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Tooth decay has increased among U.S. preschoolers, leaving them far more likely to develop oral health problems as adults. The most effective thing that parents can do to prevent tooth decay is simple: brush their child’s teeth twice a day. However, efforts to promote twice-daily toothbrushing through parent and child education have been met with little success. The barrier that parents report most often is child non-compliance or refusal. Dr. Brent Collett is pursuing a new tactic, focusing on parents’ use of behavior management skills.
“When you think about it from the child’s perspective, toothbrushing is pretty intrusive,” Collett says. “It is not surprising that child refusal is common. Many parents get worn down by their child’s tantrums, and begin to question whether it’s worth the battle. Our goal is to identify effective and practical strategies that parents can use to overcome these behavior problems.”
As a first step toward this goal, Collett and Dr. Matt Speltz are conducting an observational study to characterize child and parent behaviors during toothbrushing. For their study, they set up an observation room at the Center for Pediatric Dentistry. Parents who volunteered to participate in the study were first asked to read or play with their child. Then, when prompted by a researcher, they transitioned to brushing their child’s teeth as they would at home.
“We tried to mimic a typical toothbrushing routine, which usually involves transitioning away from something that the child would much rather be doing,” Collett says. Even though parent and child behaviors were likely somewhat constrained, given that they knew that they were being observed, the variety in child and parent behaviors has been notable. For example, some parents have very clever strategies to engage their child by taking turns or using distraction (e.g., singing a toothbrushing song), which minimize child behavior problems before they start. When faced with child refusal, some parents react to their child’s tantrum with gentle persistence while others seem to give up quickly.
“We’re definitely seeing that there are many ways for parents to be successful, or unsuccessful, in accomplishing this task,” Collett says.
Collett and Speltz’s team is now developing a coding system to categorize parent and child behaviors from these observations. This coding system will serve as a measure of oral health behavior, and as a way to identify promising “targets” for behavioral intervention. In collaboration with researchers at the University of Washington, they are also developing an intervention that would provide parents with “coaching” in the use of effective behavior management skills.
The next step will be to test this intervention on a large number of families to determine whether it has a meaningful effect on behavior and oral health. Collett hopes to eventually be able to offer evidence-based techniques that are proven to help parents break through behavior problems and succeed in brushing their kids’ teeth.
“If we can prevent tooth decay among preschoolers, we believe that we can have a pretty dramatic impact on their future health,” Collett says.
For Collett, a psychologist who sees patients at Seattle Children’s Early Childhood Clinic, the research fits into his larger goal of helping parents improve their kids’ behavior in ways that benefit their health. But he doesn’t pretend that it’s easy – Collett has two young children of his own, and plenty of first-hand experience trying to persuade reluctant toddlers to brush their teeth.
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As you are probably aware, there is widespread news coverage involving the investigation of an Oklahoma oral surgeon for allegedly poor infection control practices and delegation of dental procedures.
- I want to assure you that in my dental practice, we follow stringent infection control procedures. The Centers for Disease Control and Prevention has developed special recommendations, which we follow, for use in dental offices. Studies show that following proper infection control procedures greatly reduces risk to patients. Let me describe just a few of the things that we do in my practice in terms of infection control:
• All dental staff involved in patient care scrub their hands before each and every patient and use appropriate protective garb such as gloves, masks, gowns and eyewear
• A new set of gloves and masks are used for each patient.
• Before you enter the examining room, all surfaces, such as the dental chair, instrument tray, dental light, drawer handles and countertops, have been cleaned and decontaminated.
• Non-disposable dental instruments are cleaned and sterilized between patients. In my office we sterilize instruments using an autoclavethat is tested weekly.
• Disposable items like needles or gauze are placed in special bags or containers for special, monitored disposal.
Your well-being is important to me and my staff, which is why we follow stringent infection control procedures and comply with all state regulations for the protection of patients.
- Also, as your doctor, I would only delegate procedures to my staff that they are licensed or qualified to perform per state regulations. I care about my patients and your health and safety are my foremost priorities.
PLEASE ask about our sterilization procedures if you have any questions or concerns. 360-779-3958
Healthy snacking tipsfrom your friends at Modern Dentistry!
Choose whole foods, such as fruits and vegetables for a healthy snack. Try sticks of celery and dip it into all-natural peanut butter, or a juicy and crunchy apple cut into wedges. If you or your child is in orthodontic treatment, aim for softer fruits and vegetables instead to avoid damage to their braces.
Drinks are another murky area. Often time’s patients presume that fruit juices are an acceptable beverage when in reality many of them are loaded with excessive sugar. The best beverages for your teeth are water and low-fat milk. Milk has the added benefit of containing calcium, which is highly beneficial for the bone structure that supports the teeth.
An apple a day might keep the doctor away, but it is also a great snack to keep teeth healthy. The next time you’re looking for snack lean toward healthier, low-sugar options that are beneficial to your overall health and teeth.