Tag Archive for 'Dr. Valerie Woo'

Going to the Dentist: Interview with Pediatric Dentist Dr. Valerie Woo (Part 2 of 2)

Dr. Valerie Woo grew up in the local Washington, DC area and received her undergraduate degree at University of Maryland, College Park. She went on to Harvard School of Dental Medicine where she received her DMD cum laude and completed her Pediatric Dental Residency at Children’s Hospital, Boston. Dr. Woo currently practices at NOVA Pediatric Dentistry & Orthodontics, in Ashburn, VA.

This is Part 2 of the interview with Dr. Woo. If you missed the first interview, which covered brushing and flossing, you can read it here.

When should children go to the dentist for the first time?
When the child is between one year and 16 months. A nice rule of thumb is first tooth and first birthday. The American Academy of Pediatric Dentistry recommends that children have their first visit before one year.

Pediatric dentistry is all about trying to prevent anything from ever happening. It’s not just a cleaning. I’d rather not ever diagnose cavities. I did my residency in Boston and all we saw was rampant decay. We can contribute this to both the child’s diet and genetics. The food is all fast and pre-packaged. If you look at why our children are getting sick, why they are getting cavities, you go back to their diet. It’s preventative. That’s why coming to see the dentist twice a year is preventative and so important. Your insurance covers preventative services. Once you get a cavity, it will cost you more, you’ll have to get x-rays of your child’s mouth, etc.

Sometimes people forget that doctors need to examine to make sure that everything is ok. We don’t call it “just a cleaning.”

Prophylaxis is our preventative cleaning procedure. And a “sealant” is the preventive film that we put on the molars to prevent cavities. They get the plastic coating on the 6 year molars and again on the 12 year molars. For the 1 and 2 year molars, if they have very groovy teeth then we recommend them on those. I have sealed the molars of my two older kids, ages 5 and 4.

But I don’t want to give parents the preconceived notion that just because they’ve sealed their children’s teeth that they won’t get cavities. They still need their check ups every 6 months and fluoride treatments. I get that all of the time. Parents ask, can’t I just seal all of their teeth? Sealants are for molars. And it helps prevent cavities, but it does not prevent cavities.

How often should children go to the dentist?
At least twice a year. There are some patients I see 3 or 4 times a year because their parents are very proactive and if I see something in their children’s teeth, they want to bring them in more often. Once you have decay, you’re at a higher risk of decay in the future.

What do you look for when you examine a child’s teeth?
I look for whether the enamel is healthy, how the hygiene is, whether the gums are healthy. We’re always doing an oral cancer screening. We look for any possible indications where there could be difficulty in speech, eating or brushing properly. We also look for when the skin between the teeth and top lip (frenulum) don’t allow parents to properly brush their child’s front top teeth. The frenulum could also be a barrier to nursing.

What is the most common problem you see in children under 5?
Cavities. Usually the majority of my patients with cavities are under 5. Not a lot of my older patients come in with cavities. That’s because when they’re older, they do a better brushing. We also do sealants on the 6 year molars, which helps prevent cavities. Pre-school right before entering school is where we see the most cavities.

Any tips for parents to help make the dentist’s visit a positive one?
Not to make your own fears your children’s. Children are really aware of when their parents are uncomfortable. You can tell that the parent is more worried than the child at times, probably because the parent had a bad experience at the dentist. Children can sense those things.

For more information, check out Dr. Woo’s tips for parents on how to improve the chances of a positive dental office visit via her practice’s website.

What should parents do when/if a child’s tooth is knocked out?
If it’s a baby tooth and it gets knocked out due to trauma, first thing you want to do is find the tooth. Make sure that they didn’t swallow and/or aspirate it, and do not put it back in their mouth. It could look like it got knocked out, but could have gotten shoved further up into their gums. The child will need an x-ray to determine that no part of the tooth is remaining. Make sure to bring the tooth to the dentist.

If it is a permanent tooth, that’s different. If it’s a permanent tooth and it got knocked out, you need to contact your dentist immediately. If the child feels comfortable putting it back in their mouth right way, go ahead and do that and still see your dentist. If it’s dirty after the tooth got knocked out, submerge it in milk until they can get to the dentist.

What questions do you have for Dr. Woo?

-Heather

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Brushing and Flossing: Interview with Pediatric Dentist Dr. Valerie Woo (Part 1 of 2)

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Brushing and Flossing: Interview with Pediatric Dentist Dr. Valerie Woo (Part 1 of 2)

Dr. Valerie Woo grew up in the local Washington, DC area and received her undergraduate degree at University of Maryland, College Park. She went on to Harvard School of Dental Medicine where she received her DMD cum laude and completed her Pediatric Dental Residency at Children’s Hospital, Boston. Dr. Woo currently practices at NOVA Pediatric Dentistry & Orthodontics, in Ashburn, VA.

I had the pleasure of sitting down with Dr. Woo last week, to ask her LOTS of questions about caring for our children’s teeth.  A tremendous thank you to her for taking time out of her very busy schedule to sit down with me and talk about pediatric dental hygiene. In fact, after our interview, Dr. Woo was heading out for a training run for an upcoming marathon. She’s also training for a triathlon. And did I mention that she has three beautiful children? Talk about an inspirational mother!

We also wanted to thank our readers who submitted interview questions via our FaceBook page. We hope you learn as much about pediatric dental hygiene as we did! Tomorrow’s post will be the second part of this interview and will cover “Going to the Dentist.”

When should parents begin to brush and floss their children’s teeth?
Parents should begin “brushing” their children’s teeth before they come in. Always use a washcloth and wipe the gums after a meal because it stimulates the child so that they don’t become orally sensitive. And it soothes the baby when they’re teething.

When their teeth come in, just the sensation (with water) is all they really need. And to make sure that debris is removed from their teeth. The non-fluoridated toothpaste is for flavor only.

Not everybody needs to floss. It’s only necessary when the child’s teeth are closer together. Around age 3 or 4, the 6 year molars are moving the teeth closer together. It’s really child dependent. A good rule of thumb is that you want to be able to clean every surface of the tooth. So if teeth are touching, they need to be flossed. There are also times when you have too much space, and food gets stuck, like corn on the cob.

How often should parents brush/floss children’s teeth?
You always want to develop good habits, even before the teeth come in. Brushing twice a day and flossing at least once a day (once they have teeth) is always recommended. With my kids, we always brush in the morning. I get each child into the routine of putting the toothbrush in their mouth. It’s about getting them more into the routine. As they improve their dexterity, they can begin brushing on their own.

When can children brush their own teeth?
A good rule of thumb is that they can start brushing their teeth on their own when they can tie their own shoes (around age 6, 7 or 8). Nowadays with all of the laceless shoes, some kids lack the dexterity until they’re about 8 years old. Let them have a turn first and then you, the parent, go in after. They tend to miss the spots in the back.

What kind of toothpaste should parents use?
I recommend Non-fluoridated toothpaste until age 2 ½, and then I recommend the toddler toothpaste, which has less fluoride (than regular adult toothpaste). Around age 6 or 7 the children can move up to normal toothpaste, once they perfect spitting. I like the fluoride rinse. The child can dip their toothbrush in and then brush their teeth.

Do you have any tips or advice for parents whose children refuse to have their teeth brushed?
Just like anything else, when you take them to have a haircut or give them a bath, try to make it as fun as possible. And switch it up. Switch up the location. You don’t have to brush their teeth in the bathroom, you can do it at the kitchen sink, or in the child’s bed. After breakfast, if your child doesn’t want to go back upstairs to brush their teeth, put a toothbrush downstairs. Use books or something other than food as a reward.

Is fluoridated toothpaste necessary/recommended? What if my water is fluoridated too?
The fluoride in the water helps strengthen the teeth that are developing. For example, a 3 year old, who has baby teeth, the fluoridated water is strengthening the adult teeth that are developing in their gums. The topical fluoride toothpaste helps strengthen the teeth already in the mouth, the baby teeth. Drinking fluoride water won’t help any weak enamel in baby teeth.

I see some kids with brown spots on their teeth. Their teeth start developing at 7 weeks when you’re pregnant. So the brown spots usually mean that mom was sick, took antibiotics, etc., when they were pregnant. But what is a mom to do if she gets sick when she’s pregnant? She’s not not going to take the antibiotic. The brown spots end up being markers of indicating when the “insult” occurred to the mom, and thus, the baby’s teeth. When we see white snow-flake spots or brown spots in their adult teeth we know that something systemic has happened to the child since they were born. That’s why sometimes parents think that it’s decay because it can all look similar. It’s called enamel hypoplasia.

What if my child swallows fluoridated toothpaste?
Research shows that even 8 year olds are still swallowing the toothpaste. Depending on your child’s weight, a normal 3 year old is 30-something pounds. In order for it to become toxic, a child would need to eat 3 large tubes of toothpaste. And it’s not cumulative. That’s why they don’t make larger tubes of toothpaste, because it’s regulated. You’d have to eat 3 large Costco size tubes of toothpaste before it gets toxic. Some kids are more sensitive to fluoride. If they swallow a little bit they’ll throw up. I don’t have a lot of that, but sometimes it does happen. Just makes them nauseous. But it’s not toxic.

What can parents do to ensure that their children have healthy teeth?
Brushing, flossing, healthy diet.

What brushing and flossing challenges do you face with your children?

-Heather

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