The Changing Face of Pediatric Dentistry in Connecticut
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Back in the day (the day being some 15 to 20 years ago), most kids didn’t go to the dentist until they were well out of Pull-Ups. Some didn’t go unless they had a cavity, in which case they had it filled, thus beginning most people’s hate-hate relationship with the dentist.
“I remember taking my kids for the first time when they started school, when they were six,” says Jennifer, a Trumbull mother of two. They saw the family dentist, like everybody else did. It wasn’t until her son’s malformed frenum started impacting the spacing of his teeth that Jennifer took him to see a specialist.
Today, a visit to a dentist who treats only children is far more common than even 10 years ago. Their offices are bright and cheery, kid-friendly in every way. Whimsical murals adorn ceilings and walls, and colorful pint-sized chairs surround low tables filled with learning toys and storybooks.
As their numbers increase (there are more than 8,800 pediatric dentists in private practice in the U.S.) and parents learn more about the nuances of proper dental care for kids, visits sometimes start even before a single tooth has erupted.
In fact, the official recommendation of the American Academy of Pediatric Dentistry (AAPD) is an oral exam on a child’s first birthday, or when the first tooth comes in, whichever occurs first—not because there’s any drilling to be done, but because many kids’ dentists see that first meeting as a teachable moment. “A full 50 percent of what we do is parent education,” says Dr. Scott A. Bialik, a private practitioner in Brookfield.
Dr. Warren Brill, a pediatric dentist in Baltimore and president of the AAPD, says its members are “interested in giving every child the best possible start, and that means getting parents to understand the importance of proper care.”
The first visit also helps to establish a relationship and comfort level that the dentist hopes will last. Just as the anatomy of children’s teeth is different from those of an adult, so too is the specialist’s manner of relating to his young patients. During a pediatric dentist’s two- to three-year residency, he or she is required to take seminars in childhood growth and development, as well as behavior management.
“We have to establish a means of communicating with every child, talk about things that interest them, get them to like and trust you,” said Brill. “Dental students are taught to never lie to a child. Never tell them something won’t happen if there’s a chance it will.”
Parental involvement is important, too. “We were told to never let parents into the room so we didn’t split the child’s concentration,” says Bialik, a past president of the Connecticut Society of Pediatric Dentists. Now, he couldn’t disagree more with that thinking: “I welcome parents in the room. In fact, I always have.”
To be sure, pediatric dentistry isn’t all about getting children to enjoy the experience. “The technologies and materials have gotten so much better, and the amount of time a child has to sit in the chair is much shorter now,” says Bialik. “A filling that used to take an hour now takes 11 minutes.”
Prevention and vigilance drive treatment. A risk assessment is done very early on, according to Dr. Steven D. Ureles of Children’s Dental Associates of New London County. “By identifying the bacteria in a child’s mouth, we can categorize his or her risk factors and establish a program for prevention,” says Ureles, who teaches at both at the Harvard School of Dental Medicine and the UConn School of Dental Medicine.
As teeth emerge, they’re cleaned regularly and sealed as a matter of course. “When I started practicing in 1997, sealants were not covered by insurance,” said Bialik. “Today, even Medicaid covers them.” If alignment or spacing is a concern, patients are referred to orthodontists. Most dentists agree that fluoride, which strengthens tooth enamel, is endemic today, so rinses are largely a thing of the past.
Dentists agree that snacking on sugary treats should be kept to a minimum, and brushing and flossing remain the twin mainstays of good oral health. “There is absolutely no substitute for brushing and flossing,” says Bialik. “Parents have to help younger kids, tirelessly, until they learn to do it properly. And they should never, ever let a child go to sleep without brushing— even at naptime—because saliva production slows down when we sleep, and we know that’s what keeps teeth clean.”
With so much “science-based evidence” at their disposal, pediatric dentists are equipped not only to fill cavities, but “to treat the whole person,” suggests Ureles. Yet, despite all the preventive medicine, cavities are five times more common in kids than asthma, he says. The problem is a significant population that is uneducated, uninsured and underserved.
“There are many parents who simply don’t know the consequences of putting a baby to sleep with a bottle in its mouth,” says Bialik. “I have to say that social services is doing a very good job of reaching out to this population. We have a serious language barrier in the greater Danbury area, where many speak Portuguese, but it’s improving. And the advent of social networking is helping. Once the word gets out to one Medicaid patient, it spreads.”
At the end of the day, children’s dentists say they have your kids’ best interests at heart—and by all accounts, they love what they do. “I’ve been doing this six days a week for 25 years and I can honestly say I look forward to coming to work in the morning,” says Ureles. A recent AAPD study shows that more dental students are choosing pediatric dentistry over any other specialty, adds Brill. “When you can treat someone from a very young age and have such a positive impact and watch them grow into healthy adults,” he says, “well, there’s a real level of satisfaction in that.”
The Changing Face of Pediatric Dentistry in Connecticut