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A head-to-toe guide to your child

Author: Mary Keating

For:  Family Living Magazine

Date:  May/June 2007

1800 words (including sidebars)

Making a list and checking it twice is important when it comes to your children’s health. Unlike new cars, children do not come with the standard glove compartment manual detailing maintenance schedules, troubleshooting assistance and guidelines for maximum mileage.

Without such a manual, parents must take an active role in prevention and seek out what and when to schedule well-child visits. To help families, local doctors weigh in on the nationally recommended well-child checkups – the when and the why.

The Whole Child:

The American Academy of Pediatrics has specific recommendations for preventative pediatric health care.

“Many people underestimate health prevention and promotion,” said Andrew Smith, MD, Pocatello Children and Adolescent Clinic.

Children have different health care needs than adults, both medical and emotional. Pediatricians are specially trained to address the growth and development, illnesses, nutrition, immunizations, injuries and physical fitness needs specifically of children. Their main goal is to prevent and manage the range of health concerns of a child from birth through adolescence.

“During the first year, we normally like to see a child every two months,” Dr. Smith said. “Thereafter, we recommend well-child visits at 12, 15, 18 and 24 months. Between the ages of two and five, we like to see the child once a year and every one to two years after the age of 5.”

As a child grows, a pediatrician can help guide the child and the family in areas of nutrition, exercise, weight concerns and emotional issues.

A pediatrician can respond to a teen’s special needs and can offer advice and counseling on: puberty changes, growth and hygiene, emotional development, dating and sexual issues, acne, eating disorders, and coping with being happy with oneself and with others.

“We feel it is very important to do these annual visits,” Dr. Smith said. “If a child is seen on a regular basis, things don’t get overlooked. During sick visits, we are focused primarily on the illness. During well-child visits, we access the whole child including any emotional or social concerns and we look at all aspects of a child and their lives including behavior, social development and academic progress.”

One benefit of regular well-child visits is relationship building and understanding. Through regularly scheduled well-child visits, a child builds and establishes a relationship of trust with their doctor. This relationship is very important when a child needs to speak to a doctor about a specific issue or problem. Further, it helps a pediatrician in guiding a child as they grow and develop so that issues such as obesity, behavior problems, social problems, illnesses or emotional issues are identified early.

Teeth:

The American Dental Association recommends that a child visit the family dentist within six month of getting their first tooth. As a general rule of thumb, all children should be seen by a dentist by their first birthday. After which, a child should visit the dentist twice a year.

“If we are able to see a child when the teeth are coming in we can help prevent future problems,” said Jason Mauseth, DDS. “During the first visit, a dentist will talk with and distribute information to parents about how to properly care for their child’s teeth. The first visit, often called a happy-visit, doesn’t include x-rays or traditional cleaning, but focuses more on preventative education and includes a brief visual examination of the teeth and mouth.”

Early childhood is an optimum time to lay the foundation for a lifetime of good dental habits. Issues such as bottle decay, nutrition, fluoride and proper oral hygiene will be discussed.

“Starting at birth, parents should be cleansing their child’s gums with a soft infant toothbrush and water,” Dr. Mauseth said. “And, it is important for parents to know that a child’s brushing should be supervised until they develop the dexterity to properly handle the routine, which generally occurs between six and eight years of age.”

Tooth problems develop over time and poor oral hygiene, when left untreated for years, can lead to very serious consequences and in some cases, even death.

Both Dr. Robert McWhorter and Dr. Mauseth stress the rule of twos. It is simple. Brush twice a day for two minutes each time and visit the dentist twice a year.

“If people would stick to the basic rule of twos, 95 percent of individuals would be okay,” Dr. McWhorter said.

When it comes to brushing, two times a day is the minimum. And, the before bedtime brushing is critical.

“If the teeth are not cleaned before going to bed, bacteria sits on the teeth all night and can cause significant acid to form. This acid overtime can result in tooth decay and/or gum disease.”

Sometimes the rule of twos is easier said than done. Both dentists admit that parents often speak about being at odds with their children when it comes to brushing.

“We hear from parents all the time about how their child hates to brush their teeth,” Dr. McWhorter said. “One of the easiest ways to make it happen is to make brushing fun. Set a timer, make up games and be positive about brushing.”

Because, in the long run, parents serve as the single most influential factor in children’s oral hygiene.

“The biggest factor in compliance is parent’s attitudes,” Dr. Mauseth said. “Parents are role models and children often mimic or pick up on parental habits.”

Again, early childhood visits to a dentist opens a dialogue among parents, children and their dentists to promote a lifetime of healthy oral hygiene and foster a bright white smile.

Orthodontics:

The American Association of Orthodontist recommends that a child get an orthodontic check-up no later than the age of seven.

It is true, when most people think about braces, they think of teenagers. But, the basic philosophy governing orthodontic work is that problems are often easier to correct if found early. Uncovering a problem early does not necessarily mean putting braces on a seven year old. Rather, it gives orthodontists a chance to spot subtle problems with jaw growth and emerging teeth while the mouth is still growing and while the teeth are still emerging.

“For every patient who may require treatment, there is an ideal time to begin treatment to achieve optimal results,” said Eric Johnson, DDS, MD. “In this past week, we have place more patients in a guidance program than we have referred to treatment.”

Jeffrey McMinn, DDS and Dr. Johnson’s practice has established a guidance program they feel is a win-win for patients and parent’s pocketbooks.

“Our guidance program results are very evident,” Dr. Johnson said. “Patients who have been in the guidance program often have shorter treatment times and more successful outcomes. The patient wins and the treatment is often much kinder on the family’s pocketbook.”

In some cases, early treatment may prevent more serious problems from developing, and may make treatment at a later age shorter and less complicated. In some cases, the orthodontist will be able to achieve results that wouldn’t be possible once the face and the jaw have finishing growing. Early treatment can often guide jaw growth, lower the risk of trauma to protruded teeth, correct harmful oral habits, guide permanent teeth into a more favorable position and improve the ways lips meet.

“In many young patients whose permanent teeth are coming in crooked, it is often possible to borrow some space temporarily by removing baby teeth,” Dr. Johnson said. “This allows us to help guide the permanent teeth to grow into a more normal position.”

When permanent teeth are left to crowd their way into a crooked position, the treatment to straighten them is not only more difficult, but the results are more likely to return to their pretreatment crowded positions.

The following early warning signs may indicate that your child should have an orthodontics exam: early or late loss of teeth; difficulty in chewing or biting; mouth breathing; thumb sucking or other oral habits; crowding, misplaced or blocked-out teeth; jaws that shift or make sounds; speech difficulties; biting cheeks or tongue; protruding teeth; teeth that meet in an abnormal matter; facial imbalances such as lips that don’t close without strain; and lower jaw that protrudes or retrudes.

“It is not always easy for parents to tell when a child has an orthodontic problem,” Dr. McMinn said. “Even teeth that look straight may be hiding a problem.”

As with routine well-child visits to the pediatrician and routine dental care, early orthodontic appointments are an important step to early detection and optimal treatment.

Eyes:

The American Optometric Association encourages parents to include a trip to the optometrist in the list of well-baby checkups. Assessments at six and 12 months of age can determine healthy development of vision. Early detection of eye conditions is the best way to ensure your child has healthy vision for successful development now and in the future.   

It is recommended that children receive their first eye exam when they are six months old. Initial eye exams are usually done by the baby’s pediatrician. At six month and 12 months, the pediatrician will performs a few simple tests to make sure the baby’s vision is tracking properly, that light is getting through the retina and that there is no evidence of the eyes crossing.

Although vision tests for young children are often done in the family doctor or pediatrician’s office, the American Academy of Ophthalmology website states, “Even if the eyes are fine, children should be seen by an eye doctor at the age of three and once more before they start the first grade.”

Vision screening programs in schools often pick up the most common problems. However, if you have a concern about your child’s vision, visit an eye doctor; they are skilled to spot subtle problems.

Conclusion:

In order to be healthy and stay healthy, Americans must take an active role in their health care. If we take the time to schedule routine screenings and exams, to educate ourselves on risk factors associated with illnesses and, to focus on reduction of high risk factors, many illness would be significantly prevented or postponed.

In the end, Americans who want to live into old age with minimal illness need to focus on health and lifestyle when they are young. Because it is true, an ounce of prevention is worth a pound of cure.

Wellness benefits are usually included in insurance plans. Before scheduling, check with your insurance company to learn more about your specific benefits. If family members are eligible for wellness coverage, make certain to mention that you are scheduling a wellness visit when making an appointment. This helps ensure correct billing at the time of service.

BREAKOUT

www.aap.org – American Academy of Pediatrics

www.ada.org – American Dental Association

www.braces.org – American Association of Orthodontists

www.aao.org – American Academy of Ophthalmology

www.aoa.org– American Optometric Association