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Caring for Baby Teeth Means Healthier “Grown-Up” Teeth

Baby teeth are referred to as many things such as; deciduous, milk teeth, temporary or primary teeth. These teeth are the first set of teeth that a child develops. They develop in the womb and become noticeable in the mouth during the infant years. Permanent teeth are those which replace the baby teeth when they fall out.

healthy baby teethDeciduous dentition consists of central incisors, lateral incisors, canines, first and secondary molars. The lower, two front teeth are the first teeth to go, followed by the upper two front teeth, moving on to the teeth on either side of the front teeth. The primary teeth may continue to fall out until the age of 12-13. The ages are general guide lines. Different children, even in the same families, vary in age ranges

Many times we are asked how to tell the difference between a baby tooth and an adult tooth. Primary teeth start to exfoliate between the ages of 4-6 years. Primary teeth tend to be whiter and smaller then the permanent teeth. The permanent teeth are 1.5 times the size of the baby teeth.

Care of baby teeth is just as significant as caring for permanent teeth. While the truth of the matter is that baby teeth only spend a short period of time in a child’s mouth, they play a fundamental role for the permanent teeth that come later:

  • They not only save space for their permanent tooth replacement but they also give the face a normal look.
  • They assist in clear pronunciation of words, help manage good nutrition for the body and help protect the permanent teeth.
  • When a primary tooth is decaying or infected, it can also damage the permanent teeth underneath the gum line.

Care for baby teeth starts before they breakthrough the gums. Start getting in the habit of wiping your baby’s guns with a soft, wet washcloth or gauze during bath time. Toothpaste is not necessary at this stage. You can wrap the cloth around your finger and gently wipe over the gums. This also helps your baby get used to having his or her teeth cleaned as part of their regular routine.

After your child’s teeth start to show around 6 months of age or so, purchase a baby toothbrush with small bristles. Don’t get worried if your child hasn’t cut any teeth by the end of their first year, for some kids this doesn’t happen until 18 months of age. If you are cleaning your baby’s teeth regularly at this stage, toothpaste is still not necessary just yet. Brush gently on both sides of the teeth twice a day. You can brush your baby’s tongue gently to remove bacteria.

It’s always important to replace any toothbrush when it looks worn or the bristles start to spread out. Remember to start forming good brushing habits with your kids at a young age. Call your dentist with questions or concerns you may have with your child’s teeth. There is never a silly question for your dentist; we understand the importance of your child’s health.

The Last Time I Checked My Child’s Allergy Supplies Was…. ???

As summer approaches and families begin making plans for long-postponed vacations, for our family, it means beginning a summer check up for our allergy needs. Especially since vacation time can also make us forget about other details, summer is a yearly reminder to clean out, update and refill.

Inhaler clean-out - smallCleaning Out A few months ago, something prompted me to check my son’s asthma inhaler. Upon examination, I was horrified. At some point, the inhaler must have discharged while it was enclosed in the holder and had “grown new friends”- yuck! Worse yet, I realized that my son had used the inhaler recently (which means all of what was hanging out in his inhaler was also having a party inside of his lungs too). In times of being a normal mom who worries about her son’s asthma, I was fast forwarded into dry-heave mode quickly followed by recycling the old case and getting a brand new one altogether. I sent the stretchy outer case through the washing machine and let it completely air dry.

The food allergy mom in me sent an email to the wonderful people at the Allergy & Asthma Network. With a tinge of embarrassment for feeling like I was the world’s worst allergy mom, I sent a picture and asked if they had any words of wisdom for me as well as to others on how to prevent a dirty inhaler from entering our lives again. They quickly responded with some helpful information from their Understanding Asthma Guide:“Clean your inhaler following the manufacturer’s instructions, usually once per week. Clean the actuator — not the metal canister — with warm water and leave time for it to air dry before another dose is needed. Holding chambers also need to be washed, especially when the unit becomes cloudy or filmy inside. Replace disposable parts as recommended to avoid bacterial growth. Talk with your doctor if there’s any uncertainty about cleaning your inhaler or holding chamber.”

UpdatingDuring my frantic summer allergy cleaning binge, I also noticed my son’s emergency contact paperwork was faded and torn. This is something that I consider to be an extension of safety for him in the event that he is unable to speak for himself. It contains a copy of my son’s Allergy Action Plan. I also updated his picture because, gosh, don’t all children seem to change overnight?! This is also helpful when your child is with people they normally aren’t around (such as a substitute teacher) so that they have immediate confirmation that the person with the food allergy pack matches up with the listed allergens and contact information. Never assume, always overdue. Nobody ever died from too much information, only not enough.

I also checked expiration dates on his medications both inside his allergy pack and the extras that we keep on hand in the house and made sure our stock was full. It only took one bad asthma night with just a few counted doses available in his inhaler for me to realize that expiration dates on these life-saving medications are something that cannot be forgotten. Again, as a mom of an asthmatic child, the last thing that you want to tell your child who is gasping for breath is to not use their inhaler unless they have to because it might run out. I’m not proud of that moment but it happens to the best of us and teaches us new organization and safety techniques to avoid future repeats.

Early script refills - smallRefilling Because of the discount cards available the past few years, this is one area that is super easy and non-stressful. Both EpiPen and Auvi-Q have continued to provide copay assistance, which means one less expense. Nothing can beat refilling a prescription for twin packs of epinephrine and seeing a giant $0 on the receipt. Don’t get me wrong- my son’s safety is priceless and I would gladly pay to keep him that much safer at all times but not having to spend that money each year is a food allergy parents dream.

I do recommend discussing how to write out the prescription correctly with your child’s pediatrician or allergy specialist. This will ensure full benefit of the copay discounts, additional epinephrine to have on hand and for the next school year and ultimately, it will save you time going back and forth to the pharmacy for repeat refills. Also discuss correct dosages of medications for your child’s height, weight and age to prevent wasting a refilled prescription (ex: filling an Epipen Jr prescription and finding out after the fact that your child is now considered to be within the EpiPen adult dosage range…then what to do with the wasted medications?)

Allergies can be tricky but each year brings new techniques and better ways to come up with a strategy on what works best for your child and family. Just remember to be accepting of what might not work in the beginning, or even the year after and always give yourself more than enough time to be ready for school. The better prepared and calm that you seem, the less stressed your allergic child will begin another school year.

How Concerned Should Parents Be About Whisper?

Whisper is an anonymous app, launched almost 10 years ago, where people post things that they might not want to admit to in public. While maybe not as well known by parents as some others, it has over 900 million accounts, according to the Washington Post and many of them are teens.

According to the Whisper’s own terms and conditions, users must be at least 13, but anyone under the age of 18 may only use the app under the supervision of a parent or legal guardian who agrees to their terms of use. They indicate that anyone who does not agree with these terms should simply not access or use the service. How often do you expect that happens?

While the company calls what people post on the app, “User Content”, most people simply call them either “Whispers” or “Secrets.” I’ve used Whisper and found it to be one of the most interesting apps out there. Of course, I fully expect that most of the “user content” is fake.

Assuming that people actually use it for its intended purpose, to secretly tell things about themselves and that they probably wouldn’t tell people they know, it’s probably harmless. But that’s clearly not all that happens on the app. Below is a graph for a grading system that I devised to help parents understand the risks involved for their children using popular apps. In my most recent article on Instagram, I explain in detail what the values on the graph mean and how using an app might endanger a child, but here it is below in a nutshell:

What the Numbers Mean:

The numbers / ratings represent the likelihood that you will see the risky behavior occur within this app.

  • Rating < 5 is minimal risk and is highly unlikely to occur on the platform, but that doesn’t mean that it can’t happen.
  • A rating of 5-6 is average risk – it should concern parents, but not overly so.
  • A rating of 7 or 8 is problematic and should concern parents quite a bit.
  • A 9 or 10 rating is very troubling as that behavior is almost a certainty within this app, and involves issues that are likely of extreme concern to parents, such as sextortion and child pornography.

Catfishing (10 out of 10)

As an “anonymous” app, there is no attempt made to identify the users. The profiles, what little of it there is on the app, don’t even include the possibility of a picture be added. That makes it perfect for people who don’t wish to be identified. When posting a secret on the app, users have the ability to upload a picture for that individual post, which may be of themselves or it may be one that they took from some other source. Additionally, Whisper has a large library of images available by users and the app will suggest images based on words typed by the user that get superimposed in front of the image.

Cyberbullying (8 out of 10)

The potential for cyberbullying exists anywhere. I’ve seen it on posts/apps where I would least expect it. With Whisper, it can often come from pictures that the person posted which were meant to be silly or sexy. Body shaming is pretty common in cases like this on Whisper, assuming that the image in the post is really of the person who posted it.

As another example, in a recent posting, a woman announced that her boyfriend had revealed online that they were engaged before she wanted it publicly known. Within just a few hours, there were well over 300 replies, many saying that she should be happy that he was excited to be engaged. In fact, the overwhelming majority of the replies were critical of the original post and a few were not polite about it, to say the least.

Language (8 out of 10)

There is virtually no filter on what people say on social media platforms and Whisper is no exception. On social media apps that are popular with kids, they may choose to intentionally spell words incorrectly, but close enough that the reader understands the message. For example, they may use “$” instead of “S” or “!” instead of “I.” Most likely, they are trying to avoid filters that search for specific keywords but considering how often I’ve seen posts on Whisper that have foul/inappropriate words on them, it seems likely that they have little to be concerned about in this area.

Nudity (8 out of 10)

This is a little bit of a gray area. Overall, I have seen very little, if any actual nudity on Whisper, but many images certainly push the boundaries. I have observed images showing both boys and girls in images that their parents would probably object to them using/seeing. As Whisper does allow people to send private messages between users, there may be cases where nudity is involved there, but I can’t say that for sure.

Privacy (6 out of 10)

As an anonymous app, this app has the advantage of not giving others easy access to users’ personal information. Facebook, for example, provides lots of opportunities for people to publicly share where they work, who they’re married to and more. So long as users practice common sense, there’s not too much risk of privacy being lost here. The risk with Whisper is how much personal information people are willing to share within their posts and through private messages. Let’s just hope that common sense prevails.

Sexting (8 out of 10)

This is a huge issue on the app. From what I can see, the majority of posts seem to have at least some sexual connotation to them. The rating would be higher than this based simply on the sheer volume of sexual content (explicit and implicit) on the app, however it is tempered somewhat by the anonymous nature of the app. It clearly has the potential for a higher rating, especially for an app that hosts groups with names such as Sexual Confessions, Horny People, etc.

Sextortion (6 out of 10)

Any app/site that has the potential for sexting also has the potential for sextortion – the act of forcing others to perform acts of a sexual nature online. This typically requires sending images or videos, which the recipient can then use against them to force them to send even more images or do just about anything else they want to avoid the images being made public.

It gets worse if the target provides their profile names for other sites/apps, which is common on Whisper. Unfortunately, it is very common to see people post their Snapchat or Instagram name on the account, (assuming that they’re providing their own information and not intentionally setting someone else up for online harassment).

Stalking (8 out of 10)

I recommend minors not use Whisper and that anyone who does use it disable the ability for the app to know their location. I say that because the app has a feature that will automatically include the location of where the picture was posted from. Other users then have the ability to search for posts made close to their current location.

A little over three years ago, a story made the news about a young girl who met a man on Whisper. She was only 14 but claimed to be 15-17 (Whisper uses age brackets). At some point, the man suggested that they switch over to a different app. At that point, he requested that she send him naked pictures of herself and she acquiesced. Eventually, they met in person, where he provided her with marijuana and eventually, sexually assaulted the young girl, according to authorities.

This was all possible because the predator was able to search geographically on the app to find potential targets. Online predators are very skilled at finding and recruiting, as I’ve written here on Pediatric Safety.

Another feature on Whisper is to find posts that were made recently. This lets predators hopefully find people before they have signed off and can engage them in a conversation. In theory, a good idea, but it is too easy for predators to exploit.

Viruses (3 out of 10)

Sending viruses via Whisper is all but impossible, from what I’ve seen. When entered as part of a secret, the words are there, but it has been converted to an image, not an active link. However, anyone who wished to send a virus could easily do so by placing it into a direct message to someone.

If they, in turn, copy/paste it into a browser, the virus could take effect. The tease of seeing naked pictures might entice someone to do that and with URL shorteners, it wouldn’t even look like a potential risky site.

Bottom Line

Whisper is riskier than it might appear were we to average the nine potential areas of concern. That is, an average would treat each of the concerns equally, but as parents, we may be more concerned with the areas of cyberbullying and sextortion than the risk of a virus. When it comes to using Whisper as safely as possible, there are some basic principles that all users, but especially kids, should follow:

  1. It may be cynical, however, assume that nobody is who they claim to be on Whisper.Trust, but verify doesn’t apply here because everyone is hiding behind a veil of anonymity.
  2. Assume that whatever you post on the app will be seen by everyone, not just the people who have access to seeing your posts. When taking the geographic search feature into account, it is very possible that people within your own community can see what you post on Whisper.
  3. Never, under any circumstances, post a picture of yourself, or anyone else for that matter, that you might regret later. It’s better to think of it not being a question of IF someone you know will see what you post, but WHEN will they see it. That includes parents, teachers, siblings, co-workers, etc.

Like most apps, Whisper can be fun to use, but it comes with risk and those risks need to be considered. As I mentioned earlier, I have already done a similar article here on Instagram and will be doing more apps in the future, so I recommend that you check back here for more articles on popular apps. You can also check out my other articles here on Pediatric Safety by visiting my profile and complete list of articles.

Another Ear Infection…What Can I Do – Part II??

Since we now understand how ear infections occur (see Ear Infections – Part I), it’s time to deal with the child who seems to get repeated ear infections. Ear infections, particularly the middle ear type, are responsible for providers ordering more prescription antibiotics than any other childhood disease.

There are a certain number of children who just seem to get an outer ear infection (otitis externa) every time they get their ears under water, usually during the warmer months of the year. There are even some who get this when they do not get their ears under water, but usually these episodes are also in the warmer months. I spoke about the treatment of the sudden or acute ear infection, but what to do about the repeated episodes. The best answer to this is using either a prescription medication or better yet, one not costing you anything at all. Mix ½ to ½ mixture of white vinegar and rubbing alcohol and place a couple drops of this into your child’s ear as soon as they get out of the pool or lake or ocean and try to limit the time those ears remain submerged. This has a way of drying out the external ear canal and helping to change the acid content of the eardrum. Ear plugs may be effective under certain circumstances but in general if you force a plug into the ear it may just irritate the skin which is exactly what we wish to avoid.

Middle ear infections (otitis media) are a different matter entirely. Remember that these are primarily due to a blockage in the normal valve system of your middle ear, with resultant pressure, fluid and infectious results. (Please refer back to part I if this is confusing). These changes happen in a progression that can occur suddenly or can develop over time.

While the obvious answer would be to use a “cold medicine” early on in the process this does not seem to influence the course of events as outlined, when looked at in controlled studies. The other end of the spectrum for treating the occurrence of multiple recurrent middle ear infections is to alter the normal anatomy in such a way as to prevent buildup of pressure in that small space which can then lead to fluid accumulation and bacterial secondary infection. This is accomplished through the use of very small tubes that can be surgically inserted through the eardrum and will serve to equalize the pressure on both sides of the eardrum. The system will calm down and the incidence of new infections will drop tremendously.

But that is a surgical procedure under some type of anesthesia, and even with tubes in the proper place, there can still be fluid production which then drains out of the ear chronically. Also, the mere act of making a hole in the eardrum through which a tube can be put in place, can slightly damage and scar that eardrum. Depending on the type of tube implanted in the eardrum, it usually comes out by itself after six to twelve months and the eardrum heals. Occasionally, the ear drum fails to heal completely and there is a perforation that might need to be surgically repaired in the future.

We treat middle ear infections for one of several reasons: to control the pain, to prevent any further extension of the infection into sensitive areas, and to preserve speech and hearing in your child.

Fortunately there are other approaches to the treatment of recurrent middle ear infections. Each significant ear infection should recognized and treated appropriately and the fluid buildup behind the eardrum monitored for resolution.

  • Fluid constantly in touch with the ear drum will dampen the usual vibrations and dull the hearing while it is there. Hearing testing can be run routinely to follow any changes in hearing.
  • All types of medications have been tried at one time or another: preventative doses of antibiotics have and still are being used for several weeks to months in an effort to prevent the bacterial infections, but the increasing number of bacteria becoming resistant to common antibiotics have caused physicians to re –think the use of long term medication.
  • Cortisone preparations by mouth have been tried to help with the middle ear inflammation, with varying results.
  • Occasionally, when all forms of treatment fail it is up to the ENT surgeon to place those tubes and let the middle ear system calm down.

So, there are many things to consider in finding a course of action for your child with recurrent ear infections and your Doctor will be familiar with each of the methods and can discuss them with you.

How did my child get an ear infection – Part I ??

Last updated on April 5th, 2021 at 11:44 pm

Ear infections come in two basic varieties; external, commonly occurring in the warm weather and referred to as “swimmer’s ear”, and internal or middle ear infections occurring mainly in the colder weather. The designation of external or middle is dependent on which side of the ear drum the infection is located. The outer ear canal, seen from the outside if you try to get a look in an ear, is a narrow bony channel covered with skin leading to the eardrum which is totally air tight and seals the chamber. On the other side of the ear drum lies the middle ear cavity containing specialized bones and small organs that allow sound frequencies entering the outer ear to be converted to impulses that eventually reach the brain and are interpreted as sound. This space would also be a closed space if it were not for the Eustachian tube which goes from the back of the nose to the middle ear cavity and keeps the pressure the same as the external canal.

The frequency of sounds represents a pulsed pattern and each frequency has its own pulse pattern. As the sound, usually consisting of different frequencies, reach the ear drum they set the eardrum vibrating at different rates; these vibrations are transferred from the outer ear to the middle ear by way of the eardrum, and then picked up on the other side by a connected series of small bones or ossicles that transmit the information to the auditory nerve and then on to the brain.

Now that we know how the ear works as relates to the anatomy we can discuss more fully what ear infections are all about:

External otitis is caused by a damp, warm environment in the outer ear canal which breaks down the skin and causes irritation leading to possible mild bacterial infection. There is swelling in the skin lining that narrow canal and very little space to allow for that swelling. As a result there is more irritation and resultant pain which can be quite severe at times. As this occurs there is a change in acid content of the external ear leading to more discomfort.

The first thing to do is to prevent any further fluid or moisture from entering that ear canal, no swimming or diving for several days. If there is mild pain a ½ to ½ mixture of vinegar and alcohol can be used in that ear for several days, along with mild pain killers such as Tylenol or Advil. If the pain is severe go to see your Doctor who may prescribe further treatments. In general this is not a dangerous problem even though it can be very painful.

A middle ear infection starts with a pressure change in the middle ear cavity from congestion and narrowing or complete blockage of the Eustachian tube. AT this point the child may say he/she cannot hear well or the ear “feels full”, or even hear the sloshing of fluid. After some period of time there is a collection of clear fluid with more pressure buildup and resultant pain. As the fluid builds up, bacteria can migrate into that space and begin growing leading to more pressure, pain, discomfort and sometimes fever. Your Doctor will suggest treatment methods that will greatly decrease pain and help heal the infection.

Some children tend to get repeated episodes of ear infections and I will deal with that problem in Part II of this post.

Eating Issues and Kids with Special Needs

Last updated on April 5th, 2021 at 11:44 pm

The "I'm Not Eating This" FaceSo many parents and caregivers struggle with issues surrounding food, with special needs kids and typical kids as well. For some kids the issues are medical so they require a specific diet, or they have a condition than includes low muscle tone. For others it’s a sensory thing, so they will only eat crunchy foods, or white foods, or the rules may change daily. For other kids it may be a control issue, and refusing food or demanding certain foods can be the only thing way they feel they can influence their world.

Whatever the underlying reason (and of course there may be more than one at the same time), the issues usually fall into two separate categories; getting kids to eat more, and getting kids to eat less.

All kids need to eat healthy foods and get all their vitamins, minerals and nutrients. Supplements and nutritional drinks can fill in the gaps for both kids who seem to exist on nothing as well as those who seem to only allow junk food to pass through their lips. My own child survived on Pediasure for years, but we never stopped encouraging actual food and expanding on her diet.

Both types of kids seem to be fairly picky about their eating. Pizza, chicken nuggets and hot dogs may be the only dinners that get their approval. Buying or making the healthiest versions is a good bet, so that each calorie will be full of nutrients and not just preservatives and chemicals – but something is always better than nothing, especially for the kids who need to eat more. For those who need to less, veggie-covered pizza is more filling than plain cheese pizza, and a salad eaten before the all white-meat chicken nuggets may keep the child from asking for seconds. At my house we have a strict veggies first policy. We also demand that a second helping of veggies is finished before a second helping of anything else. But we are mean at my house (LOL). Sometimes the veggies even appear as an appetizer while my ravenous children suffer through the torture of waiting for me preparing dinner. It’s amazing what will get eaten when a child is truly hungry.

All kids can benefit from a little undercover food. Fruits and veggies that might be refused (usually loudly) can be smuggled in undetected in many ways. Of course smoothies are a great way to slip in lots of ingredients, as well as protein powders. Pureed popsicles are also good, especially here in the hot weather. I got away with steamed, pureed cauliflower added to boxed mac and cheese and shredded zucchini in marinara sauce for years. Sadly, as my kids got older they also got wise to my tricks. Zucchini muffins, however, are still a big hit.

I grew up in a house with a VitaMix, which is a high-powered combination of a blender and a food processor. This workhorse is perfect for making your own nut betters or flours if you have specific dietary needs. It also makes killer smoothies and soups, and can even heat the soup. Check the customer reviews for great usage and cleaning tips. Nowadays we have a Magic Bullet, which is great for individual servings and smoothies as well as some chopping chores. The Nutri Bullet is an entire juicing system.

Fruitn_Cheese_Snack_MixThere are ways to sneak calories other than veggies into food for kids who need to bulk up. Try buttering bread before making a sandwich, or pair a favorite food with a new one to expand the child’s repertoire so it isn’t overwhelming – there is something familiar and comforting on the plate. Stick with whole milk, cheese and cottage cheese even if you swear by skim. I knew a mom who always served sandwiches with dip – salad dressing or veggie puree. Added calories and a bit of sensory fun, too! Food presented in a fun way or in fun shapes may also get gobbled up easier than the same old sandwich.

Both kids who need to eat more and kids who need to eat less should be involved in the food in the house. Take a trip to a local farm or a local farmers’ market so the child can see, feel, smell and taste the varieties. Getting to choose an item may make it seem more appealing on the table. Gardening is also great and lets the kids watch the growth and maturation of the fruits and veggies.

There are food and eating therapists who use exposure therapy and rewards. I heard of one that had a cute, friendly dog in the room – if the child licked the new food he or she got to pet the dog. Her patients made great progress and the dog got a lot of attention! There are also eating groups where kids come together to try new items in a fun atmosphere. If there is a control issue between you and the child then he or she may have more success with food away from you. My child is a social eater and is more likely to try something new if we are out at a restaurant or at a party. Then I can observe what she likes and try to make it for her at home. It takes about 6 exposures to a new food before a picky kid with actually try it, sort of how they naturally desensitize themselves, so try to be patient.

A nutritionist can also help. There may be a biochemical reason a child craves a certain food constantly. Get allergy tests done, too, especially if your child is avoiding an entire food group. Again, for older kids, it seems to help to hear advice from someone other than mom.

Food issues can be frustrating for everyone, whatever challenges they face. Try not to make mealtimes a battle; these kids have enough struggles in their daily lives.

Got a specific question about your child’s eating? Post it below!

Disclosure: this article contains affiliate links, fyi after all, a girl and her kids have to eat. Also, I am not a nutritionist so I am not giving anyone medical advice. Check with your pediatrician for any dietary questions.