My Blog
By Abraham I. Green MD FAAP
June 18, 2019
Category: Child Health
Tags: Diabetes  

If your child has just been diagnosed with diabetes, it’s important that you have a pediatrician you can turn to in order to create a customized and effective treatment plan. While diabetes cannot be cured, diagnosing, and treating your child’s diabetes as soon as possible is key to helping them maintain a long, healthy and happy life.

There are two different kinds of diabetes: type 1 and type 2. Type 1, also known as insulin-dependent diabetes, usually happens during childhood. This autoimmune disorder occurs when the body attacks the pancreas so that it doesn’t produce insulin. Type 2 is the most common form of diabetes in adults; however, children can also develop type 2 diabetes.

Unfortunately, with the increase in childhood obesity our doctors are seeing a rise in type 2 diabetes in children, as well. The pancreas of children and teens with type 2 diabetes does produce insulin but the body just doesn’t properly respond to it.

Symptoms of Diabetes

Both types of diabetes often present with the same symptoms including:

  • Fatigue
  • Increased hunger and thirst
  • Frequent urination
  • Blurry vision
  • Sores and cuts that don’t heal properly

Other symptoms may include:

  • Mood swings
  • Irritability
  • Unexpected weight loss
  • Numbness or tingling

Treating Type 1 Diabetes

There is no cure for type 1 diabetes. Since your child’s body doesn’t produce insulin this means that they will need to receive daily insulin injections. Along with taking these injections, you will need to monitor your child’s blood sugar every day to make sure their levels aren’t too high or don’t drop too quickly.

Treating Type 2 Diabetes

Even though children and teens with Type 2 diabetes produce insulin, the body doesn’t respond properly to it. Because of this, your child will need to take daily medication to maintain healthy glucose levels. As with type 1 diabetes, daily blood sugar monitoring is necessary to make sure that the medication your pediatrician prescribed is effective.

Along with taking medication, there are certain lifestyle modifications that can also go a long way to controlling your child’s type 2 diabetes. In fact, sometimes type 2 can be reversed with a healthy diet and regular exercise alone, depending on the severity. Lifestyle modifications include:

  • Eating a healthy balanced diet
  • Limiting sugar and carbs, which can spike blood sugar
  • Getting at least 30 minutes of exercise a day most days of the week
  • Losing excess weight and maintaining a healthy weight

If your child is experiencing symptoms of diabetes or if you have questions about the best way to treat your little one’s diabetes don’t hesitate to contact your pediatrician for an appointment.

DontStressOverYourChildsTeethGrindingHabitUnlessitPersists

Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.

But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.

Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.

While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.

But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.

You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.

At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.

If you would like more information on your child’s teeth grinding habit, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?

HealthySmilesforAlfonsoRibeiroandFamily

If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."

Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:

  • Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
  • Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
  • Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
  • Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
  • Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.

Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.

If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

Implant-SupportedDentures-aBetterFitwithExcessiveBoneLoss

Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.

But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.

Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.

Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.

On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.

If you would like more information on dentures supported by mini-implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The ‘Great’ Mini-Implant.”

ProsandConsforFlossingBeforeBrushingandVice-Versa

For best results in cleaning your teeth of disease-causing plaque you need both the power of brushing open teeth surfaces and flossing in between them. But you may be wondering: should you perform one task before the other?

In general terms, no—there’s no solid evidence that flossing is better before brushing, or vice-versa. But that being said we do recognize each way has its own advantages.

If you floss before brushing, it’s possible you could loosen plaque that can then be easily brushed away when you perform your second hygiene task. Flossing first can also reveal areas that need a bit more attention from brushing if you suddenly encounter heavy particle debris or you notice a little bit of blood on the floss. And, by flossing first you may be able to clear away plaque from your tooth enamel so that it can more readily absorb the fluoride in toothpaste.

One last thing about flossing first: if it’s your least favorite task of the two and you’re of the “Do the Unpleasant Thing First” philosophy, you may want to perform it before brushing. You’re less likely to skip it if you’ve already brushed.

On the other hand, flossing first could get you into the middle of a lot sticky plaque that can gum up your floss. Brushing first removes a good portion of plaque, which can then make flossing a little easier. With the bulk of the plaque gone by the time you floss, you’ll not only avoid a sticky mess on your floss you’ll also have less chance of simply moving the plaque around with the floss if there’s a large mass of it present.

It really comes down to which way you prefer. So, brush first, floss last or vice-versa—but do perform both tasks. The one-two punch of these important hygiene habits will greatly increase your chances for maintaining a healthy mouth.

If you would like more information on effective oral hygiene, please contact us or schedule an appointment for a consultation.





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