Gummy Vitamins: A Sticky Situation

By Ashley Valco

We want to do what is best for our kids, always. This, of course, includes making sure they are getting all the nutrients they need. So, many of us turn towards vitamins to get our daily dose of goodness. The current trend seems to be Gummy Vitamins. Many of my patients tell me they are giving them to their kids every day. While they might be the trend now, they have actually been around since the 60’s! Do the benefits of these gummies outweigh the risks of the damage they can do to teeth? Let's find out...

Do you even need them?

First, you should always consult your child’s pediatrician before giving your children any kind of supplement. Having a balanced diet will go much further than any supplementation. 

If your child does need further supplementation for their diet, be sure that whatever product you are choosing has the significant amount of the vitamin needed. 

When I was pregnant, I was so nauseous that I couldn’t even bare the thought of swallowing that horse pill of a prenatal vitamin. So, reluctantly, I turned to the gummy version. Looking at  the ingredients, I noticed that they didn’t have any Folic Acid! What is the point of a prenatal vitamin without it? It just shows that all vitamins are not created equal. Make sure the vitamins you are giving your kids have what they need!

So, what’s the problem? 

Even if Gummy Vitamins meet all the nutritional needs of your child, they can still cause enough damage to their teeth that make them not worth the purchase. Look past the vitamins and minerals they need that are contained within the gummy, to the ones that do the damage.

They are like our favorite sticky candy, the gummy bear! They contain large amounts of glucose syrup to get that chewy, sticky consistency. Glucose syrup is a mixture of water and glucose - a kind of sugar. Yep, sugar. Even if they are sugar free, these “candies in disguise” still contain damaging ingredients. To get a chewy texture without glucose syrup they need to use a sticky gelatin or citric acid. 

What does all of this mean?

Run your tongue over the biting surfaces of your back teeth. Feel all of those crevices and grooves? They are much more narrow and deep that your tongue can detect. Children have even deeper grooves. When sticky substances get inside those grooves, they stay there. Toothbrush bristles are not always able to get into those grooves to get that stuff out. Bacteria eventually consume the sugary substance and produce acids that break down the tooth (aka a cavity). Citric acid will only move this process along quicker. 

Every day your child will chew this vitamin only adding to her chances of getting cavities. I find many of my patients will eat them after brushing, which means that gummy is now hanging out all day or night, increasing the chances of a cavity.

While chewable, chalky vitamins (think Flinstones) also settle into those groves, the chalky substance is dissolved by your saliva at a much quicker rate. These are much better options for the overall health and dental health of your child, if supplementation is necessary. 

Do you give your kids vitamins? What is your favorite brand?

Why Morning Appointments Are Best

Why Morning Appointments Are Best

By Ashley Valco

You just spent the entire day running errands, working, straining your brain, or whatever it is that you do every day. You are tired, probably hungry, and would love to take a nap. Instead, you have to go to the dentist. Not everyones favorite place, I know... You suck it up and get through it. Hey, maybe you even appreciate the fact that you can lay down for 30 minutes in a quiet room! Either way, you have had a lifetime of learning how to act appropriately in a situation you would absolutely rather not be in. 

Now, imagine you are 3 years old. It is 4:45 pm. You are hungry, cranky, and you need a nap. You are being forced to go to the dentist and you don’t understand why you can’t just stay asleep in the car. Now someone is expecting you to sit quietly with your mouth open and it seems like torture. You have not yet learned how to act appropriately in any situation...

This is common, and it is why we encourage morning appointments for the little ones. We want to make sure your child has the best experience possible, which is why it is imperative to schedule their appointments accordingly. Just like you, children are well rested in the morning and will be much more cooperative and refreshed. As the day goes on they become tired and cranky. This puts the appointment in a difficult situation before it even starts. 

We recommend early appointments for young children that are scheduled around their nap time. No one wants to get their teeth cleaned when they should be sleeping! I had a child in my chair not too long ago that was 4 years old. Mom brought her into the office during a time that she would normally be napping. She was so tired that she couldn’t even keep her mouth open for me to examine her. After a few minutes, she began to cry. Not because she was afraid, or apprehensive, or even because she wanted her mom. She cried because she was tired and wanted a nap. Just like most children. Of course, Mom felt terrible for her and said she simply didn’t think about it when she scheduled the appointment. She made sure to schedule future appointments with this in mind. 

Sometimes we simply don’t think about the time. We, as moms, have so much going on that it may be the last thing we are thinking of when we are scheduling. Just as I am writing this I am remembering when I scheduled my sons pediatrician appointment at 9:30am. He was 6 months old and took a nap every day at 9am. I don’t know what I was thinking. My God did I regret that so bad! He screamed through the entire thing. My son is a very happy baby. Most people comment that they never see him upset or crying. Always smiling! However, he was being poked at prodded and everything else when he should have been fast asleep cuddled up with his Wubby.

With older children there is another aspect that should be considered. Especially for restorative appointments (fillings, extractions, crowns, sealants, etc). Some children are apprehensive about what may occur during the visit. We do everything we can to make them feel comfortable. When they are scheduled for an after school visit they have the entire day to think about it! By the time they walk into our office they are about to burst from anxiety! If your child does not have any anxieties about the dental office than no worries here. Some are very nervous so it would be best for them to schedule earlier appointments.  

We know that this can be very inconvenient for some parents, however, the Rose Tree Kids staff puts the safety and comfort of your child first. A positive dental experience will have an impact on their dental health as they grow into young adults. 

My Child Chipped Their Tooth! Now What?

My Child Chipped Their Tooth! Now What?

By Ashley Valco

Like most Americans, I spent the weekend gardening and going to BBQ’s. Beautiful weather for a holiday weekend. One of the BBQ’s I went to had hundreds of water balloons and the kids were going crazy! A friends child was chasing the other kids and fell right on his face and hit his mouth on the stone that outlined the garden. 

Instant screaming ensued, from the child and the Grandmom, as well as a fountain of gushing blood. 

Now what?

Well, let's first make sure nothing was cut open. Luckily, a trip to the hospital on Memorial Weekend wasn’t in the cards for them. Once everyone had calmed down, and the blood had been cleaned off, we could assess the situation. Joey had a swollen lip, a cut tongue, and a chipped front tooth. 

The swelling will go down, the tongue will heal. While tissue trauma to the mouth bleeds very heavily, it also heals faster that any other place on the body. What about the tooth? 

I told Mom it would be all right to wait until tomorrow to get an appointment with Joey’s dentist. There are several different types of “chips” and they are determined by how many layers of the tooth are affected. This can only be seen by an x-ray. Therefore, it is necessary to take an x-ray of the tooth when they go into the office.

If he had a tiny chip on the edge of the tooth, and the x-ray looked fine, the dentist would probably smooth the edge so it isn’t jagged. 

If it was a larger chip it could be or become sensitive to cold air and water because of the exposed nerve. In this case the tooth might require more extensive treatment. 

The biggest concern is if a tooth is knocked out of the mouth or if it is knocked out of position.  In this case, time is of the essence.  You must get to the dentist or hospital within 90 minutes.  If the tooth has been fully knocked out of the mouth, placing it in a cup of Hank’s Balanced Salt Solution or milk will help maintain the tooth until a dentist can be seen.  When touching the tooth, try to hold the tooth by the crown (the part we see when a person smiles) instead of the root (the part that is inside the gum tissue).  

In Joey’s case it was a good sized chip and it was a little wiggly. Even though it is loose now, it can still repair itself and become tight again over time. It might become discolored as time passes depending on the trauma to the nerve inside. I believe Joey’s tooth will just need time to heal. The bone and tissue will tighten. His hygienist and dentist will closely examine it at every visit until it looks normal. 

Then it will just be a bad memory. 

Just keep in mind that the amount of blood you see after a fall is not an indicator to the amount of damage. The mouth bleeds very easily and it is very scary to the child and anyone observing, especially Mom. 

If after a fall, there are no serious cuts that would require immediate attention, apply a cold compress to reduce swelling and contact your child’s dentist. 

I hope you all enjoyed your Memorial Weekend! Did you do anything special? 

Sports Drinks and Teens

Sports Drinks and Teens

By Ashley Valco

It is a 95 degree, July, Sunday afternoon and your 13 year old has a big soccer game. She is sweating through her uniform and is very thirsty. Needing to replenish her electrolytes and quench her thirst the coach tosses her a Powerade and she guzzles it down. Good? Bad? Is there a potential problem? They are at every sporting event for your children. Almost everyone drinks them. Vitamin Water, Gatorade, Powerade, Propel...

While it still may be controversial, in this situation it might be acceptable. When someone is involved in a vigorous activity, in high temperatures, needing extra sodium and electrolytes may be necessary. However, with the amount of sugar and the acidic nature of these sports drinks, it could do more damage than good.  What’s more important, most children are consuming these sports drinks during little to no activity. 

These power drinks are either high in sugars, sodium, calories, or all of the above. None of which are good for you, let alone your teens. 

Here’s the deal:

Erosion of Teeth:

Just like the soda you try to keep your kids from drinking often, sports drinks have acid. The acid will destroy the enamel, the strong, outer surface of teeth that keeps teeth healthy. 

Dehydrates:

Already dehydrated from the activity, drinking a high sugar drink will delay hydration further. Not only that, but since you are lacking saliva in the mouth you are welcoming cavities. Our saliva has enzymes that help prevent tooth decay. When it is not present our mouths become an ideal place for bacteria to do their dirty work. Give them some sugar to gnaw on and thats their euphoria. 

Sugar, Sugar:

This can cause two problems. First, drinking something high in sugar may give you some energy but it is temporary. Just like that cup cake you eat at the office birthday party around noon, your energy will come crashing down around 3pm. Sports drinks have the same effect. 

What Electrolytes?

Yes, there are electrolytes in sports drinks. However, the amount of sugar found in them cancels out most of their benefits. 

Tons of Sodium:

It seems like majority of the country is looking for ways to cut sodium out of their diet. It is abundant in most packaged foods and drinks; and sports drinks are no stranger to it. Heart disease, high blood pressure, stroke... These are risk factors for high sodium diets, to name a few. As adults we are learning how to modify our nutrition so we can avoid these deadly issues. Yet, we do not generally consider the effects of seemingly innocent products on our children. 

So now you are thinking, “Are you kidding me? So what am I supposed to do?”

First, for those teens that are not involved in sports, change their drinking habits now and try to direct them towards better alternatives. 

Second, for those that are involved in sports, water will hydrate them during the game, which is most important. Give them a healthy meal with protien after to replenish everything else they need. These are two great habits to pick up. 

While discussing this weeks topic with Dr. Alex, she brought up an interesting tip that I never knew. I think it is such a great suggestion and want to share it with you guys. 

Dr. Alex says, “Drink unflavored coconut water instead of sports drinks. It has easily digestible carbs with electrolytes. It will give you energy without the crash!”

I checked out some of the nutrition facts and you better believe that will be my new go to drink when I am working out and playing sports. 

Less calories

Less sugar

More potassium

Less sodium

In the end, whatever you choose to hydrate with, it is important to keep healthy snacks on hand incase the water, or coconut water, isn’t enough! Bananas, almonds, or a protein bar. 

Tell me what you do to keep up the stamina yourself or for your kids during physical activity! What are your go to drinks and snacks?

Brushing: The Ultimate Battle

Brushing: The Ultimate Battle

By Ashley Valco

Most moms have been there... The before bedtime big brushing battle. Some kids may be very compliant while others are fighting like their lives depend on it. If that toothbrush touches their lips then the world just might end. And man, some kids can put up a serious fight! Trust me, I know. Many of these kids have sat fighting right in my chair while their parents say, “What am I supposed to do?!”

 You know you need to get their teeth clean but you need to pick your battles. Well, this is a battle worth fighting. Your child’s oral health will effect their overall health, their perspective of the dental office, your time, and your money. However, maybe we can find a way for it to NOT be a battle...

• Wipe the gums with a wet cloth after each feeding from birth. You never know when that first tooth will pop through and you want to keep the gums clean incase you miss it!
• The most important thing to do is make teeth-brushing a normal routine in their day when that first tooth appears.
• Make it fun the same way you would with baby spoons during dinner. 
• Some moms have said that brushing after the bath makes it easier because they are wrapped up in their towel still, restraining all limbs. 
• Sit baby on your lap, facing and straddling you while wrapping one arm around him and gently hold his chin, use your other hand to brush. He is much easier to work with. Especially when I make train sounds while doing it! Since the front of his body is facing you he isn’t able to move as much. 
• You could use a two person “knee to knee” technique we use in the office. One parent sits on the chair (I have used my rocking chair in my sons nursery) with your child straddling you. Lay them back with their head placed in the other parents lap. Then you have easier access to brush from above. 
• Most kids like to imitate. Brushing your own teeth in front of them regularly may help. Or let your child brush your teeth first and then brush theirs. Sometimes I let my patients do this to me and they crack up. 
• Create the idea that toothbrushes are fun. Let the tooth brush be a toy, and let them brush teddy’s teeth. 
• We recommend waiting until a child can write in cursive to brush on their own. Thats when they can demonstrate the dexterity to move the toothbrush properly. 
• Give them a visual timer, something to be interested in while brushing. Many times they are just bored. In my office we give out colorful sand timers (2 minutes) some kids really love watching all the sand pour through and will brush the entire time. 
• Bringing music into the bathroom will make it more fun and you could even turn it into a game. 
• Put together a chart to track their progress with a goal or prize (suited to their age) when they are consistent. 
• Education. Show them pictures of what happens when they don’t brush. ie: gum disease, cavities. 
• Go to the experts. At your child’s next dental visit (which needs to be scheduled every 6 months) mention to the hygienist or dentist that you are struggling at home. It might be a good idea to mention it out of ear shot of your child. If they hear you telling us to tell them, the tend to think we are just trying to help you- not them.  

There are a million different ways to get the job done, just like everything else you do as a parent. There isn’t a right way. What have you experienced? Do you have any tricks or struggles you can share?

Age One Dental Visit

By Ashley Valco

I am a new mom to a beautiful 10 month old baby boy. He is happy and healthy and very curious. Around 6 months of age the happy disappeared for a bit while we experienced the dreaded sleepless nights and unconsolable screaming that came along with some teeth. His bottom two teeth came through without a peep! In fact, I didn’t know he had them until he bit me! 

So, at this point, you may be thinking this is about teething. I will address that at some point in the future, but, not today... 

When my sons top two teeth came busting through with a vengeance, the first thing I noticed was the small yellow spot in the center of each one. I couldn’t believe it. Could he be missing the enamel from his teeth? I patiently waited until they were fully showing to determine what to do next. 

So, today, we will be talking about the importance of getting your little one to the dentist at age one, or within 6 months of the appearance of their first tooth.  

“What?”

“Age one?!” 

“But everyone else said age 3.... Even my pediatrician.” 

“What could you possibly do during a visit with a 12 month old??”

First and foremost, just like everything you have heard from the day you found out you were pregnant, each baby is an individual and should be treated as such.

My son, as an individual, needs a bit more diligence when it comes to keeping his teeth plaque free and watching his nutrition. If I wasn’t a dental hygienist I wouldn’t know that. I actually wouldn’t know until I brought him to his first dental exam. And if I had listened to my pediatrician, that would have been at age 3. But, by then he could have had two large cavities. What a terrible way to start off the dental experience. 

Supporters of the age one dental exam:

• AAP (American Academy of Pediatrics)
• ADA (American Dental Association)
• AAPD (American Academy of Pediatric Dentistry)
• ADHA (American Dental Hygiene Association)

Why you should bring your little one to the dentist by age one:

• Assessment of the needs and treatment that are specific to your child. 
• Cavities are preventable. 
• Baby teeth are important and are present until age 12. 
• The health of baby teeth can effect the health of adult teeth. 
• Cavities in baby teeth can lead to problems including growth, development, and self-esteem.
• Decrease in health care costs. 

What you should expect during this visit:

• Discussion about oral health care and nutrition that can effect overall health and dental health.
• Current habits like thumb sucking or pacifier. 
• Discussion about tooth development and if your specific child needs fluoride. 
• An exam.
• Fluoride treatment
• A cleaning if it is possible.
• Answering all of your questions and concerns. 

I know that was a lot to take in, but the bottom line is to not wait to get your little one into the dentist. We prefer to prevent cavities rather than treat them. And I am sure you, your child, and your wallet would prefer that too! 

Questions? Let me know!  You can comment in the comment section below!  Come back next week to discuss brushing problems & tips for all ages!!