Monthly Archives: March 2010

Oral Health – Kids and Cavities

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Posted by admin on March 30, 2010 – 7:37 pm
Filed under Pediatrics

Tooth decay, also known as early childhood caries, is the most common chronic children’s disease in the country and the number one dental problem among preschoolers. The Centers for Disease Control and Prevention (CDC) has stated that dental caries is five times more common than asthma and seven times more common than hay fever in children. The good news is that tooth decay is a disease that is mostly preventable. Good tooth care can keep cavities from happening in your child

Tooth decay starts to develop when a child’s teeth and gums are exposed to any liquids or foods for long periods of time. Cavities are holes in teeth that are formed when certain bad bacteria in your mouth use the sugar in food to make acid. This acid eats away at the enamel covering of the teeth and causes holes.  The more sugar on your child’s teeth, the more bad bacteria, the more acid, the more cavities.

Your child might be at risk for cavities if he or she eats a lot of sugary foods (such as raisins, cookies and candy) and drinks a lot of sweet liquids (such as fruit juice and punch, soda and sweetened drinks).  Your baby or young child is especially at risk for cavities if they go to bed with a bottle or if they carry a bottle or sippy-cup of juice or milk around during the day.  Your child also might be at risk if he or she was born early or very small, has special health care needs, has white or brown spots on their teeth, has a primary caregiver who has a history of many cavities or “soft teeth”, or do not go to the dentist very often.

An ounce of prevention is worth a lifetime of smiles.

Fluoride is an important part of your child’s dental health.  Fluoride is a naturally occurring mineral that is often added to the tap water. Fluoride helps make teeth strong by hardening the tooth enamel and preventing tooth decay. If you live in an area where the tap water doesn’t contain fluoride, or your family uses well water, or you drink un-fluoridated bottled water, your health care provider may prescribe daily fluoride supplements.  Only give as much as the directions say to use, because too much fluoride can cause spots on your child’s teeth.

Prevent Tooth Decay:

Feed your child healthy food. Healthy eating habits lead to healthy teeth.  Choose drinks and foods that do not have a lot of sugar in them. Sweets (candy or cookies), starchy foods (crackers) and sticky foods (fruit roll-ups, fruit-snacks or raisins) stay in the mouth longer, so they can easily cause tooth decay. If your child wants a snack between meals, give your child fresh fruits and vegetables instead of candy and cookies.  Be careful with dried fruits, such as raisins, since they easily stick to the grooves of the teeth and can cause cavities if not thoroughly brushed off the teeth.

Baby-bottle tooth decay:

Babies who go to bed with a bottle of milk, formula or juice are more likely to get tooth decay. Teeth can decay quickly because the sugar in formula, milk or juice stays in contact with the teeth for a long time during the night.  Because dental caries is a complex disease, the current preferred term for baby-bottle tooth decay is Early Childhood Caries.

Tips to avoid Early Childhood Caries:

Never put your child to bed with a bottle or food. Not only does this expose your child’s teeth to sugars, it can also put your child at risk for ear infections and choking.  If you do put your child to bed with a bottle, only fill their bottle with plain water, not milk or juice.  Again, this is not recommended.

Stop nursing when your child is asleep or has stopped sucking on the bottle.

Do not to let your child to use a bottle of milk or juice as a pacifier.

Start to teach your child to drink from a sippy-cup at about 6 months of age. Plan to stop using a bottle by 12 to 14 months at the latest.

A teeth owner’s guide

Check and Clean Your Baby’s Teeth:

Healthy teeth should be all one color. If you see spots or stains on the teeth, take your baby to your dentist.  Baby teeth are important.  As soon as a baby’s first teeth appear—usually by age six months or so—the child is susceptible to decay. It’s important to care for your child’s baby teeth because they act as “placeholders” for adult teeth. If baby teeth are lost too early, the teeth that are left may move and not leave any room for the adult teeth to come in. Children with dental caries in their baby teeth are at much greater risk for cavities in their adult teeth.  Tooth decay in baby teeth can be painful and cause health problems like infections, which can at times be life threatening. It can also lead to teasing and speech development problems. 

Establish good oral health habits early:

Start children with good dental habits before the first tooth appears.  After feedings, gently brush your baby’s gums using water on a baby toothbrush that has soft bristles. Or wipe them with a clean washcloth.

Brush ‘em if you got ’em:

Clean your child’s teeth as soon as they come in, using a clean, soft cloth or by gently brushing the gums and teeth with water and a soft infant toothbrush. Clean the teeth at least twice a day. It’s best to clean them right after breakfast and before bedtime. Once your baby has 8 teeth, you can start using a child-sized toothbrush for daily cleanings.  At about age 2, most of your child’s teeth will be in. Once your child can spit and not swallow the toothpaste, begin using fluoride toothpaste. Use a pea-sized amount of toothpaste and push it into the bristles of the toothbrush with your finger before brushing your child’s teeth.  This will limit the amount she can accidentally swallow. As your child gets older let her use her own toothbrush. It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish. Be sure that you spread the toothpaste into the bristles of the brush and use only a pea-sized amount of toothpaste.  Flossing is also a good habit to get your child into.

Cavities are unfortunately common in children.  Learn good habits that you can do prevent problems in your child.  Don’t use a bottle to put your child to bed.

It’s okay to let your child drink water, but set limits on when your child can have other kinds of drinks.  Look at your child’s teeth for discoloration so you can find cavities early.  Find a dentist when your child turns one. This gives the dentist a chance to look for early tooth problems and to talk to you about how to care for your baby’s teeth. It also helps your child feel okay in the dentist’s office. 

Be a good role model – eat healthy foods – including snacks, don’t drink sugary drinks, brush at least twice a day, floss, and go to the dentist twice a year. 

Sources

American Academy of Pediatrics; First Steps to a Healthy Smile (Copyright © 2008)
American Academy of Pediatrics; HealthyChildren.org; Healthy Children Magazine, Winter 2007
American Dental Association: www.ada.org/public/topics/decay_childhood.asp
American Family Physician; Taking Care of Your Child’s Teeth, www.familydoctor.org
National Maternal and Child Oral Health Resource Center; Facts on Early
Childhood Caries (ECC) (2nd ed.)© 2004 by the Center,Georgetown University. www.mchoralhealth.org

Spring/ Summer Safety Tips

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Posted by admin on March 11, 2010 – 7:53 pm
Filed under Pediatrics

As the weather begins to warm, the kids want to get outside to play.  Here are a few tips on how to keep your children safe during the spring and summer. 

Sun and Fun

As the sun begins to shine and we increase the activity outside, remember your sunscreen.  Rule number 1- Do not use expired sunscreen.  If you are unable to find an expiration date on last years sunscreen, throw it away and buy new. 

For babies under 6 months, it is best to avoid sun exposure, and dress infants in lightweight long pants and long sleeved shirts, and a brimmed hat.  When unable to prevent exposure, a minimal amount of sunscreen with at least SPF 15 may be applied to small areas such as the face and hands. 

For children greater than 6 months old, apply sunscreen with at least 15 SPF and protects against UVA and UVB rays.  Apply sunscreen at least 30 minutes before going outside and use sunscreen even on cloudy days.

For all children.  Reapply sunscreen every 2 hours, or after swimming or sweating.  Be sure to apply enough sunscreen- about 1 oz per sitting for a young adult.  Be cautious of reflective surfaces such as water, snow, and sand as they reflect UV rays and may result in sunburn more quickly.  It is best to remain in the shade whenever possible, and limit sun exposure during peak times- between 10 am and 4 pm.  Sunglasses that block 99-100% of ultraviolet rays are important.  Clothes should be light weight and breathable such as cotton clothes. 

Heat Stress

Activity and exercise is important for all children.  Within that, a few things can be done to reduce the stress of the heat.  High intensity activity lasting more than 15 minutes should be limited during high heat and humid times.  At the beginning of strenuous exercise, the intensity and duration of exercise should be limited initially and gradually increased during a period of 10-14 days to accomplish acclimatization to the heat.  Hydration is very important.  During activity, periodic drinking is important.  For children about 90 lbs, 5 oz every 20 minutes is encouraged, adolescents about 130 lbs, 9 oz every 20 minutes even if they are not thirsty.  Clothing should be light-colored and lightweight and limited to one layer of absorbent material.  Sweat saturated shirts should be replaced by dry clothes. 

Bug Off

As the weather improves, the bugs begin to hatch.  To avoid bugs, avoid scented soaps, perfume, and hair sprays.  Combination sunscreen/ insect repellent products should be avoided because sunscreen needs to be reapplied every 2 hours, but the insect repellent should not be reapplied.  Children under 2 months old should not use products containing DEET.  Children over 2 months old should use 30% DEET.   The concentration of DEET can range from 10% to over 30%.  Ten percent DEET only protects for about 30 minutes, which is inadequate for most outings.  Children should wash off repellents when back indoors.  Avoid areas where insects nest and congregate (stagnant pools of water, uncovered foods, and gardens where flowers bloom).  Avoid clothes with bright colors and flowery prints. 

Outdoor Play

As the weather warms up, getting your children outside and active is very important.  It is also important to keep your children safe at play.

Bike Safety

Your child should wear a helmet on every bike ride, no matter how short or how close to home.  Many accidents happen in driveway, on sidewalks, and on bike paths, not just streets.  Children learn by observing you.  Whenever you ride, put on your helmet too.  It is important even for infants in bike carriers to have helmets.  When buying a helmet, look for a label or sticker that says the helmet has met CPSP safety standard.  A helmet must be worn properly in order to be effective.  It should be level on the head, not tipped forwards or backwards.  The strap should be securely fastened, and you should not be able to move the helmet in any direction.  If needed, the helmet’s sizing pads can help improve the fit.  Borgess Trauma Services offers helmets at cost for all sizes for $8.00.  Ski helmets are also available.  Please call 269-226-6917 for more information or contact Jodie Vining at 269-226-5981.

Skateboards, scooters, in-line skates, and Heely’s

They should never be used in or near traffic.  Helmets and other protective gear us as knee, wrist, and elbow guards are very important.  Skateboard parks are more likely to be monitored for safety then ramps and jumps constructed at home. 

Pool Safety

Never leave a child alone in or near a pool, even for a moment.  Whenever infants and toddlers are near water, an adult should be within arm’s length, providing “touch supervision.”  Keep rescue equipment (a shepard’s hook- a long pole with a hook on the end- and life preserver) and a telephone near the pool.  Choose a shepard’s hook and other rescue equipment made of fiberglass or other material that do not conduct electricity.  All pools should have fences with a minimum of 4 feet high fence on all four sides.  Gates should open out from the pool with self close and self latch at a height children can’t reach.  Children may not be developmentally ready for swim lessons until after 4 years old.  Swim programs for children under 4 should not be seen as a way to decrease the risk of drowning. 

Open Water Swimming

Never allow children to swim alone.  Even good swimmers need buddies.  Young children should be closely supervised with “touch supervision,” keeping no more than an arm’s length away.  Make sure children know never to dive into water except when permitted by an adult who knows the depth of the water and who has checked the underwater depth.  Never let your children swim in canals or any fast moving water.  A lifeguard (or another adult who knows about water safety) needs to be watching children whenever they are in or near water.  Ocean swimming should only be allowed when a lifeguard is on duty. 

Boat Safety

Children should wear life jackets at all times when on boats.  The life jacket should be the appropriate size and fit, not loose.  All straps should be belted.  Adults should wear life jackets for their protection and to set a good example.  Adolescents and adults should be warned against boating when under the influence of alcohol, drugs, and some medications. 

RESOURCES

Colorectal cancer awareness: Kalamazoo area residents, risk factors and early detection

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Posted by admin on March 9, 2010 – 6:02 pm
Filed under Colorectal Cancer

March is National Colorectal Cancer Awareness Month.  Awareness is necessary to dealing with the challenge of colorectal cancer, and the first thing we should be aware of is our individual risk.

Risk factors for colorectal cancer include:  increasing age (older than age 50); a personal history of colorectal cancer; chronic inflammatory bowel disease; a family history of colorectal cancer, adenomatous polyposis or nonpolyposis colon cancer; a diet mostly from animal sources; a physically inactive lifestyle; obesity; smoking; and heavy use of alcohol. Descendents of Jews from Eastern Europe may also be at greater risk of developing colorectal cancer.

These are risks that should be known by the individual.  Another major risk factor is colorectal polyps, and these can only be detected by a colonoscopy.

Early detection is key to treating colorectal cancer.  Unfortunately, the greater Kalamazoo area has been identified as having a significantly lower rate of early detection than the nation as a whole.

I recommend patients in the Kalamazoo area with average risk factors to have their first screening at age 50. If you have a family history of colon cancer or other risk factors, you may want to begin screening at any earlier age; please consult with your physician.  If a patient’s colon screening reveals no polyps, nor any other issues, then every 10 years thereafter is appropriate for routine screening.  If polyps or other issues are identified, the screening physician may recommend repeat screening every 3 or 5 years based on individual findings.

To help increase the rate of early detection for Kalamazoo area residents, Borgess has made screening easy, offering free colorectal screening kits to persons with significant risk factors throughout March.  This screening test is simple and easy to use.    

For the sake of yourself and your loved ones, I urge you use go directly to the screening kit site or call 1-800.828.8135 or 269.226.8135 today.

Brij Dewan, MD
Kalamazoo Gastroenterology & Hepatology, PC

National Colorectal Cancer Awareness Month at Borgess – Free Help for Kalamazoo Area Residents

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Posted by admin on March 2, 2010 – 6:54 pm
Filed under Colorectal Cancer

If you are one of millions of Americans who should be checked for colorectal cancer, this is a special time of year. 

March has been designated National Colorectal Cancer Awareness Month, for some very good reasons.  Based on statistics from previous years, colon and rectal cancer may cause more than 50,000 deaths in 2010.  Unfortunately, some of these deaths are likely to occur in the Kalamazoo area.

The good news is that the colorectal cancer death rate has been declining for the past 15 years.  This is due to many factors, including increased colorectal screening.  Screening and colonoscopy help identify polyps so that they can be removed before they turn into cancer. 

When colorectal cancer is treated early, it is easier to cure.  Regrettably, all too often the disease still goes undetected because people are afraid and uncomfortable about the screening process, so they do not get tested. The greater Kalamazoo area has been identified as having a significantly lower rate of early detection when compared with national rates.

Fortunately, Borgess makes it easy to be tested.  Free colorectal cancer-screening kits are available from Borgess for area residents who have significant colorectal cancer risk factors.  The test used by Borgess is simple and easy to use. 

As a surgeon who has seen many persons who have been diagnosed early and cured, and others who have been diagnosed too late, I hope you and your loved ones taken advantage of this opportunity if you are at significant risk for colorectal cancer.  Visit colorectal.borgess.com or call 1-800.828.8135 or 269.226.8135 for more information about colorectal screening kits from Borgess for Kalamazoo area residents.

Thank you. 

Brij Dewan, MD
Kalamazoo Gastroenterology & Hepatology, PC