It’s common for kids to be less than enthusiastic about visiting the dentist. For some, though, it’s even more of a challenge: A child with extreme anxiety and fear during dental visits could interfere with them receiving the dental care they need. The impact could even extend into adulthood.
Recognizing the need to reduce this high anxiety, dentistry has used a number of pharmacological tools for many years that relax a child during dental care. Sedatives have often been the only choice for reducing anxiety, especially during extensive procedures and treatments. But now there’s a promising new approach in dentistry that doesn’t depend on drugs.
Cognitive behavioral therapy (CBT), a psychotherapeutic method used for decades to treat depression, phobias and eating disorders, has been investigated recently as a possible approach for relieving children’s dental anxiety. During CBT, trained therapists use specific behavioral techniques to help patients develop mental and emotional strategies for dealing with stress.
During the usual course of CBT therapy, a therapist meets in counseling sessions with patients weekly over several months to help them change their routine thinking or behavior surrounding a stressful issue. Initially, the therapist guides the patient toward understanding the underlying causes for their negative reaction to the issue. They then work with the patient to devise an objective way to test whether those emotions and beliefs about the issue are true.
Using this effective method for changing behavioral and emotional responses for dental anxiety has had encouraging results from initial research. One study found CBT successfully reduced dental anxiety among a majority of a group of European children ages 9 through 16 who participated in the method.
CBT isn’t an overnight cure, often requires a number of months to achieve results. But for children who suffer from extreme fear of professional dental care, this drug-free method may provide long-term benefits that extend well past their childhood years.
If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."
Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:
- Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
- Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
- Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
- Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
- Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.
Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.
If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
With summer vacation season in full swing, you and your family might be planning a trip away from home, maybe even far from home. If you’re vacationing out of the country, you’ll want to be as prepared as possible—including protecting your dental health.
Dental problems are difficult enough in the familiar surroundings of home, but even more so in a foreign locale. However, with a little preparation and planning, you can keep your exotic dream vacation from becoming a dental nightmare.
Here’s what you can do to avoid or minimize an unpleasant situation with your teeth and gums while on vacation abroad.
Take care of any dental problems before you leave. If you know or suspect you already have a problem with your teeth or gums, it’s better to have it corrected if at all possible before your trip. So, make an appointment to see your dentist if you notice things like a toothache or tooth sensitivity, unusual spotting on your teeth, or swollen or bleeding gums.
You should also have sinus problems like pain or congestion checked too, since these may actually involve your teeth and gums. If at all possible, undergo recommended procedures like gum disease treatment or root canals pre-trip—just be sure you allow adequate time for recuperation before your departure date.
Know who to contact in a dental emergency. Even with the best of planning, you should also prepare for the possibility of a dental injury or emergency while you’re on your vacation. So be sure you pack along with your other travel documents the names and contact information of individuals or organizations near your vacation destination that might be of assistance in a dental emergency. These might include hotel concierges, military personnel or other English speakers living in the area, or the nearest embassy or consulate.
In addition, the International Association for Medical Assistance to Travelers and the Organization for Safety, Asepsis and Prevention are online resources that can help you with your trip planning and give you medical and dental information specific to your destination.
A vacation trip to a foreign land can be a unique and fulfilling experience. Just be sure a dental problem or emergency doesn’t spoil the moment—be prepared. If you need to take care of any dental issues before you go on vacation, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental & Medical Tourism” and “10 Tips for Daily Oral Care at Home.”
Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.
Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.
It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.
But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?
That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.
For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.
More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.
Because it requires jaw movement, eating can be difficult and painful if you have a temporomandibular joint disorder (TMD). During flareups you may switch to foods that are easier to eat but may be less nutritious than those you're giving up.
But there are ways to keep healthier foods in your diet while minimizing TMD discomfort. In many cases, it's a matter of preparing your food differently. Here are a variety of food groups known for their nutritional value and what you can do to prepare them for easier eating with TMD.
Fruits and Vegetables. You should peel any fruits or vegetables with hard or chewy skin like apples, peaches or cucumbers. Try chopping or pureeing fruits and vegetables you can eat raw to reduce their size and make them easier to chew. Vegetables like carrots, potatoes, broccoli or cauliflower can be cooked, then chopped or mashed.
Legumes and nuts. Pod-based vegetables like beans or peas provide a number of nutritional elements, as do nuts with their healthy fats. Your motto with these foods should be "Not too large and not too hard." Be sure then to cook, mash or puree legumes that are larger than a pea. With nuts, try nut butters for a softer serving than eating them out of the shell.
Protein and Dairy. Any meats like poultry or beef should be cut into bite-sized pieces; you can also moisten them with broths, gravies or sauces for easier chewing, or braise or stew them in liquid to tenderize them. You can also consume most milk, yogurt or cheese products you can tolerate. If you can't, try alternatives like meal replacement or whey protein beverages.
Grains. Prepare grains by cooking them until they're softened. Hot cereals like oatmeal offer a lot of nutrition and they're relatively easy to eat. Toast your bread and cut the slice into smaller pieces to minimize jaw movement.
One last tip: take your time while eating. A slower rate not only helps you enjoy your food more, it reduces the amount of work your jaws perform while eating. Less jaw work can help further ease the discomfort of TMD.
If you would like more information on how to relieve TMD pain and dysfunction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What to Eat When TMJ Pain Flares Up.”
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