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Dr. Pamela Stein - Oral Health in Children · Look Who's Talking

0:14
You are listening to Look Who's Talking. I am
0:18
Cameron Minter. I am your co -host with the most.
0:21
I got to put something on my name. I'm the co
0:23
-host with the most. Our host is Jessica Coffie,
0:29
our Head Start Director. What's going on, Jessica?
0:32
Not much, Cammy. Are you enjoying this? Are you
0:35
a snow girl? Are you a snow girl? No. No, not
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at all. You know, I think I remember probably
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in the past I said I prefer snow, which I still
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prefer snow over ice any day. Any day. But I've
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had enough snow. I've had enough snow. Oh, yeah.
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So usually I'm like, I want one big snow. And
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right around Christmas. I would rather have it
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around Christmas. And then be done. But I want
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a big snow to where, like, we can't go outside.
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Are you still looking for school days? Yeah.
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Those are what I use as personal. Personal snow
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days. But the whole back and forth, like. No,
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I don't like snow anymore. I'm done and over
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it. I'm over it. I mean, so far this year, as
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soon as I get in a good rhythm, boom, snow. Adjust
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your schedule. Snow is fun, like on the weekend
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when you don't have to be out in it. Say that.
1:38
I'd rather not. Have snow like on a Monday or
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like how we just had a random Wednesday, Tuesday.
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I know. I don't even know. It messed me up so
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bad. I don't know what today is. Look, I went
1:50
out this morning, you know, because according
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to the meteorologists who get paid a lot of money,
1:56
who changed their mind at the last minute. And
1:58
we would need to rethink their pay scale. I know.
2:00
We just, I mean, okay. So I wasn't expecting
2:04
any snow this morning. And there's snow. So before
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I go, I got to shovel. I got to get this. I'm
2:11
just tired. Yeah, I'm over the snow. I'm done.
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We are on one accord when it comes to that. Very
2:18
good. What's going on? What's up with you? Cam,
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you always ask me that, and I never know. You
2:23
never know what's up with you? Well, no one else
2:25
will be able to tell you that. I can make up
2:28
some stuff if you like. The only thing I know
2:30
is I'm tired of seeing snow. Man, amen. What
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else been up with you? That's the real question.
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Oh, I'm just trying to get, I'm still, it is
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almost the end of February and I still am trying
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to get into my groove for the first of the year.
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I'm still trying to get there. I'm almost there.
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We have two weeks before March. I know. I'm like
2:53
90 % there, but there's snow. You know what?
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This is, I just told someone today at work, I
3:01
said, It seems like these first two months of
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the year have lasted 80 months. Like, I feel
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like this year has been so long. It's taken life
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off of us. Oh, my goodness. And you know what?
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We've just had crazy weather. We're talking about
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the snow, but in less than 72 hours, we had warm
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weather. It rained 40 days and 40 nights in 24
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hours. And then there were some tornadoes in
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Kentucky. Yeah. Then. Flooding. Flooding and
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a blizzard. And now Arctic cold. Yeah. Just so
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that by Sunday we'll be up in the 50s. Guess
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what? You gotta love it. As my mama would say,
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that's pneumonia weather. I am. You're going
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to catch something. You're going to get something
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with all this up and down and up and down and
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up and down. I'm just not with it. Yeah. Yeah,
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I am anticipating spring. And if you hear me
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say, it's too hot. Smack you. Just remind me
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of the winter we went through. Go! Yeah. It's
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done for me. I know. I know. We can't be pleased
4:17
because we will be complaining. That. And you
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know what? When March comes, no, tell them what
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kind of weather we're going to get. Right. Right.
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It may be snowing. Right. Exactly. Right. But
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that's Kentucky weather. And I love it when people,
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like I saw on the news where the UK men's basketball
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coach. Uh -huh. when he decided to come to Kentucky,
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said, y 'all don't get snow, right? And the person
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said, no, we don't ever get snow. He was like,
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what is going on? Yeah, no, we definitely get
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snow. Well, we usually don't. We definitely get
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ice. We've always been in, you know, when you
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look at the map and it's on, this part's going
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to get ice. We're always in that ice area. I
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usually want the weather that will cancel work.
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Whatever that is. But we had that, what, like
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January 6th. After that first day, I said, oh,
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no, no, no, no. I just wanted it for one day,
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not for a whole week. That ice didn't go anywhere.
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Because what? It reminds you of what? COVID?
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I know. I can't be in the house anymore. It reminds
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me of COVID. We all have COVID PTSD. We do. We
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really do. And, you know, it's going to be a
5:39
thing in a couple of years. But I'm telling you
5:41
right now, we got PTSD. Well, because there will
5:45
be some case or something that, you know, blames
5:48
COVID PTSD on something stupid, right? I'm just
5:52
claiming it now. So hold up. You said something
5:56
about Kentucky weather that made me want to ask
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you, where would your ideal, where would you
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want to live if it wasn't Kentucky? Thinking
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of weather. It's rough. Yeah, because. Anywhere
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you go. If you don't live here, you're going
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to live somewhere that gets something else. That
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gets something else. And to be honest with you,
6:19
I love the Caribbean. I love the sand. Ooh, flooding.
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Ooh, and Dylan. Hurricanes. No, I'd rather put
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some snow. I'd rather. That's a good game. You
6:33
ever played? Yeah. There's a movie that's in
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my queue to watch, but my wife has issues watching
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drowning movies because she can't swim and she
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takes it personal. So, yeah. I mean, just the
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idea of like a tsunami. Yeah, I think there's
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this other movie we watched where a tsunami,
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and it was crazy. But, yeah, I'd much rather
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push snow. Okay. Yeah. I think I'd rather hurricanes.
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You'd rather? Yeah. Girl, bye. No. No. But think
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about it. But you know you can't swim, although
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you were a swim instructor. I can swim to save
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my life. You were a swim instructor. You was
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a lifeguard. You was a lifeguard. No, I was not.
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I was a swim instructor. Oh, my God. I did not
7:23
say I could not swim. I said I was never going
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to bring that up again. I just said I couldn't
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save other people. Oh, okay. And I don't like
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my face in the water. Okay, moving right along.
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After all of that, I think it's time for a Coffie
7:39
Break. Okay, guys, so for today's Coffie Break,
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I would like to say, be the reason someone feels
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welcomed, seen, heard, valued, loved, and supported.
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That's a lot. It is. That's a lot. It is. You
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need to put oars in between there. No. And think
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about it this way. And I was thinking about this.
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You know, sometimes I have bad days. Oh, come
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on with it. And how I walk into the office could
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affect the people around me. It does. You know?
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So it's so important to try not to bring, you
8:28
know, your frustrations. into the office well
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it might be because of the office but still exactly
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you know we have to learn how to be able to control
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our emotions but also try to bring light into
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someone else's just being i like that i like
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that it's it's hard for me because sometimes
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you know you can't get out of your own way sometimes
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yeah sometimes you are the problem you know what
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i'm saying and But sometimes I just need a minute.
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Let me get it out of my system. Let me be mad
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about it. Let me punch something over here in
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the corner and come over here and act like everything's
9:07
good. Just let me do. But you know what? Have
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you ever been in a place and someone. walked
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in with such a positive attitude that it kind
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of changed you you posted something the other
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day about someone who received their wings and
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i messaged you and i said he's a taste creek
9:26
legend and i remember him always coming into
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the grocery store like smiling smiling always
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yeah And almost getting hit by cars, but he's
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smiling the whole time. And that just kind of
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made me think about that. Like, no matter how
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you saw him, he came in smiling. And that, like,
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just sometimes affects you and say, hey, you
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know what? It could be worse, but let me get
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out of my feelings. You know, like, if you go
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to, like, a nursing home and visit somebody and
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you're trying to encourage them and you leave
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encouraged, that's what. that's about yeah you
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know what i'm saying even though in their circumstances
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and this guy uh had a disability yeah but he
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was always smiling so you had no choice but to
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hey take that on right exactly and since we're
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talking about smiling What's going on today's
10:24
show? So, Kim, on today's show, so you know I
10:28
absolutely love the dentist, right? Okay. Is
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this somebody else who gets all your money? Is
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this somebody else? Absolutely. Do you know how
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much my mouth is working right now? A lot. A
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lot. But I absolutely love going to the dentist,
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and I would go every single day if I could. So
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on today's show, we have Dr. Pamela Stein. What?
10:53
We're going to talk about the importance of oral
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health today. Oral health in our children. But,
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you know, I have some personal questions that
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I have. I've already asked her how my teeth look.
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And she said they look good. Off the clock. Off
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the clock. Hi. Welcome to the show. Hello. Thank
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you for inviting me. Yes, yes, yes. Well, she
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has some problems. I'm sure you've already seen
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some of them. And now dentist is going to be
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one of them. So welcome. And, you know, just
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lock in for these questions. Yes. So, Dr. Stein,
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of course, now you know that I love the dentist.
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And tell the viewers, I did ask you how my teeth
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looked when you came in. Forced her to lie. Yes,
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she did. And she has very nice teeth. So let's
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talk about oral health and specifically with
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children. One question that pops in my head is,
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you know, I hear a lot of parents say, oh, well,
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does my child really need to go to the dentist
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at this age because their baby teeth are going
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to fall out? Talk a little bit about that. Yes.
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Well, there's a couple of things about baby teeth
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and taking their child to the dentist early.
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The recommendation now is that every child should
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be in by age one. Which when I was in dental
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school in the 80s, it was age three. So they've
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moved it back now to age one. And one of the
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reasons is we really want to prevent early childhood
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caries. They're devastating. So if a child is
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susceptible to getting cavities, and that can
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be for a number of reasons, they can actually
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start to develop those cavities around age one
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or two. And by age three, they sometimes have
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to go to the hospital and have those fixed. So
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it can be a very serious problem with a swelling,
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infection, abscess. Very uncomfortable for the
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child and really affects their overall health,
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not just the health of their mouth. So for that
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reason, it's important to go just to make sure
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that the child is on the right track. And also
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to understand whether the child might need some
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supplemental fluoride. Some children don't have
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fluoridated water. They're on well water. Or
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maybe they drink bottled water. And maybe that's
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okay in some situations. It's a very case -by
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-case decision. Yes. But for children that are
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at greater risk, the dentist can make the decision
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about whether or not they need that extra protection.
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See, you just brought up something. I'm thinking
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cavities is because you ate some candy or you
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ate something wrong, and now you've got cavities.
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But you said like at one and two, and pretty
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much at one and two, you're drinking milk and
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eating baby food. Is the cavity connected to
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food, or you had just mentioned about not having
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enough fluoride in the system. Right. So I think
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the cavities are definitely related to food and
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sugars in food. We don't think about milk so
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much as we think about milk as being good for
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our bones and teeth. And they do have, you know,
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there is a lot of calcium in milk, but there's
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also natural sugars. So the issue is when a child
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has a baby bottle or a sippy cup and they're
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sipping on that throughout the day, juice obviously
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has some natural sugars in it, that continual
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bathing of the teeth in those natural sugars
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can cause cavities. One of the most detrimental
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things you can do to the teeth is to put the
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child to bed with the bottle or let them go to
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sleep because then the milk or the juice... Unless
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it's water, but really you don't want to do that
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for choking reasons anyway. That can pull around
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their teeth and cause a lot of decay. The other
15:00
way a young child can get cavities is by getting
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it from their caregiver. So, for example, if
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I'm a mom or grandma, I have four grandchildren,
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and I'm tasting the food, making sure it's not
15:17
too hot before I put the baby food in the baby's
15:19
mouth. And I have some cavities in my mouth.
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That bacteria gets shared with the baby. Wow.
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I did not know that. Stop it. It's true. Oh,
15:30
my goodness. So it's really important that the
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people who are caring for the child don't share
15:37
their saliva. Yeah. And make sure they have really
15:41
good oral health because even kissing the baby.
15:44
Could be a problem. Oh, wow. We are learning
15:47
so much. We are learning some good stuff today.
15:49
But we are about to take a break. We will be
15:52
back. You are listening to Look Who's Talking.
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That's c -o -m -m -action .org. Dr. Kelly Stein,
17:48
who is a dentist. And we were just having great
17:53
conversation about baby teeth. Are there some
17:56
other things that we need to know about those
17:59
baby teeth, the importance of baby teeth? Yes,
18:03
I think obviously the baby teeth are important
18:07
for chewing and eating and talking, but they're
18:11
very important for preserving the space for the
18:14
permanent teeth. So there's 20 baby teeth, and
18:17
for each of those baby teeth, there's going to
18:20
be a permanent tooth that comes in under it to
18:22
replace it. So usually children start losing
18:25
their baby teeth when they're about six years
18:26
old, and whenever their tooth gets loose and
18:30
it comes out, and then the permanent tooth erupts
18:33
right under it. If the child has an issue with
18:37
their baby teeth, let's say they have a lot of
18:39
cavities, some infections, and they have to have
18:41
those baby teeth removed for any reason, that
18:46
space that was supposed to be saved for the permanent
18:50
tooth to come in and replace the baby tooth is
18:53
compromised. So the teeth on either side, it
18:56
could cause a crowding issue, basically. So they're
18:59
important for a number of reasons, functional
19:02
reasons, and also reasons of space saving for
19:06
the permanent teeth. So are you saying because...
19:09
Everyone knows some kid who's had a tooth knocked
19:12
out before their teeth naturally falls out. So
19:17
you're saying that could cause harm when the
19:21
other teeth. The permanent tooth erupts. It depends
19:24
on when the tooth is knocked out. If the child
19:28
is going to get their permanent replacement in
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the next six. to nine months, it's probably not
19:34
going to be too much of an issue. But if it's
19:37
several years before that tooth is supposed to
19:39
come in, usually a space maintainer can be put
19:43
in to preserve the space. But that's an additional
19:49
expense and an additional trauma for the child.
19:52
So it's just best to... have healthy baby teeth
19:54
what about i sometimes see kids with silver caps
19:58
what does that mean so a silver cap is usually
20:01
placed when the cavity is so big that a regular
20:06
filling won't be able to stay in the tooth. It's
20:10
almost like a cap that an adult would get. Once
20:13
your cavity gets so big, you need to support
20:16
the tooth. And the baby teeth, obviously, I mean,
20:19
they're not very big. They're pretty tiny little
20:21
teeth. So it doesn't take too big of a cavity
20:24
to cause the need for a crown or a cap. I'm sorry.
20:30
I'm going to go somewhere else. Children, I don't
20:36
see this as much anymore of children sucking
20:38
their thumbs because it was very prevalent when
20:40
I was growing up. Oh, my sister was awful. It
20:43
was a big old thing. And the forming of their
20:46
teeth. The kind of like. Yeah, where there's
20:51
an indention or you can tell. Is that? Okay,
20:56
so I would think that's something that formed
20:59
as a baby. When those baby teeth are out. Why
21:03
are the other teeth coming in unless they continue
21:06
to suck their thumb? Why are they coming in disformed?
21:14
The permanent teeth? Yes. Well, let me back up
21:19
for just a minute. So when a child sucks their
21:23
thumb, the roof of their mouth, their palate,
21:26
is still forming. So the palate is actually in
21:29
two different bones. midline suture between it
21:33
or space between it and as the child grows that
21:36
closes kind of like the soft spots in the head
21:38
as you grow the as the baby grows the soft spots
21:41
close so um if you're sucking on a thumb it actually
21:47
not just changes doesn't just change the way
21:50
your teeth look it's actually changing the bone
21:52
oh wow the bone is forming so it's it's pushing
21:57
the jaw, the upper jaw out a little bit. Right.
22:01
And making it more kind of, you know what it
22:04
looks like. It's kind of an overjet of the upper
22:06
teeth to make room for the lower teeth. So then
22:10
when the permanent teeth come in, they're coming
22:13
in on that ridge that is now molded into the
22:17
tongue, the shape of the tongue. I've heard that
22:23
pacifiers can do the same type of damage. Is
22:27
that true? Well, it depends upon the pacifier.
22:30
There's some orthodontic pacifiers that are better
22:33
than others. Pacifiers in general are better
22:38
than sucking the thumb. There are appliances,
22:42
thumb -sucking appliances, that pediatric dentists
22:45
can put in the mouth to help a child stop sucking
22:50
their thumb. Oh, wow. When I was coming up, there
22:54
was some juice or something you put on it that
22:56
didn't taste well. Yeah. So, yeah. I don't see
23:00
that. Or the fingers. Oh, gosh. Yeah. Yeah. I
23:04
haven't seen it in a while, so maybe it's not
23:06
a thing anymore. What? You haven't seen people
23:09
or kids? Thumbsuckers, yeah. Oh. Still. It's
23:13
still a thing. It's still a thing. Okay. Definitely.
23:16
What kids have you been around, Cam? Because
23:18
it's still a thing. I mean, yeah. Yeah, I guess
23:22
I'm not. And you know what? A lot of children
23:24
that we see in our program do it like as a soothing
23:27
mechanism. Yeah. Help them to sleep or calm down.
23:31
Especially when, this is when I see it the most,
23:35
when a child is upset. They first come in and
23:39
they don't want to leave their parent and they
23:40
leave their parent. They're crying and they'll
23:42
put their fingers in their mouth. Yeah. But you
23:45
know what? Dr. Stein talked about that tooth
23:49
decay and it's almost like your tooth just bathing
23:55
in whatever. So one thing we do here at Head
24:01
Start is we brush our kiddos teeth. So after
24:04
a bottle, after they eat lunch or sometime during
24:09
the day, we will. You know, have our kiddos brush
24:13
their teeth and our babies will do that for our
24:16
babies as well. So what I want to ask is whether
24:20
it's a child or an adult, how often are you supposed
24:24
to brush your teeth? Well, in a perfect world,
24:29
we would brush our teeth every time we ate or
24:32
had a drink besides water. But every twice a
24:38
day is, you know, kind of considered the standard.
24:41
The most important time to brush your teeth is
24:44
before you go to bed. That shouldn't be the only
24:48
time we brush our teeth all day. But that is
24:50
the most important time. When we sleep, you know,
24:52
when you wake up, your mouth is usually pretty
24:54
dry. And we just create an environment when we're
24:57
sleeping that's very conducive to forming cavities.
25:01
And so if you have any kind of sugars. plaque
25:05
left on your teeth, it's really going to give
25:07
them a good opportunity to do their thing and
25:11
create a cavity. So that's a really important
25:13
time. But any time, I'm so glad to hear that
25:16
you're performing the toothbrushing for the children
25:19
because any time that you can get the plaque
25:23
and the sugars off the teeth is a good time.
25:25
Now, how do you brush the teeth for the kids?
25:32
Let me do, how do you? how does a parent brush
25:35
a kid's teeth because let me tell you i got i
25:38
got Nico, Nico, Nico, he wants to suck on the
25:42
toothbrush and the toothpaste and I can barely
25:46
get them teeth and I'm trying to struggle. And
25:48
so how do you because he will not go like this.
25:52
You know, he's not smiling so I can get the front
25:55
teeth. I got to kind of get it from underneath
25:57
how old he is. He is seven, 18 months. He's 18
26:02
months. Yeah. You know, I don't think that's
26:04
that unusual. I experienced that with my own
26:06
kids and my grandkids. as well it can be really
26:10
challenging you know they are on one hand they
26:15
like to put things in their mouth but they want
26:16
it to be on their turn exactly exactly so um
26:20
you know i think it's important to do just a
26:23
really small amount of toothpaste like rice size
26:27
amount just a little smear until they're about
26:30
three and then you can do a little bit bigger
26:32
like a small pea So that's one thing, just getting
26:36
a little bit of that fluoride in their mouth
26:38
is going to be important. And try not to make
26:41
it a huge battle, letting them do some of it
26:45
themselves. So giving them some agency and some
26:48
control usually helps a little bit, like we'll
26:50
take turns. What has helped me with my children,
26:53
also with my young patients, because I was a
26:55
Head Start dentist for years. I saw the little
26:58
ones. Come back. Three, four. And did, you know,
27:03
did fillings and things like that. But I would
27:06
ask the children when I was cleaning their teeth
27:08
or brushing my children's teeth, make a mean
27:11
face for me. Make as mean as you can make. And
27:14
I would show them and they're just baring your
27:16
teeth. And we're going to clean your mean teeth
27:18
real good now. And you help me. All right, now
27:21
let's get back. So just kind of coming up with
27:24
some games or things. Children are, you know,
27:27
what works with one child works with one child.
27:29
It doesn't work with them all. You know your
27:31
child better than anybody. You know what might
27:35
work. Playing a song for them while they're doing
27:38
it or telling them jokes or making funny faces.
27:41
Distracting them is usually good with something.
27:44
So those are pretty much my tips. We want to
27:50
get, if we can. Especially at that age, it's
27:53
going to be hard. But the outsides of the teeth,
27:55
like the cheek side and the lip side. He'll let
27:58
that because those other teeth are trying to
28:00
get in and it feels good. Yeah, those top ones,
28:03
I got to get it on the top and just brush. Yeah,
28:06
yeah. And it's really hard to get the tongue
28:08
side. Yeah. It makes them feel like you're gagging
28:11
with the toothbrush. Another really important
28:13
thing. That's hard for me and I'm an adult. Well,
28:15
me too. It's hard for everybody. Make sure you
28:18
have the right toothbrush. So you want it to
28:20
have, especially with a little bit like that,
28:23
a really small head, like for a baby. And it
28:27
needs to be as soft as possible because you don't
28:30
want those bristles to be abrading the tissue.
28:35
I feel like I have at least 50 more questions.
28:37
Right, because every time she says something,
28:39
something else pops up. Yeah, I want to ask,
28:41
okay, so Dr. Stein is seeing my Coca -Cola right
28:44
here, and I feel so judged. No, I don't. But,
28:47
you know, sometimes. We know the effects that,
28:51
you know, regular soda, Kool -Aid, whatever,
28:56
that has real sugar, the effects on your teeth.
28:59
But what about something that is diet or zero?
29:02
Oh, you just trying to throw off on me. I'm just,
29:05
people want to know, Cam. Okay, all right. They
29:09
don't know what you drink. Right, okay. Well,
29:12
you know, I think it depends upon the drink.
29:15
But in general, if we're talking about soda,
29:18
even if there's not sugar in soda, there's also
29:21
acid. Yeah, okay. So that's a concern as well.
29:27
And we don't really know completely yet. Research
29:31
tells us some things about the artificial sweeteners.
29:34
So that's a bit of a concern too. Okay. So for
29:39
children and for adults, when should you get
29:42
fluoride treatments? What we teach in the dental
29:47
school, and I think what is accepted, is it depends
29:50
upon the risk of the child. So if the child is
29:55
not able to have good oral hygiene and for whatever
29:59
reason the child's teeth aren't brushed very
30:03
well and they don't have access to a lot of healthy
30:08
foods or maybe they're eating. sugary snacks
30:12
or they don't really you know children can be
30:14
very difficult when it comes to what they eat
30:16
so no judgment i'm just saying you know sometimes
30:20
when a child is not eating the way they should
30:23
or drinking what they should then the need for
30:26
fluoride really increases gotcha yeah cam well
30:30
did you ever eat the little things in school
30:33
that turned your teeth colors and it showed how
30:36
much Taught her a black U .S. closing solution.
30:40
I think I might have done that. Yes. Do you not
30:43
remember that? I will tell you this. I was 51
30:47
before I had my first cavity. What? Say that.
30:52
Wow. I was straight a teenager. 18. Wow. It went
30:57
downhill from there. I know, right? Dr. Stein,
31:00
we are so glad that you've been on the show.
31:02
Thank you for coming. We need to get you back
31:05
to talk more because every time you said something,
31:08
it just pop, pop, pop, pop, something else came
31:10
up. I think I learned more than I know. I thought
31:14
I knew a lot about you. That whole contagious
31:17
cavity. Quit kissing my baby. Go on. Get away.
31:24
Bird feeding. I know, right? All right, guys,
31:28
you have been listening to Look Who's Talking.
31:31
Share the show. Tell your friends. Do what you
31:34
do. We'll see you on the next show.