They re Just Baby Teeth, What s the Big Deal? Dr. Heidi Ostby, DDS

Transcription

1 They re Jst Baby Teeth, What s the Big Deal? Dr. Heidi Ostby, DDS

2 They re Jst Baby Teeth, What s the Big Deal? DR. HEIDI OSTBY, DDS JUST KIDS PEDIATRIC DENTAL CENTER

3 Meet the doc Born in Arlington Hts, IL and raised in Kildeer, IL B.S. in Biology and 4 year scholar-athlete at East Carolina University in Greenville, NC D.D.S. from the University of Iowa Met hsband Dr. Jesse Ostby, dentist here in Anchorage Pediatric Dental Residency at ANMC in Anchorage, AK Private practice at Jst Kids since 2013 (became the new owner in 2016) AK Mission of Mercy Pediatric Dental lead 2013 and 2015 OH2020 Grassroots rep for AK Two (and a half) kids and two dogs Samantha (4 in October), Griffin (2 in November), Baby #3 de December 7 Sasha & Loie (Rhodesian Ridgebacks)

4 Pediatric dental offices for reference Jst Kids Pediatric Dental Center: 700 Mldoon Rd, Dr. Ostby & Dr. Roalofs Arora Children s Dentistry: 3340 Providence Dr #552, Dr. Barnes Denali Pediatric Dentistry: 2600 Denali St Ste 500, Dr. Foster & Dr. Rabatin Kids Dental Tree: 1310 E Dimond Blvd, Dr. Keller & Dr. Etter Anchorage Pediatric Dentistry: 4200 Lake Otis Pkwy #2, Dr. Warnick, Dr. Darby & Dr. Jen Pediatric Dental Associates: 330 E Tdor Rd, Dr. Slezewski & Dr. Walsh Kidsmile: 625 E 34th Ave #302, Dr. English *I have created a flyer with this list, as well as listed them all on my office website for yor convenience

5 Why is a dentist speaking? I am a private pediatric dentist withot any pblished research or articles I am not an expert in edcation, pblic speaking, or pblic health, nor am I claiming to be the absolte expert in pediatric dentistry However I am in the trenches every day and see the damaging effects of lack of edcation and lack of early intervention on the most vlnerable poplation or children! I have become passionate abot spreading the word to anyone and everyone who will listen to me in order to help these at risk babies and cavities don t discriminate, everyone is ssceptible I ve made it my job to tackle this disease on the front line, before babies are even born in hopes that one day every child will be cavity free I m trying to MAKE AMERICA GREAT AGAIN!!!

6 Day One The most precios, perfect baby!

7 Day Nine Hndred One Where did things go wrong??

8 10 ot of 20 teeth were nonrestorable and were removed

9 Was that a rare case? Unfortnately cases like this are a normal occrrence in my office (and every pediatric dental office in AK) every day On average my office sees 40 children/month for fll moth dental rehab nder general anesthesia along with the other pediatric dentists that s roghly 300 kids per month! Childhood caries (cavities) is one of the most prevalent chronic diseases of childhood and it is preventable Rare cases like amelogenesis imperfecta or dentinogenesis imperfecta are genetic and the dental complications cannot be avoided however the majority of people who claim to have weak teeth actally have perfectly adeqate teeth that have cavities de to poor dietary and hygiene habits Many moms say the teeth came in like this when in reality they never really looked closely in the moth becase they weren t brshing, and didn t realize the teeth were getting cavities ntil it was grossly obvios

10 ECC is devastating How can we stop it?? TEAMWORK!!!!

11 Early Edcation and Prevention The first prenatal exam typically occrs arond the 8 th -10 th gestational week (baby teeth have already begn to form) The first pediatrician check-p is typically dring ronds at the hospital on day 1 or day 2 babies have several check-ps within the first year Unfortnately, the first visit to the pediatric dentist often happens too late and the child already has several cavities General dentists often won t see kids for a thorogh exam with x- rays ntil they are 5 years old! I know firsthand my hsband is a dentist! We re looking to yo for help!

12 How Can Yo Help??? Medical commnity is already aware of the importance of oral health on overall health Specifics are often misnderstood that s where I come in to help edcate YOU to properly edcate yor patients Myth1: Cavities are genetic Myth 2: Pregnancy rots yor teeth Midwives, OB/GYNs and pediatricians can begin implementing prenatal oral health screenings and edcation: Myth 3: It s not safe to have dental treatment or x-rays while pregnant Myth 4: Breast milk doesn t case cavities Myth 5: Baby teeth will fall ot so they don t need to be brshed or fixed Provide prenatal referrals to general dentists for mom, and provide referrals to pediatric dentists for the pcoming baby Pediatricians can discss dietary risk factors for ECC dring 1 st year of life, discss brshing teeth ASAP, apply floride varnish, and refer to pediatric dentist by 1 st birthday

13 Prenatal Care As we all know, mother s health is directly related to baby s health. The foods and drinks she consmes, the chemicals she s exposed to, and her overall health affect the developing fets, inclding facial strctres and teeth Drgs and alcohol can case cleft lip/palate Drgs, illness/fevers can case hypoplastic teeth Moms are the nmber one sorce of caries inoclation, spreading bacteria that case cavities to baby (s. mtans) Moms shold establish a dental home for herself if she doesn t already have one, and find a pediatric dentist prior to delivery Mom s ntreated cavities almost doble the risk of their child having severe cavities

14 Prenatal tips Consme dark leafy greens, frits & vegetables, and floridated water for optimal mineralization of developing permanent teeth Avoid alcohol for overall health of the baby, bt also to minimize risk for developmental anomalies like cleft lip/palate Minimize freqent consmption of refined carbohydrates, which pts mom at risk of cavities Rinse moth with water (may also add ½ tsp baking soda) if experiencing hyperemesis with morning sickness Wait 20 min before brshing after emesis Maintain good oral health by brshing 2x day with floride toothpaste and flossing, especially since pregnancy hormones can increase ssceptibility to gingivitis (~60-75% women report pregnancy gingivitis) Pregnancy eplis/ pyogenic granloma Periodontal disease has been associated with preterm birth

15 Prenatal Tips contined Contine rotine dental care inclding x-rays and floride treatment, and treat dental decay prior to delivery to prevent the spread of carios bacteria Local anesthetic is safe dring pregnancy Establish a pediatric dental home similar to choosing a pediatrician pediatric dentists are helpfl for newborn anomalies (congenital eplis, natal teeth, latch isses), and diet/hygiene edcation to prevent early childhood caries Health isses and complications dring pregnancy can alter the mineralization and calcification of the developing baby teeth- if mom takes antibiotics, abses drgs/alcohol, or has bacterial/viral infections with associated fevers the teeth may not form with adeqate mineral Hypomineralized teeth are more prone to cavities

16 Lip Closre 5 th -6 th Week The first two months of embryonic growth are integral to the early formation of many facial strctres inclding the jaws, nose, eyes, ears, and moth.

17 Tooth Development 6 th week A child's first set of 20 teeth are called the primary, or baby teeth. Dental development of the primary teeth begins arond the 6th week of pregnancy.

18 Palate closre 7 th -11 th weeks The closre of the embryonic palate occrs rapidly starting at the 7th week of development. This fsion completes at approximately the 11th week in tero. Improper closre of the palate cases cleft palate. Cleft lip or palate occrs in approximately 1 ot of 700 live births with variation among different ethnic grops.

19 Primary tooth formation and calcification Baby teeth will contine to form and calcify throghot the pregnancy and even after the child is born. Dring this time, the crowns and roots of the primary teeth will begin to take shape, and by 32 weeks, the enamel crowns of the primary teeth are flly formed. Proper ntrition, inclding a diet rich in Vitamin D, calcim, and floride will help spport proper tooth development.

20 Postpartm Care Encorage moms to have a pediatric dentist lined p before delivery in case there are any dental isses Gingival cyst of the newborn Congenital Eplis Natal/neonatal teeth & Riga Fide Erption cyst Tonge tie (lip tie?) Edcate mothers abot oral hygiene practices before teeth erpt so that baby is sed to oral maniplation Edcate moms abot nrsing/bottle feeding throgh the night once teeth erpt

21 Gingival Cyst of the Newborn Keratin nodles, derived from remnants of the dental lamina Solitary or mltiple nodles on the edentlos newborn ridges Self-limiting, shed on their own, no treatment necessary Similar to Epstein s Pearls or Bohn s Nodles (EP on the palate, BN on the ridges)

22 Natal/Neonatal teeth Natal teeth are present at birth Neonatal teeth erpt within the first month of life These are the primary incisors, not extra teeth Might case feeding isses Can be smoothed if sharp to alleviate pain for mom Nipple shield can help Sometimes they are very mobile and need to be extracted to prevent aspiration (sally done knee-knee withot nmbing)

23 Lip/Tonge tied?!? Some providers in town are becoming frenectomy happy Please stress eval by a PEDIATRIC DENTIST or pediatrician prior to frenectomy Latch isses that are trly dentally related are de to a tight lingal frenm...extremely rare to be de to labial frenm (class 4, <1%) Lingal frenectomy sally indicated within first few weeks of life and the feeding almost immediately improves if a parent tells yo their toddler is lip-tied and needs it snipped PLEASE refer them for second opinion Labial frenectomies can actally worsen a diastema/gap between front teeth if done too early (scar tisse)

24 Early childhood caries (ECC) White spot lesions are the first sign of decay, and can qickly become frank cavitations When caght early (especially with dental visits by age 1) the need for treatment can be prevented SECC sally reqires oral sedations or general anesthesia Very closely associated with lack of proper hygiene and bottle/sippy cp habits at night and dring the day *diet discssed later On demand nrsing/bottle strongly associated with ECC, shold be stopped when teeth erpt

25 Case: 5 yr old female Had been seeing general dentist since age 3 GD visalized cavity pper left at age 4.5 and GD placed filling withot taking x-rays to verify presence/absence of other caries Took first set of x-rays at age 5.5, mom came to s for 2nd opinion becase there were 6 more cavities ended p needing GA. Parents were devastated becase she had always had great dental checks GA might ve been prevented with pediatric dentist at age 1 and earlier X-rays

26 The F word and S word

27 FLUORIDE According to the CDC, water floridation is one of the top 10 leading pblic health benefits of the 20th centry! Topical floride (daily toothpaste and professional applications) helps to remineralize yor erpted teeth Systemic floride (water, food, Rx) helps the developing, nerpted teeth Similar to parental resistance to immnizations, many parents resist Floride despite its safety and benefits The strggle is real

28 Floride Floride Toothpaste: Begin sing floride toothpaste when the first tooth erpts (as yong as 6 months old!) to matre the newly erpted enamel and begin the remineralization process Smear/ grain of rice size Professional Floride: Rotine applications give demineralized areas a boost and also help newly erpting teeth matre with floroapetite 20x stronger than OTC toothpaste Silver Diamine Floride: Great way to delay or even avoid treatment (antibacterial), especially very yong or limited access (villages) Floride spplements: De to the halo effect floride spplementation has become less common Halo effect is the sm of all F exposre even if yor home doesn t have floridated water (frits/veggies, infant formla, school water, etc)

29 Sgar...not so sweet after all The medical commnity is already very aware of the effects sgar has on overall health and development High sgar diet dring pregnancy increases the risk for gestational diabetes, increased pregnancy weight gain, pre-eclampsia, pre-term delivery High sgar diet increases the risk of type 2 diabetes, childhood obesity, poor attention, and dental caries Sgar is sgar, no matter what kind...so when considering diet recommendations it is important to accont for all sgar exposres Processed, refined sgars are worse than natral sgars Sgar hides in nlikely sorces (chips, crackers, milk) Breast milk ~17g sgar, Cow s milk ~15g sgar per serv *I have postcards and brochres available for qick diet recommendations

30 Where do we go from here? Now that yo are armed with information abot the importance of prenatal and early infant oral health, floride, and dietary risks, what are YOU going to do??? Jmp in and get yor feet wet!

31 Baby Steps Begin planting the seeds abot the importance of oral health at prenatal visits *I have brochres and board certified pediatric dentist provider lists that can be part of new-mommy goody bags Make sre mom starts/contines her dental care Encorage infant dental exams at/before age 1 Edcated mothers with appropriate providers can avoid nnecessary treatment (lip/tonge tie srgery) and can totally prevent early childhood caries

32 Prevention is Key to be Cavity FREE!

33 Qestions? Comments?

34 THANK YOU!!!