, headache, muscle aches, and joint pains. These side effects may be more pronounced after the second dose, but are similar to side effects from other vaccines. After my first dose, I had moderate arm pain for about 2 days and mild fatigue. After my second dose, I had more fatigue and body aches for about a day. 

How long will immunity from the vaccine last?

  • It’s unclear at this point how long the vaccine induced immunity will last, but studies will be ongoing. The first Pfizer vaccine recipients received their vaccines May 2020. 

Can children obtain the vaccine?

  • The Pfizer vaccine enrolled participants down to age 12. Moderna is now enrolling children down to age 12 as well. Currently only the Pfizer vaccine is approved for children ages 16+. Studies will continue to enroll younger children gradually and the vaccines may be approved for younger children over the coming months. The American Academy of Pediatrics has advocated for the inclusion of children in vaccine trials. 

My child had COVID-19, does he/she still need the vaccine once it’s available for children?

  • Yes. It’s unknown how long natural immunity to the virus lasts. The current data from the CDC suggests it is unlikely to get COVID-19 again within 90 days after the initial infection. However, the current recommendation is to obtain the vaccine regardless of prior infection. Per the CDC, if you were treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. If your child obtains any other vaccines, there should be a 14 day period between those vaccines and the COVID-19 vaccine.

Kids generally are less likely to have severe complications from COVID-19, why should they get the vaccine anyway?

  • While generally less severe in kids than in adults, COVID-19 can cause significant illness in children. Per the AAP: “In children for whom COVID-19 caused serious illness, half had an underlying condition, and half did not. This is similar to influenza. We need to vaccinate children because we do not know which children may be at higher risk of serious, possibly life-threatening illness. Children can also transmit the virus, including to more vulnerable adults who are in their family or in their school, so it is important that children be included in the vaccine distribution in order to reduce community spread.” 

After the vaccine are face masks and other precautions still necessary?

  • Yes! It will be a while before enough of the population can be vaccinated successfully and more data is still needed on whether the vaccine not only provides immunity (95% efficacy) but also prevents spread of infection to others. So for the time being, even after completing the vaccine series, we should all still continue to wear face masks, wash hands frequently, avoid travel and large gatherings when possible, stay home when ill, and social distance as much as able. Hopefully with these measures and the vaccines, life can return to “normal” sooner. 

As always, please feel free to discuss any questions or concerns with us in the clinic!

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