Healthy Living in the North

Helping your child embrace the open cup

Caribou mascot in front of oral health poster

For a lifetime of healthy smiles, let your child drink from a lidless, regular cup.

Sippy cups are popular with parents and preschoolers alike. Many parents find comfort in knowing that there will be less mess with these spill-proof cups. They sure are handy for families on the go!

But did you know that drinking from an open cup, rather than a sippy cup, helps kids develop good tongue movements needed for speech? It may also encourage more communication and interaction, helping kids learn new sounds and words! There are also worries about dental health and nutrition if kids have regular access to sippy cups with drinks other than water. When kids carry around their sippy cups (as they often do) they tend to sip their drink over long periods of time, leading to cavities and ruined appetites.

So, how do families balance this information with the realities of everyday life? Adults play an important role in deciding what drinks to offer kids and the manner in which they are offered. Many parents find it helpful to try limiting the use of sippy cups for times when mess is an issue, like on your neighbour’s new white carpet! Or, try filling sippy cups with plain water rather than juice or milk to help prevent cavities. Whether it’s an open cup or a sippy cup, children do best with regular, sit-down meal and snacks and water in-between to satisfy thirst.

Here are some tips to help encourage the use of open cups:

  • Remove the valve on the sippy cup to help children learn to drink without sucking.
  • Use small cups that are easier for children to hold.
  • Bring home a new, special cup or let your child pick one out from the store.
  • Sit and eat with your child so they can see you drink from an open cup.
  • Avoid distractions such as toys, TV, or computers when eating or drinking to help your child focus on the task at hand.

With your example, and lots of chances to learn, children will master and enjoy drinking from an open cup in no time!

Emilia Moulechkova

About Emilia Moulechkova

Originally from the Lower Mainland, Emilia started her career with Northern Health as a dietetic intern in 2013. Since then, she has worked in a variety of roles as a Registered Dietitian with the population health team. In her current role, she supports schools across the north in their efforts to promote healthy eating. Emilia is passionate about food’s role in bringing people and communities together, and all the ways it can support physical, mental, and social health. Her overall philosophy on healthy eating can be summarized by this Ellyn Satter quote: “When the joy goes out of eating, nutrition suffers.” In her spare time, she loves exploring the beautiful northern outdoors by foot, skis, bike, or canoe!

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Baby teeth: Why they are important

Spirit mascot in front of poster

You can keep your child’s teeth healthy by brushing them in the morning and before bed, starting as soon as those teeth erupt. Use a little smear of toothpaste that has fluoride in it.

They eventually fall out and are collected by the tooth fairy anyways, so why are baby teeth so important?

Healthy baby teeth are important for many reasons:

  • Baby teeth hold the space for the replacement adult teeth.
  • Baby molars will not fall out until your child is about 12 years old.
  • Early loss of a baby tooth may cause the movement of the other teeth, possibly resulting in crowding or bite problems.
  • Baby teeth are important for appearance, proper chewing of foods, and speech.

But, since those baby teeth are not meant to last a lifetime, their outer covering (enamel) is not as thick or hard as the enamel on adult teeth. The enamel in the first 18 months after a tooth erupts is fragile and can decay very quickly.

Why does this matter? Just like in adults, tooth decay in our kids may cause pain, infection, difficulties chewing, problems sleeping or concentrating, and poor self-esteem. Tooth decay is largely preventable. Health care providers, child care providers, and parents can all work together to spread healthy messages regarding oral care and we can all model behaviours that can lead to a reduction in tooth decay and oral health problems.

You can keep your child’s teeth healthy by:

  • Brushing your child’s teeth in the morning and before bed, starting as soon as those teeth erupt. Use a little smear of toothpaste that has fluoride in it.
  • Do not put your child to bed with a bottle or, if you do, offer only water in the bottle.
  • Help your child to learn to drink from an open cup (not a sippy cup). This can be used for small sips of water starting at 6 months and for milk starting between 9-12 months.
  • Limit how often your child gets sticky, sugary foods and drinks. Children one year and older benefit from 3 meals and 2-3 snacks per day. These should be spaced 2-3 hours apart. Choose a variety of healthy foods that do not stick to the teeth.
  • Make an appointment for your child’s first dental appointment by their first birthday or about 6 months after their first tooth erupts.
  • Lift your child’s upper lip once a month to check for any whitish marks on the teeth which may be the start of decay.
  • Avoid saliva sharing habits like using the same spoon.
  • Parents should have any decay treated to reduce the chances of passing on the cavity causing bacteria to their child.
Brenda Roseboom

About Brenda Roseboom

Brenda was born and raised in Terrace. She has worked in the community first as a certified dental assistant and then as a hygienist. After being in private practice for many years, she joined the Northern Health dental team in May of 2016. Brenda enjoys gardening, quilting, and many other crafting hobbies. The beauty of B.C. continues to amaze her and keeps her rooted in the north.

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Oral Health Month: Working in the Emergency Dental Outreach Clinic

Spirit the caribou in front of baby teeth poster
I am very grateful to have been given the opportunity to be involved in the Emergency Dental Outreach Clinic (EDOC) as the clinic coordinator. It’s an amazing clinic where our services are extremely valued. This year, EDOC was even nominated for a Healthier You Award in the Outstanding Multicultural Contribution category! With Oral Health Month now upon us, I wanted to take this chance to tell you a little more about this special service.

What is the Emergency Dental Outreach Clinic?

EDOC is a not-for-profit clinic that was started in 2006 by Carole Whitmer, RDH, and Dr. Richard Wilczek as they sought to remove barriers for community members without access to dental care.

There are 20 not-for-profit clinics in B.C. and, apart from coordinator support offered by Northern Health, the clinic in Prince George is the only one that operates strictly with the support of volunteers. I think this speaks volumes to the amazing Prince George dental community! This clinic is only possible because of community partnerships between the local dental community, the Native Friendship Centre (who provide free space, accounting, utilities, and security), and Northern Health.

What do we do at the clinic?

The clinic provides a place for people to go to have emergency dental care free of charge. It is an extraction service only and runs in the evenings on the second and fourth Tuesday of every month out of a clinic in the Native Friendship Centre (1600 3rd Avenue, Prince George). Although free of charge, we gratefully accept donations, which help cover the cost of supplies.

Who uses EDOC services?

The people who access EDOC come from a variety of backgrounds and locations, but the common thread is a need and appreciation for the no-barrier access to emergency dental care. We have many repeat customers and there is a sense of community and caring amongst those waiting. A few months ago, on one of the coldest nights of the year, one of our clients left after his extraction only to return with a “Take 10” of Tim Hortons coffee for the dental volunteers and those still waiting for care! Even though those who use the clinic face financial challenges, what I’ve seen is that they gratefully donate what they can for the treatment provided.

EDOC is a much needed and appreciated program that serves the Prince George and the outlying areas – I feel lucky to be a part of this great program!

Jane Bartell

About Jane Bartell

Jane works at Northern Health as the Emergency Dental Outreach Clinic coordinator and as a community dental hygienist, travelling to many communities in the northern interior. Her passion is to have children in the north grow up as healthy as possible, especially from a dental perspective. In her spare time, Jane most enjoys spending time with family and friends hiking, snowshoeing, and skiing on the amazing trails around Prince George. She also enjoys the great music culture that Prince George offers.

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Oral Health Month: Caring for the health of our children’s teeth!

Spirit the caribou entering fluoride varnish clinic

Brenda and her colleagues offer free dental assessments and fluoride varnish applications to children ages 0-6.

Most adults realize having strong, healthy teeth is important. But did you know that having healthy baby teeth is just as important? Childhood tooth decay may result in pain and infection. Pain impacts your child’s ability to chew, sleep, and concentrate at school. Active decay also increases the risk of cavities in adult (permanent) teeth.

The good news is childhood decay is very preventable, but it does require a few good daily habits such as daily brushing with a fluoride toothpaste and healthy feeding practices.

My Northern Health regional dental program colleagues and I work to educate parents and caregivers to prevent decay in children’s teeth. We offer oral health instruction, feeding tips, and fluoride varnish applications. We want to teach the public how the systemic use of water fluoridation improves the dental health of a community. Finally, we teach community partners and other health care providers prevention strategies to ensure that good dental messaging is being presented by all sorts of different people and different professions involved in the care of our children. Our partners are nurses, early childhood care providers, and parent groups – and our education helps to ensure that they have accurate dental messages to provide to their community.

For many families in our region, it isn’t always easy to access a dentist’s office. My colleagues and I in Northern Health’s dental program aim to encourage a family’s relationship with a dentist and support the parent or parents to make changes that can reduce the risk of tooth decay for their child. We offer free dental assessments and fluoride varnish applications to children ages 0-6. The fluoride varnish helps to stop or lessen tooth decay and is used by Northern Health to reduce the rate of childhood cavities.

Since joining the dental team in the spring of 2016, I have come to realize how great the needs concerning early childhood caries are. From 2010-2014, for example, 1,504 children in northern B.C. required treatment in hospital operating rooms for dental work. This is three times higher than the provincial average and uses valuable hospital time and resources.

I provide fluoride varnish clinics two times a month at the Terrace Health Unit and once a month at the Kitimat Health Centre. Come see me! In addition, I am available to do clinics at other locations and provide education for parent groups and caregivers. My greatest reward is being able to offer encouragement to those who need it, providing advice on changing a habit, or having a reluctant child get to the point where they can have a complete exam and any necessary dental work done in a dental office instead of in the hospital!

I hope that by sharing what I’ve learned and what I do with the dental team, I will motivate parents and those involved with caring for our children to value children’s dental health. Modelling good behaviours and providing daily brushing with a fluoride toothpaste can result in better dental and oral health for children.

Brenda Roseboom

About Brenda Roseboom

Brenda was born and raised in Terrace. She has worked in the community first as a certified dental assistant and then as a hygienist. After being in private practice for many years, she joined the Northern Health dental team in May of 2016. Brenda enjoys gardening, quilting, and many other crafting hobbies. The beauty of B.C. continues to amaze her and keeps her rooted in the north.

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A lifetime of healthy smiles

Did you know that tooth decay is the third most common disease in Canada? And that four in 1000 children require dental treatment in hospital operating rooms? Not only that, but dental caries (cavities) interferes with a child’s ability to eat, sleep and thrive.

The good news is that dental caries is a preventable disease! Simple changes to you and your child’s diet and dental health behaviour can have a great impact on the development of a healthy mouth and a bright smile. Oral Health Month is a great time to start these changes!

Display with food photos

There are some foods that seem to protect against tooth decay, including hard cheeses like cheddar and mozzarella, nuts, meats, fish, poultry, and eggs.

What can you do?

  • Take care of your own dental needs. Decay-causing bacteria can be spread from person to person so brush and floss daily and have the dentist remove active decay. Limit passing bacteria to infants by not sharing toothbrushes or cutlery and by not licking soothers to clean them.
  • Once teeth appear, brush your child’s teeth twice daily with a rice-sized amount of fluoride toothpaste. Don’t rush your brush! Starting at one point, slowly work your way around the entire mouth until the fronts, backs, and chewing surfaces of both the upper and lower teeth are done – this will take you three to five minutes.
  • At least once a month, lift your child’s lip to check for newly erupted teeth and white or brown spots on the teeth.
  • Teach your child to drink from a regular, lidless cup. Offer plain water instead of other liquids for thirst between meals. Limit acidic drinks like pop and fruit beverages.
  • A balanced diet is crucial to the development and maintenance of healthy teeth and gums. Choose a variety of healthy foods that do not stick to teeth. There are some foods that seem to protect against tooth decay, including hard cheeses like cheddar and mozzarella, nuts, meats, fish, poultry, and eggs.
  • Start regular dental visits at age one or after teeth start appearing. Refer children with signs of dental decay to dental staff at your local health unit. Public health dental staff offer free counseling and fluoride varnish treatments.

For more information, visit the BC Dental Association or HealthLink BC.


Look for this article – along with several other stories about child health – in the upcoming (Summer 2016) issue of Healthier You magazine!

 

Shirley Gray

About Shirley Gray

Shirley is the Team Lead for Dental Programs at Northern Health. She moved to Terrace for a two year position as a Dental Hygienist and has stayed for 27 years! She feels it's a privilege to live and work in the North. She loved teaching children and has been mistaken for the tooth fairy! She is not magic like the tooth fairy, but she is proud to lead a real team of preventive dental specialists in the North who work hard to ensure children keep their teeth healthy for a lifetime.

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Certified Dental Assistants: A passion for healthy smiles!

Two toothbrushes

Northern Health has a dedicated team of public dental health professionals who are busy promoting healthy dental behaviours!

April is Oral Health Month!

You may not know that Northern Health has a dedicated team of public dental health professionals who are busy promoting healthy dental behaviours! This Oral Health Month, I’d like to celebrate and acknowledge the work that our Certified Dental Assistants (CDAs) provide. CDAs are educated, trained dental professionals who make important assessments about patient care every day. The five ladies who make up this team are often the first person that clients meet in their community – whether it’s at family health events, Strong Start, or our fluoride varnish clinics.

I had the privilege of interviewing each of the CDAs last month and discovered the deep passion each has for working with children and families. I asked that they share a few stories and reflections here with you.

Thank you for taking time to read and consider the support these ladies provide in our communities!

Pamela:

I am a Certified Dental Assistant working as a Community Dental Assistant for Northern Health. I’ve been working for six years and during that time, I have been in contact with multiple families. The families that made the biggest impression on me were the ones who had children with early childhood caries. Sometimes these children are in pain and you can really tell that their self-esteem is low. They also struggle to eat well.

After these children are treated and their pain is alleviated, the difference can make you cry! I like to compare it to a flower that is blooming – so beautiful and happy! There is nothing better than watching a child start to thrive again, eat, and be healthy and happy! This is what makes me love my job and makes me passionate about healthy children.

Wendy:

I appreciate the variety that my job as a dental assistant in public & population health offers. I love working with young children and their parents and especially enjoy working with immigrant families. Recently, our dental program was invited to the multicultural society in Prince George to meet with several new refugee families from Syria. A co-worker and I did basic teaching around oral health, screening and referral for obvious dental needs, and did fluoride applications for children under 6 years. The children and I got a great laugh as I attempted to pronounce their names. They had no problem with my name! All in all, it was a great privilege to meet these families and to be a small part of not only helping them on the road to achieve better dental health, but also to show compassion and friendship as they face many new challenges in adjusting to their new life in Canada.

Louise:

When I think of a success story in my time as a Certified Dental Assistant, I remember the first time I went out to see families in a remote community. I was screening children and doing fluoride varnish with the parents present. One mom had several children at the Health Unit. She brought her 18 month old last. We did a “knee-to-knee” dental exam and “lift-the-lip.” As we looked at this child’s teeth, I noticed the start of cavities. Not just white lines, but brown, stained upper anterior teeth with ditching in them. Further investigation revealed that the mom was breastfeeding ad lib, wasn’t brushing for the child, and that the family had cavities themselves.

I encouraged brushing at least 2-3 times a day with fluoride toothpaste and showed how to brush. I also discussed decay-causing acids from the frequency of sugary drinks, such as juice, pop, or even milk. Breast milk was the best option for her child so I encouraged continuing on, but really stressed the importance of brushing with fluoride toothpaste, having fluoride varnish done, and taking her child to the dentist. I said if we did these things, her child may not have to have work done in the hospital within the next year or two, and we could keep those cavities “at bay” until the child was able to sit in the dental chair to have the work done.

The next time I spoke with mom, she had taken him to the dentist and was brushing lots with fluoride toothpaste. The dentist had scooped out some decay and burnished the fluoride varnish into the cavitation. The fluoride varnish was done routinely (about every 2-3 months) and the teeth strengthened. We built a relationship of trust through these fluoride varnish appointments. Her child had some dental work done while sitting in the chair at 5 years of age. The upper anterior teeth weren’t involved; it was the back molars that had fillings done. There was no hospital work done and fewer cavities/fillings. Overall, we saw much better outcomes. We still have a trusting relationship when I see her and her family in the community. Now, her children are having children: the next generation. Hopefully there will be more great changes in their dental health and overall health!

Thank you card

Thank you card received by a Certified Dental Assistant.

Dianne:

This is a very special card to me. The inside note says, “You have been an amazing ‘Tooth Fairy’ for us!”

This was given to me by a very grateful young mother. This mom’s 2.5 year old was in urgent need of dental treatment. When they came to me, he had already been on antibiotics and was not sleeping or eating very much. Mom was very worried and did not know where to start to help her son.

Because of some special circumstances, this mom had spent over two years trying to figure out the paperwork to get dental coverage for her son. She had even started some personal fundraising for dental care, but even these funds had to be redirected to a family emergency.

I got involved and supported the many levels of communication required in this case. There was communication to coordinate with a dental office (which took the case knowing that they may not be paid), local government staff for travel arrangements, local and regional administrators, doctors’ offices, Save a Smile program, dental therapist, and a local church.

Ultimately, people worked together and this child received full treatment within one month of their visit with me! The family was not able to pay the dental office in full at the time but the mom is still committed to sending this office extra money as she is able to. Mom is so thankful that her child sleeps and eats well and can run and play as a child should. I see him regularly for fluoride varnish; he is doing very well and will start kindergarten in the fall. He and others like him are why I love my job!

Kim:

After I graduated as a Certified Dental Assistant and started working, I quickly realized that chair-side assisting wasn’t for me. I wasn’t proud of the work I was doing or the setting I worked in. I job-hopped for a while gaining experience and looking for something that would satisfy my mind. The job-hopping stopped when I was hired as a Public Health Certified Dental Assistant!

Public health has given me the opportunity to use my life skills and personal abilities in my daily work in a way that I wasn’t able to in an office setting. I’ve also had a lot of personal growth in this career. It has come to me through different work experiences such as teaching clients, presenting to groups, coaching clients through oral hygiene changes, learning about statistics and cultures, gaining computer skills, and the freedom to use my creativity to reach people when the “usual” way doesn’t work.

My career as a Public Health Certified Dental Assistant has contributed to me being a well-rounded person with the confidence to tackle whatever is in front of me.

Shirley Gray

About Shirley Gray

Shirley is the Team Lead for Dental Programs at Northern Health. She moved to Terrace for a two year position as a Dental Hygienist and has stayed for 27 years! She feels it's a privilege to live and work in the North. She loved teaching children and has been mistaken for the tooth fairy! She is not magic like the tooth fairy, but she is proud to lead a real team of preventive dental specialists in the North who work hard to ensure children keep their teeth healthy for a lifetime.

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Oral Health Month: Healthy smiles for your family

Smiling child

Keep your family’s smiles bright! Registered dental hygienist Kelly has tips to ensure a lifetime of healthy smiles.

Good oral health is something we all try to work on every day as a healthy mouth contributes to overall good health. But, at certain times of the year, the choices we make are even more important to our dental health. April is Oral Health Month in Canada and it’s a great time to think about your family’s smiles!

For many families, last week included a special visit from the Easter Bunny. It’s common for a child’s Easter basket to be filled with chocolate and candy. As a registered dental hygienist, my role is to help prevent tooth decay in children, so I’m always conscious of the effects these traditions have on children’s mouths.

Baby teeth are very important and need to be well cared for; primary teeth can remain in a child’s mouth until the age of 12. They help with chewing, speech, and allow the proper spaces for the adult teeth to come in.

It is important to know that sugars turn to acids in the mouth. If your child is eating candy throughout the day, numerous acid attacks are happening in the mouth. Constant sugar/acid exposure can wear down enamel and lead to dental decay. If untreated, this can cause pain, infection, and problems with eating and sleeping for the child. Decay is preventable and can be avoided.

You can help your children avoid getting cavities by limiting the amount of sugar they consume. If treats are offered, it’s best they are given at meal time when there is more saliva to help maintain an optimum pH level in the mouth. It’s also a good idea to avoid sticky, chewy candy as it is harder to remove from tooth surfaces and it tends to stay in the mouth longer, leaving your child vulnerable to decay.

Some other tips to help prevent childhood cavities include:

  • Offer a variety of healthy choices, including fresh fruits and vegetables, cheese, and nuts.
  • Limit sugar intake in snacks and drinks. Water is the best choice for thirst as fruit juices and pop have a very high sugar content.
  • Brush your child’s teeth with a pea size amount of fluoride toothpaste two times per day (morning and before bed). Introduce flossing to your oral hygiene routine.
  • At times like Easter, offer alternatives to candy like stickers, tattoos, pencils, toys, or sugar free gum.
  • See your dentist regularly.
Kelly Esopenko

About Kelly Esopenko

Kelly is a registered dental hygienist working with Population & Public Health. Kelly has been a dental hygienist for over 20 years and has worked in a variety of clinical settings. She joined Northern Health in 2012 and works with a wide range of clients promoting good oral health practices. Kelly is married with two children. In her free time, she enjoys spending time with family and friends, walking her dogs, and cheering on her children in their various sporting activities.

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