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Questions for a pediatric dentist

April
13

We have so many smart and talented parents here in the Lower Hudson Valley whom it has been my privilege to meet, either through this blog or in my job as a reporter. So, today I am introducing a new feature on Parents’ Place: A question-and-answer session with an interesting local mom or dad. I decided to call the feature Questions & Parents, or Q&P for short.

qp.jpgOur first Q&P is with Dr. Leyla Z. Nakisbendi, a pediatric dentist who practices at Mayers & Nakisbendi Dental Associates on Mamaroneck Avenue in White Plains. She’s also been a wonderful participant in the Parents’ Place blog. She lives in Pleasantville with her husband, Michael Mayers, also a dentist, and her three children, 9-year-old Aliya, 6-year-old Aydin and 3-year-old Maia.

Q: At what age should children have their first dental visit?

leyla2.jpgP: I like children to have their first dental visit as soon as they start getting their first eight teeth (four on top and four on bottom). We don’t expect the baby to sit in the dental chair, but we like to check for hygiene, dietary habits, well-formed enamel and any developmental anomalies. This screening theoretically is done by pediatricians, but we like children to have a dental home by 1 year old. The exam is usually done on a parent’s lap and usually doesn’t involve a cleaning unless the child has staining from antibiotics or tartar that needs to be removed.

Q: How should you choose a dentist for your child? What questions should you ask? Should you visit the office first alone?

P: Being a pediatric dentist, of course I think children should see a pediatric dentist who has received two to three years of extra training in treating children, either at a children’s hospital or dental school. That said, there are a lot of general dentists who are very adept at treating children. A pediatric dentist should be chosen based on location, comfort level with the practice and referrals from pediatricians and friends. Ask around. I see all new patients. This does not always happen in all dental offices. I like to meet the families and get a sense of their needs and I feel I can only do this by seeing patients myself first. Right now, my husband and I do everything ourselves so our patients always see us. I think if you trust the people referring you, you don’t have to visit an office alone first, but that is always an option. It all depends on your schedule. I do not recommend choosing practices based on insurance. While it may save money, being part of a dental plan doesn’t necessarily mean it is the right practice for you. This is not an area I skimp on.

Q: How often do children need to brush their teeth? Is it the same as adults or more/less often?

P: Children should be brushed two times a day, as should adults. After breakfast and before bed. If children swallow toothpaste, they should get a training toothpaste with no fluoride. If they are good at spitting, they can use real toothpaste. Flossing is required if the teeth are touching. If you can see spaces, you don’t need to floss.

Q: At what age is a child old enough to brush his or her own teeth? Use adult toothpaste?

P: Age 7 or 8 is when children should be able to brush their teeth alone, but this all depends on your child’s manual dexterity and attention span. I’ve seen 2- and 3-year-olds who really can do a good job brushing their teeth!

Q: What age do you start seeing cavities?

P: I’ve seen cavities in children who have only two to four teeth! Children who nurse on demand all day or night or have a bottle with milk or juice at night are at very high risk for decay. Children whose parents or primary caregivers are still actively getting new cavities are also at increased risk for cavities.

Q: Is there any special advice you have for teenagers?

P: Teenagers are tough! It’s hard to get them to shower let alone brush their teeth. Access to junk is much easier. I think kids who were raised with good oral health habits and dietary habits, for the most part, continue that way with minor detours. Soda is brutal — diet or sugared. They are very acidic and actually can etch teeth. Sports drinks for athletes are also a very high-sugar drink and the frequent sipping while rehydrating is high-risk for cavities.

Q: Are teeth-whiteners safe for teens?

P: Unless a child has severe cosmetic issues, we try to discourage bleaching until kids are in their late teens. Even then it can cause sensitivity because the teeth are very young. As we age the sensitivity decreases, usually. I’ll do isolated in-office bleaching for severe issues.

Q: What is the biggest mistake parents make with regard to their child’s dental health?

P: I think the biggest mistake people make with regard to taking care of their children’s teeth is assuming that because their child will not behave well at the dentist, that they aren’t going to go. We change our children’s dirty diapers with them screaming, we let the pediatrician check ears while screaming and we clip finger nails, etc. Parents need to let the pediatric dentist do their job even if the child cries. If the parents follow the pediatric dentist’s advice as to follow-up care almost every crier at the first visit turns into a great patient eventually. That is the goal of my pediatric dental practice — raising children so that they grow up to be great dental patients. It is not a perfect science and sometimes takes some trial and error but eventually all the kids gets there.

Q: What advice would you like to give parents reading this blog?

P: Teach your children that taking care of their teeth is not optional! Teeth get brushed and flossed every night and morning no matter what. Also, do not show your children that you have any dental phobias. They don’t understand and it just makes it harder for your pediatric dentist to work. Don’t use the word drill, needle, etc. Let your pediatric dentist do his/her job. I’m including a link to the American Academy of Pediatric Dentistry Web site, which is a great source of information.

Thanks very much to Leyla for being the first to do a Q&P! If you know any parents who you think would be great to feature, please comment here on the blog or send me an e-mail at jalterio@lohud.com.

Also: I’d love to know if you like this feature. Do you think it’s worthwhile? What kinds of questions would you like answered?

This entry was posted on Friday, April 13th, 2007 at 2:31 pm by Julie Moran Alterio.
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4 Responses to “Questions for a pediatric dentist”

  1. Caroline

    I have read that fluoride is harmful to children. Is this accurate?

  2. Alicia Pascale

    I took Nadia to the pediatric dentist at 18 months. She had nasty build up behind her bottom teeth. Our pediatrician recommended Dr. Gary Heitzler in Hastings on Hudson. I have to say that the experience while not thrilling was not as bad as I thought. He and his staff are absolutely great! Their training and demeanor with children is outstanding, but most of all how they deal with the parent, who surprisingly is worse than the child (at least in my case). Even though we still have a very hard time getting her to brush her teeth, I’m relieved that she gets this checkup and cleaning every six months. It’s worth it! In addition, my daughter’s pediatrician gave her sodium fluoride tablets because Croton on Hudson does not add fluoride to the town water. They started her out on peach flavor drops I think as early as 12 months and at 3 she continued on grape flavored tablets.

  3. Leyla Z. Nakisbendi

    Fluoride that is ingested in drinking water or supplements helps to make the developing adult teeth more resistant to cavities.

    Too much ingested fluoride can cause fluorosis which causes white spots and sometimes brown spots on the developing teeth. The goal is to balance how much fluoride is taken in.

    This means that a child who gets fluoride in her tap water shouldn’t be getting supplements too. If you live in an area with no fluoride and give your child supplements, but she goes to daycare in a fluoridated area where she has water, she shouldn’t be getting a supplement. If she swallows fluoridated toothpaste, she shouldn’t be getting supplements.

    If you live in a fluoridated area and your child swallows toothpaste too, they should be switched to a non-fluoridated toothpaste.

    If you only drink bottled water that has no fluoride, your child may need a supplement.

    I have worked in areas with no fluoridation and it is dramatic the differance in cavity rates between fluoridated and non-fluoridated areas even with supplements.

    Fluoride won’t win out over a horrible diet or bad habits but it has been a very strong warrior in helping many children and adults in battling tooth decay.

  4. tovorinok

    Hello

    Great book. I just want to say what a fantastic thing you are doing! Good luck!

    G’night

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About this blog
Parents’ Place is a hangout for openly discussing the A’s to Z’s of raising a child in the Lower Hudson Valley. From deciding when to stop using a binky to when to let your teenager take driving lessons, Parents’ Place is here to let us all vent, share, and most of all, learn from each other.
Leading the conversation are Julie Moran Alterio, a business reporter and mom of a toddler, Jorge Fitz-Gibbon, a reporter and single father with joint custody of a 9-year-old son, and Len Maniace, a reporter and father of two sons.


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About the authors
Julie Moran AlterioJulie Moran AlterioJulie Moran Alterio, her husband and baby girl — “Pumpkin” — share their Northern Westchester home with three iPods and more colorful plastic toys than seems necessary to entertain one tiny human. READ MORE
Jorge Fitz-GibbonJorge Fitz-GibbonJorge Fitz-Gibbon has been a journalist for more than 20 years and a father for nine. READ MORE
Jane LernerJane LernerJane Lerner covers health and hospitals for The Journal News in Rockland, where she lives with her husband and two children. READ MORE
Len Maniace.jpgLen ManiaceLen Maniace is a reporter and father of two sons. READ MORE



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