Your child's first visit to the dentist.

      Over the years, the recommendation has changed about when to first take your child to the dentist. One factor is that across the U.S. the number of cases of cavities and tooth decay (dental caries) has risen significantly. One of the big reasons for that is that more and more children are drinking bottled water. It is tap water that has fluoride. Bottled water usually has no significant amount of fluoride. Without that fluoride, more and more children are having early tooth decay, cavities, and/or dental caries.
     The current recommendation is for the children to see the dentist by 12 months of age. The complete recommendations are available here at the American Academy of Pediatric Dentistry's website. One thought: remember to add your child to your dental coverage during their first year so that they are covered by this age.
     There are many excellent dentists in the area. Two pediatric dentists that we recommend the most are Dr. JoJo Strickler (Hilliard Pediatric Dentistry at 5138 Norwich Street in Hilliard; 614-876-5500) and Dr. Robert Haring (100 N. High Street in Dublin; 614-761-3361). Call our office if you have further questions.

Note as of January 15th, 2014: We have heard feedback from parents and dentist offices to realize that each dentist office is handling this a little differently. If you have questions or concerns, having your child seen at 1 year of age for their first visit to the dentist makes perfect sense. However, if you do not have specific concerns before, make their first visit whenever the office you pick recommends.

What to do when your child will not wear a coat when it is cold outside.

     I am frequently asked this question: "What to do when my child will not wear their coat and hat when it is cold outside?" First, before I answer that question, let me give some background.
     If your child is not going to get hypothermia (a dangerously low temperature with being exposed to cold temperatures for a long time) or frost bite (skin damage due to cold exposure), how someone is dressed is really about their comfort. We all know people who, in the same house, are dressed very differently. One person is in shorts and a t-shirt. Their family member has a hoodie and jeans on that day. So comfortable temperature is certainly different for different people.
     Despite what our grandparents were told, we get sick from germs we are exposed to and not from being too cold. It was for many years that parents were told "they will get pneumonia if they do not have a coat and hat on!". This is not true. It is the exposure to the illness that causes us to become ill. I had a job one Winter before going to med school where I worked at a stone quarry in East Liberty, Ohio. That Winter, I was around very few germs but worked outside in very cold conditions. One day, when it was 20 below (!!), we would work outside for 20 minutes then go in and warm up in for 30-40 minutes. We kept us that cycle most of the day. I did not get sick because I simply was not around many ill kids or adults.
     Many children grumble around about wearing a coat and hat. I believe a lot of the "I do not need it!" from children is simply an issue of control. Children like to feel independence about many issues -- it gives them a sense of control and power in their life. And even if they ultimately do not get their way, they have frazzled you.
     So what to do when your child will not wear a coat when it is cold outside? Nothing. And if they say "I was cold today"? Calmly say something non-judgmental like "Maybe wear an something warmer next time". And if someone asks you "Why do you allow your child to dress that way?", say "If they feel cold, they will dress warmer".

Screening teenage girls for anemia at their annual well visit.

      We have traditionally checked teenage girls for anemia every year at their check-up once their menstrual periods have started. Although we have found some teens with anemia (for that age, a hemoglobin under 12.0), overall more than 90% of the teenagers have not been anemic. And most of those young women with anemia have had other signs, symptoms, or history that would make us suspicious: they are pale, they do not eat red meat, they are vegetarians, they are tired, they have heavy periods, or they have thalassemia minor.
      We have discussed at our office whether it was appropriate to continue checking those teen girls without any worrisome sign, symptom, or history for anemia each year. We have decided to start (as of know, Dec. 3, 2013) routinely checking teen girls at 15 years of age for anemia (with the finger prick that we do in the office and get the results in less than a minute) at their check-up. We will always want to check it annually if there is a history of anemia, heavy periods, tiredness, pale complexion, or a vegetarian diet. If you would like your child checked at their check-up at a different age or without any of these warning signs, please discuss it with the doctor.

Hearing Protection for Children

      I attend many concerts. I enjoy everything from quiet folk singers with an acoustic guitar to loud hard rock, and everything in between. I never leave for the show without hearing protection.
      I am not proud of some of my loud noise exposures earlier in life. For a few months one of my jobs before med school was operating stone crushing equipment and decided to not wear hearing protection (ear muff style). Also, I attended quite a few a few rock concerts without hearing protection where I left with loud ringing in my ears. Although an audiologist and ENT told me recently that my hearing is a little better than average for my age, I wish I could take back these loud noise exposures. I want to have good hearing into my retirement years!
      Protecting your children and their hearing from loud noise is important. Although the ringing in the ears might quiet down after a few hours or days, permanent slight damage happens with these loud exposures that can add up over time to hearing loss. Those events where this can happen include music concerts, air shows, monster truck shows, fireworks, and many others. Many an adult jumps when the cannon goes off when the Columbus Blue Jackets games!
      Certainly, one way to avoid these loud noises is simply to not go to those events where the loud noises are present. I realize this is not always desired or practical. So what else to do? Wear hearing protection. Ear muff style hearing protection is available for younger and older children. These typically cost about $15-30 dollars. For older children, ear plugs are available -- for 3 years and above if the kids are supervised well and tolerate the ear plugs. They are readily found on Amazon. The Banz website here has information and products available for different ages. The Ear Plug Superstore is available here and has products for different ages.
     Keep those ears protected and the hearing at it's best!