Q. Dear Doctor,
My child has lost some baby teeth from tooth decay. My general dentist wants me to see an orthodontist to discuss keeping the space. Could you explain to me why this is important?

A. Dear Sarah,
Your dentist and orthodontist understand the complex dynamics of growth and development of the jaws. What is essential for you to know is that the baby teeth also serve a very important function of maintaining space. If they are lost prematurely, the spaces created can dramatically shrink becoming smaller and smaller, leaving insufficient space available for the permanent (adult) teeth. As soon as the six-year molars have erupted into the mouth, it is important not to let them drift forward into the spaces created by premature loss of baby teeth. A “space maintenance appliance,” a type of “retainer,” can be used which can also help socially if the missing tooth or teeth show. If the spaces are not prevented from shrinking, the permanent teeth will come in crowded or crooked. As your child grows and matures these misaligned permanent teeth could necessitate prolonged orthodontic treatment (braces) with consequent greater financial impact.
Maintaining space is therefore to your advantage. It is unfortunate that your child has lost his/her baby teeth earlier than normal, but as you can see space maintenance can be critically important. If your child ultimately needs orthodontics to straighten his/her teeth, the possibility of needing further teeth extracted will be a reduced. Moreover, a beautiful smile could be compromised by not maintaining space should the baby teeth be lost prematurely. Be sure to ask you dentist or orthodontist about what to do if your child has to lose a baby tooth prematurely.

Review Date: 8/1/2007
Authored By: Dr. Barry Kayne
Reviewed By: Dr. Garry A. Rayant, Editor-in-Chief, Dear Doctor, Inc.

Reprinted with permission. This content provided is for general informational purposes only. No action should be taken by you based on this content. We urge you to consult with your dental health professional on all matters relating to you and your family’s dental health. Copyright ® 2011 Dear Doctor, Inc.

• Heart Disease is the leading cause of death for American women
• Cardiovascular disease makes up over 35% of deaths in women over 20 years old
• Heart attacks kill 5 times more women than breast cancer does every year
• More than half of heart attacks in the U.S. occur in women
• 2/3 of women who have a heart attack never fully recover

But the good news is that you can reduce your risk of being one of the numbers in the stats above. How? With diet and exercise of course! Which to be honest, we should all already be incorporating into our daily lives. Regular exercise helps ward off heart disease, stroke, high blood pressure, and stress—all of which promote heart health.  You don’t have to be a crazy obsessive workout addict to have a healthy heart; you just need to incorporate as much activity into your day as possible. Aim for getting 30 minutes, five days a week of moderate-intensity activity. On the days that you absolutely cannot workout, you should at least try to get up and take a walk; loop around your building at work, leash up your dog, put your baby in the stroller and get some fresh air, or grab your loved ones after dinner and take a lap around your neighborhood (which has an added bonus of helping you digest your meal).  As for your diet, it doesn’t have to be extreme either, just make conscious decisions when planning meals. Try to limit eating out; when you cook at home you have the ability to control portion size and nutritional content. In general, try to eat a diet high in fruits and vegetables, and low in saturated fats.

So remember, February 14 may be a day to celebrate your loved ones, but every other day should be to celebrate and love yourself! Your heart is important and if you don’t show it love then you may face some frightening realities that too many women in the U.S. have to battle.

For more information on American Heart Month or for resources to get a jump start on your healthy life, visit the American Heart Association.

Now more than ever, teaching proper oral health habits to children in their early years is of utmost importance.  Simple measures, such as brushing and flossing regularly, and getting fluoride treatments, have proven effective in preventing oral diseases.  In line with the celebration of  National Children’s Oral Health Month,  several of our Smile Generation-approved offices are conducting Oral Health Presentations in different schools and community centers.

In Texas, Sugar Land Modern Dentistry & Orthodontics and My Kid’s Dentist recently did a presentation Primrose School, and for the Fluor Daniel Corporation at Girlfriends and Giggles.  They will also be presenting at First Baptist Academy on February 16^th.

At Every Kid’s Dentist in Arizona, offices in Peoria, Desert Ridge, Laveen, Casa Grande, Queen Creek , Phoenix and Tempe are doing presentations all month long.  Recently, Every Kid’s Dentist in Peoria, participated in the City of Peoria’s 100th Birthday event at the Centennial Park in Downtown Peoria. They handed out toothbrush kits, Frisbees and other promotional items. Some children even took turns practicing brushing Dudley the Dragon’s teeth.

Also in Arizona, Every Kid’s Dentist in Laveen, participated in the Scooptacular Family Fun Safety Event. Scooptacular, a local ice cream shop, hosted the event in the parking lot. The Laveen Police Department was present as was McGruff the Crime Dog.  Children took turns spinning the EKD prize wheel for some neat prizes like Frisbees, and water bottles. Toothbrush kits were also handed out.

Laveen Modern Dentistry in Laveen, AZ participated in the Scooptacular Family Fun Safety Event for kids.

Officer McGruff The Crime Dog was on hand at the event as well.

Here are their next stops. The Every Kid’s Dentist teams in Arizona will be conducting dental health presentations at these schools on corresponding dates.

2/13 Desert Harbor

2/15 Toltec Harbor

2/16 Copper Canyon Elementary

2/17: Cambridge Academy East

2/21: Paseo Hills Elementary

2/22: Bridges Preschool

2/27: Sierra School

2/28: Paseo Hills

2/29: Brisas Kid’s Club

Meanwhile in San Diego, Tierrasanta Dental Group and Stonecrest Dental Group are offering free fluoride for all pediatric patients at no charge to them or their insurance for the month of February. Dr. Katayoun Afshar and office manager Kevin Schieffer will be at Christ Church Day School to donate 100 toothbrushes on Thursday, February 23^rd.

To find out more about oral health presentations in your area, please read our blog and connect with us on Facebook and follow us on Twitter.

I know it doesn’t seem like a big deal if you don’t get your eight glasses in every day, but it is a big deal. According to Dr. Sam J. Romeo, CEO of Romeo Medical Clinic, Inc., “Drinking the right amount of water daily can lead to better decision-making skills and concentration, elevated moods and improved coordination.” Yet half of us are at least moderately dehydrated on a daily basis. Pretty scary, huh?

Another crazy fact about hydration is that it can play a huge factor in weight loss and healthy diets. If you’re dehydrated, chances are when you go for a snack, you aren’t really hungry; you’re actually thirsty. However, we like hearing the message that we’re hungry rather than thirsty, so we act on that cue more often. Next time you feel the urge to grab a snack, drink a glass of water first. My bet is when you’re done with the water, you won’t feel hungry anymore and you’ll pass on the snack.

So what if water just sounds too terribly boring for you to get 64 ounces down every day?

Here are some suggestions:

-  Add cucumber and lemon slices to your water—not only is it refreshing, it’s great for your skin and is detoxifying.

- Add a tea bag, but do not add sugar or honey, just drink it hot or iced. I recommend Celestial Seasonings tea in Cinnamon Apple Spice or Country Peach Passion, they are perfect iced and don’t need any sweetener.

-  Make it a game: you don’t get to eat until you’ve downed a glass.

In 2012 we’re sponsoring races in Los Angeles, Las Vegas, Sacramento, Newport Beach, Denver, Phoenix, Dallas and Temecula.

The first race will take place in Los Angeles on March 24^th, 2012, Saturday at Dodger Stadium.  We invite you to support this great cause that raises funds for breast cancer prevention and research.  You can sign up for our Smile Generation Team Page and invite your friends and family to join too. Team members can run or walk the 5K starting at 9 am. Registration fees include a Komen Race t-shirt, race entry bib, and the new Smile Generation Breast Cancer Awareness t-shirt.  The registration fees are as follows: $40 for adults, $35 for  youth and seniors, $30 for kids in stadium fun run, $30 for survivors, and if you want to skip the race but still be part of the team, you can donate $40 for sleep in for the cure.

According to the Smile Generation’s We Serve (Outreach) Manager Kyle Guerin, “We sponsor Race for the Cure because we care and we listen to what’s important to our followers and teammates.  It’s hard to find someone who has not been directly affected by breast cancer whether that’s someone’s Grandma, Mom, or Daughter.  People who are involved with Susan G.  Komen are passionate about finding a cure and so are we. “

Answer by Dr. Darbro: “I am here to help think through this problem with you. As I, understand it, you have tooth pain that happens at times, sometimes when you eat. You want to know if this is a dental emergency and what you can do until you can visit the dentist.

I think you bring up a good question, namely, what does a dental emergency look like and when should you call the dentist for an emergency appointment? Let me start there.

I like to define a dental emergency as something that has happened that significantly impairs the function of your mouth. Cracked teeth that are avoided when you chew, a crown that has fallen out, pain when you eat, a toothache that keeps you up at night, all mean a special visit to the dentist to evaluate the problem. At times, a small pain in the tooth can also mean a big problem. Sometimes someone with significant dental disease can continue for months and sometimes years with no pain whatsoever. So a “sometimes” pain that is impairing your ability to chew is a concern that should be addressed by a dentist right away.

A tooth that sometimes hurts could be suffering from a number of different problems. Some of the problems that cause this kind of pain are serious and require dental treatment. Fillings, crowns, root canal and even extraction could be necessary to fix the tooth. The earliest a dentist can diagnose the problem, the more likely the treatment will be less involved. The sooner you have a dentist evaluate the problem, the better.

Seeing a dentist immediately would be ideal, but sometimes life events and dentist availability can delay dental visits. Here are some tips that can help you care for the tooth before you can get in to see the dentist.

• Keep the tooth as clean as you can, but clean it gently. Don’t experiment around with different chemicals to try to fix the problem. They usually only make it much worse.
• Do avoid chewing in that area. Go on a soft food diet. If a tooth hurts when you chew, it may be cracked. More use of the tooth may cause the tooth to further crack.
• Monitor what happens when the tooth begins hurting. Does it hurt at night? Does it hurt all the time? Only when you chew certain foods? All of this information may be very helpful to the dentist when you do get an appointment.
• If necessary take over-the-counter medications (if you can take them). Don’t attempt to take too many, if the pain persists. Taking more over the counter pain relievers than recommended is becoming a big problem. If the pain continues, don’t take more, see a dentist.

I hope this helps. I do hope you find resolution to your tooth problem, and can return to eating pain free.”

*Dr. Matthew Darbro practices at Glendora Smiles Dentistry and Orthodontics, a Smile Generation-approved office, in Glendora, CA.

So what do you need to do? As with every event focused around eating, or any day for that matter, start it off with an intense sweat session. Not only will you have burned a ton of calories but you’ll feel better and without even trying, you will subconsciously be more health-aware and make better noshing choices. It is also important to make sure you eat a hearty, healthy breakfast and drink plenty of water leading up to the big party. If you show up starving and dehydrated then you’re setting yourself up for failure because you will devour everything in sight, landing yourself in a food coma by kickoff. Do these simple steps, and of course use moderation once you’re at the party, and you’ll be able to enjoy your time without feeling guilty afterwards.

As far as what to bring to the party you’ve been invited to, check out some of my favorite healthy food bloggers who share their great low-fat, low-calorie versions of everyone’s favorite Super Bowl snacks:

Eat Yourself Skinny’s Skinny Super Bowl Snacks
http://www.eat-yourself-skinny.com/2012/01/skinny-super-bowl-snacks.html

Dashing Dish’s Super Skinny Pizza Pinwheels (check out her other recipes too, great finger-food ideas)
http://www.dashingdish.com/2012/02/super-skinny-pizza-pinwheels/

Fitbie’s The Super Bowl of Healthy Food Swaps
http://fitbie.msn.com/slideshow/super-bowl-healthy-food-swaps

So go enjoy yourself this Sunday and feel good about it! Remember, you’re there more for the party than the game (whoops, maybe that’s just me) so try to spend more time chatting and catching up with friends than stuffing your face.

Our Smile Generation-approved offices are celebrating NCDHM by creating WALLS OF FAME in their offices. Children are invited to fill in coloring sheets that will be displayed on the wall. You too can print out the coloring sheet and share with your child the importance of brushing and flossing daily.

Print this image for some coloring fun!

Here are a few more fun activity sheets that will encourage your young ones on the road to a healthy smile!

What a Tangle Activity

Word Decoder

Crossword Puzzle

Words Activity

Word Search

The American Dental Association (ADA) is the oldest and largest national dental society in the world. Our Smile Generation-affiliated dentists are proud members of the ADA. For more information about National Children’s Dental Health Month and other fun activities,  visit the American Dental Association.

The author (third from left) with her parents after completing the Disneyland 1/2 Marathon

There are numerous resources available to help you properly train for your first, or really, any race. A quick search online will bring up sample training plans for any distance race with various time lengths. That way you can pick the perfect one for you; whether you have eight weeks or eight months until your race. Another route you can take is training with a team. For my second half marathon I trained with Team in Training (TNT). We not only had scheduled training runs, but we also raised money for the Leukemia and Lymphoma Society. I highly recommend training with a team. It’s a great way to meet new people and make sure you’re staying on track and building your mileage at an appropriate rate. Plus, on race day you’ll have hundreds of teammates, coaches, mentors, and supporters all along the course cheering you on; as well as several people you’re used to running with by your side from start to finish.

For my second and third half marathons, I trained with TNT. I felt extremely prepared for my second race, until I woke up the morning before the big day with a bad cold. Even though I felt horrible and drained on race day, since I had trained properly, I still finished about 20 seconds faster than my first half marathon. For my third race, I again was well prepared thanks to TNT, and was able to shave five minutes off my time.

My fourth half marathon is this coming weekend and I am kicking myself for not signing up to train with a team because I did a horrible job training and do not feel prepared for this race. Will I finish? Yes. Will I enjoy it? Probably not, but that’s my fault. As I stated earlier, when you properly train for these races, the event is that much easier on your body physically and mentally. One thing that is often overlooked in physical challenges such as marathons is the psychological aspect. I would argue that this is the toughest part. Knowing you are as prepared as possible and you have a huge support team at your side, is more comforting and empowering than you could imagine.

So take my word for it, don’t set yourself up for a miserable challenge on race day. Take every measure to make sure you are bringing your “A” game to the starting line. Your body and your mind will thank you.

Here is what our featured dentist wrote in reply:

“Hi, my name is Dr Matthew Darbro, and I am here to help. As I understand it, you are terribly afraid of the dentist, but now you have a toothache that is actually really hurting.  As I see it, there are two problems here, your need for tooth pain relief and your fear of the dentist.

Let’s talk about fear this fear of the dentist first. The fear of the dentist can take many forms and can be caused by many things.  My recommendation is to consider what precisely triggers your fears and find methods to overcome that fear.

Many people who suffer from dental related fears are actually suffering from a form of post traumatic stress disorder because they had a traumatic experience in their past. I have found that their fear usually manifests during one part of the dental appointment. I have treated patients who were not afraid of the drill but completely afraid to have their teeth polished. I have treated patients who have been afraid of getting numb but were not at all afraid of the drill. Take a minute, and think of what it is that causes that fear. When you do go in to meet a dentist, let the team know what fears you have. Most teams are very sensitive to these fears.

Dental fear has also centered around lack of understanding of dental procedures and lack of trust. I would recommend that you meet dentists and dental professionals and find a team you feel comfortable with, someone you trust, and talk about your specific fears. There are all kinds of little tricks to make the anxious dental patient have a great appointment. The key is to talk to the dental team that is serving you and let them know, so they can be sensitive to your needs.

There are a number of pharmacological routes to take away the fears of dental work, but there are some less invasive methods as well. Headphones, for example, help some people to get their mind off the procedure. The best solution, in my opinion,  is to overcome your fears and find a dentist you can return to regularly with little emotional stress.  In the end, overcoming your fears and having regular dental appointments will mean a healthier you.

The second issue is your tooth. Your tooth is hurting and it is telling you that something has happened that is dreadfully wrong and it needs to be fixed. Bad things happen in the mouth and many times patients don’t feel any pain, but when extreme dental pain arises, this is an emergency. Please take the time for yourself, find a dentist you can trust, walk through your anxieties with this dentist and let him or her help you.

In the end, a dentist does what people cannot do for themselves. They serve their patient base keeping them healthy and happy and pain free. Find a dental team that you trust and care for all your dental needs.”

*Dr. Matthew Darbro practices at Glendora Smiles Dentistry and Orthodontics, a Smile Generation-approved office, in Glendora, CA.