My Parents Versus My Dentist

I will always remember my childhood dentist, Dr. Tarentino.  I will especially remember his eyes, boring down into my mouth as intensely as his drill.  Though my parents were smart people with advanced degrees in Theology, they could be remarkably naive about personal health care.  As a toddler I loved to walk around with a bottle in my mouth, and they let me. Since milk was expensive and filling, they substituted Kool-aid for my habit.  Thus my memories of Dr. Tarentino, his eyes, and the scream of the drill.

We non-dentist doctors see lots of tooth problems in the Emergency Department.  There are too many kids out there with bad dental hygiene, which leads to cavities, which leads to tooth pain and infection.  Yet only a few minutes per day of tooth care prevents such misery.  First, supervise your kid’s brushing.  Many parents tell their kids to go brush their teeth, and minutes later the child reports- job done!  But how good a job?  When kids are left alone to brush, they often just do a couple of strokes on a couple of teeth before moving on.  From an early age, be there to watch your kids brush every time, insuring that they get all tooth surfaces, brushing gently instead of scrubbing like they were taking off old paint.

Start tooth care at an early age.  After all, your kids get teeth in the first year of life.  Get them used to brushing as soon as they have teeth, again, gently!  You don’t want it to hurt and make them hate brushing.  If it is a habit when they are so young, it gets ingrained as a habit for the rest of their lives.  Bring them to the dentist early as well- as young as age two. Then they learn that the dentist can be fun and every dental visit won’t mean pain.

Unlike my parents, avoid that sugary diet.  We all have bacteria in our mouths, no matter how much brushing and flossing. Dental hygiene keeps down that bacteria that hurts our teeth.  Sugars in our diet feed that bacteria, which turn that sugar into acids which burn into our teeth.  Those burn holes are cavities.

It always seems that the tooth pain cases come in at night.  The lights are down, the house is finally quiet, there are no more distractions for a kid.  WIth the quiet of bedtime comes the realization that something has been hurting- ouch, its my tooth!  The child cries and the mom finally has time to notice that the side of the child’s face is swollen. They rush into the Emergency Department with their tooth infection.

However, dental infections are not sudden emergencies.  By their very nature, they are slow-growing illnesses.  It starts with a cavity.  Over weeks and months, the mouth bacteria that started the cavity chew deeper into the tooth.  The cavity finally gets deep enough to infect the gums.  The infection causes inflammation, swelling, and terrible pain in one of the most sensitive parts of the body.

Actually, dental infections don’t start with a cavity.  They start with bad mouth care. As we mentioned above, unsupervised brushing, along with not flossing and too much sugar, allow mouth bacteria to get out of hand and begin to eat into the child’s tooth surfaces. Tooth infections also start with children not getting enough flouride in their diet. The American Academy of Pediatric Dentistry is very clear on the science- communities with flouride in their water save lots of money and anguish not having to care for so many rotten, painful teeth.  In places where the water is not flouridated (Louisiana), the AADP recommends flouride supplements for children.  In other words, Louisiana children should take flouride just like they would take any other vitamin.

Back to my parents, who let me toddle about with a kool-aid bottle in my mouth and thus support my childhood dentist’s practice .  My parents were wonderful people who did more good in the world than I can ever hope to approach.  They raised three happy successful boys. Just don’t follow their lead in their third son’s dental hygiene.




Doctors Doing Dentistry?

Sometimes we emergency doctors are called upon to temporarily be dentists.  Teeth  get knocked out in injuries, and we have to tend to the tooth as well as the other, more doctory injuries.  It makes us a little uncomfortable- there is a whole profession dedicated to mouth care, and we are by comparison rank amateurs.  Then there is the non-emergency that always makes us groan in frustration, the dental infection.

Dental infections in the Emergency Department make us groan because their very nature is not an emergency.  Dental infections happen in slow motion.  They start with cavities, which take months to grow.  They are highly preventable- doesn’t everyone brush their teeth?  And when pain starts, the pain can be taken care of with ibuprofen and tylenol until the next dentist visit- no need to clog the Emergency Department!

So here are the details to take care of dental infections.  Step one- don’t have one.  Make sure your kid brushes his teeth twice daily.  And with kids from age 3 to 10, don’t always take their word for it.  Parents need to observe that their child brushes all surfaces carefully, twice daily.  I’ve seen plenty of parents who say their kids brush their teeth, but one look in the mouth tells me that maybe what the kid is doing is a quick one-two on a few teeth and done!  Older kids should learn to floss too.

Kids need to have lower sugar diets, for their teeth as well as their waistline.  No sodas, candy, packaged sweets in the house at all!  That high sugar content destroys teeth as well as general health.  Finally, all kids over age 3 should have check-ups with the dentist twice per year.  Dentists can spot and treat cavities before they become big problems.

Once a cavity gets big enough though, bacteria get into the deeper tooth and gum tissue.  Then the gums swell with infection, and it hurts!  Then the tooth really needs a dentist.  The dentist can prescribe an antibiotic to clean up the infection and plan about repairing the damage.  In the mean time, pain medicine like ibuprofen or tylenol can make your child’s life a lot easier.  Occasionally, stronger medicines can be prescribed for bedtime pain.  But of course, to take care of the above, you have to have a dentist!  If you don’t have one for your three-year old, get one now.

Preventing dental infections is easy, if you do a little work in prevention.  Teach your kids to brush their teeth and floss, and be sure with your own eyes that they do it at least twice per day.  Again, do not even bring temptation into the house- don’t buy sodas and sugary snacks.  Finally, have a dentist.  That way, you don’t have to have some dumb emergency doctor pretend that he is one.