Emergency Dental Care – Knowing When Your Child Needs It

Last updated on August 29th, 2015 at 04:34 pm

With summer in full swing, kids are as active as ever with summer sports, swimming, day camp, and more. However, increased physical activity leads to increased risk of injury, which can include mouth injuries. Some injury might not need professional attention and can be easily treated at home. But for those instances where the injury is more severe, immediate medical attention should be sought after. Many dentists provide same-day emergency care for severe oral injuries. Being proactive and taking your child to the dentist after an injury can decrease the risk of progressed or even permanent damage.

Dental emergencies come in many forms. Whether the result of a sports accident or biting into something hard, children can experience severe pain from oral injuries. Some dental emergencies that can arise include:

• Cracked or chipped tooth
• Dislodged or knocked out tooth
• Orthodontic emergency (i.e. broken wire or bracket on braces that is causing pain)
• Lost filling or crown
• Severe tooth pain
• Bleeding gums

Not all dental accidents need immediate attention, so use your best judgment when deciding whether or not to take your child in for an emergency exam. For example, accidental loss of a baby tooth may not cause extreme damage and a permanent tooth can grow in and develop normally. Nonetheless, if your child is in pain, it is better to seek help from a dentist to ensure that the injury is taken care of.

Keep an eye on your child this summer and all year round, as dental emergencies can happen at any time. Don’t hesitate to seek immediate medical attention if the injury is severe. Ask your dentist about ways that you can help prevent certain emergencies from happening. Mouth guards are an easy and relatively inexpensive solution to preventing injury in sports, especially for children with braces. This can help your child protect their teeth for a lifetime of dental health.

Protecting Our Teen Athletes – ECG Screening Saves Lives

Last updated on March 9th, 2018 at 09:59 am

Gabby Douglas, Jordan Wieber and McKayla Maroney from this year’s US Olympic team are truly amazing athletes, captivating to watch. They are 16 and 17 years old. It’s hard to imagine that any one of these could have an underlying, perhaps lethal heart problem. It’s equally hard to believe that any of our teenagers could.

Yet every year, a hand full of high school athletes across the country suffers sudden cardiac arrest. One huge difference between our Olympic athletes and our ‘normal’ teenage athletes is that the Olympians have undergone thorough and complete physicals including ECG’s.

In researching this I found a variety of red flags including that national testing standard for teenage athletes exists but is often not followed and often ECG’s are not included due to expense. I also read of one area where local EMS is used to conduct the ECG which is then read remotely by a cardiologist. This is one way to overcome the expense and it just required asking.

I also discovered that 44 states require screening but the nature of the screening is all over the place and that many doctors simply don’t know to or include ECG’s.

It is hard to define the exact number of teens and families this impacts each year- one article suggests as many as 2000 a year. The underlying etiology is almost completely invisible. A couple of histories that may be relevant include a history of fainting by the teenager and a history of sudden cardiac arrest in family members under 50 years old. Even without these, every teen athlete should be properly screened.

Another reason that this is called invisible is that a teen may attend every practice, participate in game after game, go full out with no signs or consequences and then… sudden cardiac arrest.

The timing is now as the Olympics wind down, middle and high schools all across the country are getting ready to start which means the new athletic season. Parents need to assure that their school is following national standards for screening. Look to cardiologists within the community and the parent group as well. Ask your EMS agency to participate.

Even though most schools are required by law to have EMS and physicians attend all football games, they often are not at other events. Schools MUST have AED’s at all sporting events- even when EMS is there. AED’s and EMS need to be close to the action. Often EMS and the AED are off on the side lines. It may seem close but the reality is it may take minutes to get to the patients side. Coaches, trainers, physicians, teachers etc should all know the new hands-only CPR.

Preventing a sports related sudden cardiac arrest is the best approach. But be prepared for those rare times when sudden cardiac arrest does occur.

In researching this piece I found two relevant sites both based on personal loss:

• http://nickoftimefoundation.org/
• http://learnedfromdaniel.blogspot.com/2011/03/sudden-cardiac-arrest-in-children-and.html

Kids Also at Risk for Antibiotic-Resistant MRSA Infections

Last updated on August 30th, 2015 at 03:36 pm

I have a friend who recently acquired a MRSA infection….in a karate studio! MRSA, or methicillin-resistant Staphylococcus Aureus gives rise to antibiotic-resistant staph infections that are very difficult to get rid of and which are potentially dangerous, according to the US Centers for Disease Control (CDC).

If you’ve heard of MRSA you probably picture an infection picked up by an elderly person in hospital. While the vast majority of MRSA infections are among older, hospitalized patients, rates of community-acquired MRSA (CA-MRSA) have been on the rise for over the past decade, and do not appear likely to come down any time soon. MRSA infections in the community generally start with skin infections and involve younger people prone to cuts – in places with lots of interpersonal contact, such as athletic facilities, dormitories, military barracks, and daycare centers.

Although my friend is an adult, I got concerned about the MRSA risk for the rough and tumble set because so many kids are involved in karate and other contact sports, including my 9-year old son. And sure enough – just a tiny bit of research revealed the risk young kids and teens now face. Recent data from the Agency for Healthcare Research and Quality showed a doubling over the past decade in children’s hospital admissions due to severe skin infections, with MRSA the major culprit. These skin infections now rank as the seventh most common reason for childhood hospitalization, up from 13th in 2000 (see this New York Times article for more detail). Furthermore, the CDC indicates that athletes – including school-aged athletes – are particularly at risk, because of their tendency to receive cuts and scrapes, and the person-to-person contact and often-unhygienic conditions of locker rooms. Risk of skin infections is greatest in high-contact sports such as wrestling, football and rugby, though MRSA infections have been connected to many other sports, including soccer, basketball, volleyball, rowing, and baseball (click for CDC guidance for athletes and coaches).

Thankfully, with prompt, effective treatment most MRSA skin infections do not lead to serious complications. But they can be very difficult to get rid of – and without proper treatment, can spread within the body or to other people. Indeed, my friend’s MRSA infection ended up spreading from the cut in her foot to her lungs – which resulted in problematic respiratory symptoms and literally months of unpleasant treatment with multiple high-strength antibiotics. And it’s important to note that severe MRSA infections can lead to death.

According to the CDC, eradicating MRSA in both healthcare and community settings is a high public health priority. Prevention is the best way to achieve this goal, including practices such as:

• Good hand washing and general hygiene before, during and after exercise and sports activities
• Never sharing towels, razors, uniforms or sports equipment
• Ensuring that cuts and scrapes are kept covered until they are fully healed

Check out the CDC website for more guidance on preventing MRSA infection.

However, if a member of your family does acquire a skin infection, remember that it could be caused by MRSA, especially if it is a pustule or boil or has any of these characteristics:

• Red
• Swollen
• Painful
• Warm to the touch
• Full of pus or other drainage
• Accompanied by a fever

If you suspect that an infection may be MRSA, do not attempt to treat it yourself – including draining or applying disinfectant, as this can just spread the infection. Just cover the infected area, take steps to prevent spread in your family, and contact your healthcare provider. And be sure that any prescribed course of antibiotics is fully completed, since MRSA is so difficult to eliminate. The CDC website also provides a range of educational materials for families, athletes and communities that you may find useful in identifying and dealing with a MRSA infection.

“Best of” Back-to-School Health and Safety Tips 2011: Part II

Last updated on May 24th, 2018 at 05:38 pm

If you are someone who takes care of kids in any way, shape or form (which I’m assuming you are if you’re reading this) one phrase has probably dominated your world for the past couple of weeks: “back-to-school”. It is likely that you have not spent a day, opened a newspaper or a journal or gone to the sites you typically visit online without seeing these words staring back at you in an article offering you advice on: “How can you best prepare your kids”, “The 101 things you should know about your child’s health and/or safety before you send them back to school…” etc.

Unfortunately, too much of a good thing is not always a good thing… With so many articles and so much information it can be a bit overwhelming at times. With that in mind, I’ve done a little searching and pulled together a “best of” health and safety tips across all the expert information I’ve found. While last week’s back-to-school health and safety tips focused on everything to consider before they head off to school, today’s tips focus on what you need to know to send them off and make sure they return safely. Hopefully it will save everyone a little time that they could be otherwise be using to get 5 more minutes (or 1 extra hug) with their kids. (*Please note: as with my last post, I am sourcing other author’s tips and will cite all references below – all copyrights, credit and thanks belong to them)

Heading to School:

Getting on the Bus Safely:

• When the bus arrives, stand at least three giant steps (6 feet) away from the curb.
• If you have to cross the street in front of the bus, walk on the sidewalk or along the side of the road until you are five giant steps (10 feet) ahead of the bus. Then you can cross the street.
• Be sure the bus driver can see you and you can see the bus driver.
• Never walk behind the bus.
• If you drop something near the bus, tell the bus driver. Never try to pick it up first because the driver may not be able to see you.

While on the bus:

• When on the bus, find a seat and sit down. Loud talking or other noise can distract the bus driver.
• Never put head, arms or hands out of the window.
• Keep aisles clear—books or bags are tripping hazards and can block the way in an emergency.
• At your stop, wait for the bus to stop completely before getting up from your seat, then walk to the front door and exit, using the handrail.

Getting off the Bus:

• If you have to cross the street in front of the bus, walk at least ten feet ahead of the bus along the side of the road until you can turn around and see the driver. Make sure the driver can see you.
• Wait for a signal from the driver that it’s safe before beginning to cross…then, walk across the road keeping an eye out for sudden traffic changes.
• Stay away from the wheels of the bus at all times.

Walking to school:

• Walk to school with a group of kids and always have a responsible adult with you.
• Always walk on the sidewalk if one is available. If no sidewalk is available, walk facing the traffic.
• The safest place to cross is at a street corner or intersection.
• If you are 10-years-old or younger, you need to cross the street with an adult. Before you step off the curb, stop and look all ways to see if cars are coming. When no cars are coming, it is safe for you to cross, but look left-right-left as you do and hold the adult’s hand.
• Walk, don’t run. This gives time for drivers to see you before you enter the roadway.
• Don’t dart out in front of a parked car. The driver of the car coming down the street will not be able to see you.
• In neighborhoods with higher levels of traffic, consider starting a “walking school bus,”  in which an adult accompanies a group of neighborhood children walking to school.

Riding a bike to school:

• Always wear your helmet and make sure it fits correctly. The helmet should fit low on your forehead so that two fingers fit between it and your eyebrows.
• To ride safely, you need to know the “rules of the road”. Ride on the right side of the road in a single file line in the same direction as other vehicles and come to a complete stop before crossing streets. Wait for a driver’s signal before crossing the street.
• Wear bright colors during the day and right before the sun rises or sets.
• Riding at night can be dangerous. You should have a white light on the front of your bicycle and a red reflector on the back. You also can get lights and reflective materials to put on your shoes, helmet and clothing.

By the Way – Here’s a great brochure by the National Highway Traffic Safety Administration (NHTSA) that uses graphics and humor to teach little kids how to be safe on their way to school.

Teen Driving:

• Graduated Driver Licensing allows teens to practice driving skills in low risk situations, moving through driver license stages with gradually increasing responsibility. GDL reduces teen driver crashes and deaths by up to 40%. You can implement life-saving GDL practices in your home by following these tips:
  • Extend the learner’s permit period until at least 6 months of practice has passed.
  • Set a nighttime driving restriction – no unsupervised driving after 10pm.
  • Set a passenger restriction – no one younger than 18 allowed during a teen’s first 12 months of driving.
  • Ban cell phone use and make safety belts mandatory while driving. Prohibit alcohol – zero tolerance for underage drivers.

During the School Day:

Eating during the day:

• Most schools regularly send schedules of cafeteria menus home. With advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.
• Try to get your child’s school to stock healthy choices such as fresh fruit, low-fat dairy products, water and 100 percent fruit juice in the vending machines.
• Each 12-ounce soft drink contains approximately 10 teaspoons of sugar. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Restrict your child’s soft drink consumption.

Bullying:

• “Bullying is when one child picks on another child repeatedly. Bullying can be physical, verbal, or social. It can happen at school, on the playground, on the school bus, in the neighborhood, or over the Internet”. The American Academy of Pediatrics has detailed guidelines on managing bullying from the perspective of the child being bullied, the child who is the bully and the bystander. Across all 3 categories, what is consistent is involving a parent or another adult to develop a proactive solution. Rather than try and abbreviate this section, if this is an issue for your child, well documented and excellent guidelines can be sourced here.

School Sports

• Acclimate children to hot weather workouts by gradually increasing time outdoors about ten days to two weeks before official practice begins to help prevent heat injuries.
• Make sure children drinking plenty of fluids and take frequent breaks: every 10-15 minutes while playing outdoor sports. Also make sure they wear light clothing and limit their exposure to the sun in the hottest part of the day. Apply towels soaked in ice cubes and water to the head and neck to stay cool.
• When heat illness is suspected, move the athlete into the shade or coolest area nearby. Try to cool them as quickly as possible by exposing the skin to ice/cold water and cool circulating air.
• Young athletes with asthma should use preventative inhalers 20-30 minutes before exercise, do a gradual warm-up and should have a rescue inhaler available to them during practices and during competition.
• Make sure children wear a well-fitted helmet if they play football, softball or baseball to prevent severe injuries such as concussions.
• Remind children to immediately tell the coach or trainer if they feel dizzy or have a lapse in memory after taking a blow to the head. They should not return to the same practice, game or contest and should be evaluated by a physician prior to return to play.

Keeping them safe at school:

• Ask your child about safety in his or her school. Where do they feel most safe? Least safe? Why?
• Identify comfort levels and methods for reporting safety concerns. Do students have at least one adult and/or method through which they would feel comfortable reporting safety concerns at school?
• Examine access to your school. Are there a reduced number of doors that can be accessed from the outside (while still allowing children to exit from the inside in an emergency)? Does faculty know who is in their school?
• 5 excellent questions that your school’s crisis management team should know the answer to – if not, get involved:
  • How do you dial 9-1-1 from the school phones? Do you need to get an outside line first?
  • What is the actual street address of the school if asked by a 9-1-1 dispatcher?
  • If your school’s nearby walking evacuation site is a community church, does someone have the keys to get in if no one from the church is there when you arrive?
  • How long does it really take to mobilize your school bus drivers in the middle of the day if you need to evacuate multiple buildings?
  • Have you ever trained students NOT to open doors to people on the outside trying to get into the school?

After School:

Getting home from school safely and staying that way:

• Make sure your child walks home with a group of friends or a responsible adult.
• Make sure to have an adult at the bus stop after school to ensure the kids get home safely.
• Make a code word that will be used when someone else they do not know will pick them up. Every time you have someone pick your child up from school they have to know your secret code word or your child will not get in the vehicle.
• Let them know that if an adult makes them feel uncomfortable or is following them they should call 911 and find a safe place – go back to school, to the police, or to a friend’s home as quick as possible.
• Along those lines – teach your children “No, Go, Yell, Tell”: Say No! loudly if they feel they’re in danger; Go! run fast and far to the nearest safe place; Yell! as loudly as they can while they run; Tell! a trusted adult exactly what happened as soon as they reach safety.
• If they are going to be alone in the afternoons, teach them to go straight home, lock the door and only open it for people with permission to enter the house. Never open the door to delivery people.
• They should never tell someone on the telephone or on the internet that they are home alone. If asked about mom/dad say something like “He or she is busy right now. Can I take a message?”

So folks, I know it was a long list, but I hope it’s one you’ll find useful. Until next time, keep them healthy and keep them safe…

*******************************************************************************************************************

As we did with “Best of” Back to School Health and Safety Tips 2011: Part I, we’d like to send out our thanks and recognition to some very smart folks for some really terrific advice:

1. Waiting for the Bus, While on the bus, Getting off the Bus, Walking to school and Riding a bike to school: (Traveling to School: Safety tips to share with your children: National Safety Council)
2. Teen Driving: (Teen Driving Safety: Graduated Driver Licensing saves lives: National Safety Council)
3. Eating during the day and Bullying: (Back to School Tips: American Academy of Pediatrics 2011)
   *(Note: our thanks to Kelly from Educator Labs and her student Robbie for finding us an updated link for this)
4. School Sports (Children Should Rely on Safety Equipment to Prevent School Sports Injuries: Cincinnati Children’s Hospital Medical Center)
5. Keeping them safe at school: (Parents & School Safety – Can you Prevent Another Tragedy? How Safe is Your Child’s School: Ken Trump, president of National School Safety & Security Services)
6. Getting home safe and staying that way bullets #1,2,3,4: (Children’s safety tips to remember for back to school: Melina Ann Collison, St Louis Crime Examiner, July 27, 2009)
7. Getting home safe and staying that way bullets #5: (Living Safe – Teach your children “No, Go, Yell, Tell”: Katherine Cabaniss Crime Stoppers)
8. Getting home safe and staying that way bullets #6,7: (After-school safety tips from the American Red Cross)

7 Signs Your Kids are Ready for Sports

Last updated on May 11th, 2017 at 08:53 pm

You may think your kids are ready for organized sports, especially when so many of their peers are signing up. But many young kids don’t develop the physical, emotional, or mental skills it takes to compete until second or third grade.

Kids who start too soon may end up feeling frustrated or humiliated, or suffering physical injuries. Most experts agree that 6 is the youngest age to start playing organized sports, and many recommend waiting until your kids are 8. But kids develop at different times, so readiness depends more on their size, skill and maturity than on age.

To make sure you’re not jumping the gun, look for the following signs before considering sports for your kids. They will be ready for sports when they:

1. Show an interest in sports. There’s no reason to push your kids into team sports if they have no desire to play. In fact, forcing them can make them resent all organized sports. So if your kids aren’t ready yet, let them run around outside with their friends; it will give them the exercise they need until they find sports they’d like to try.
2. Are strong and skilled. If your kids are smaller and weaker than their peers, or if they can’t throw, bat or catch very well, they’ll be at a huge disadvantage. They’ll also be more likely to get injured. Before you send them onto the field to compete with kids who are naturally more able, spend another year practicing with them in the backyard so they can build their physical strength and skill.
3. Can understand and follow directions. Processing and acting on information from multiple sources – coaches, parents, teammates and bossy siblings – is a real challenge for many young kids. Most won’t have that ability until they are 6 or 7, at the earliest.
4. Focus on an activity for two hours. When you see young kids picking weeds or staring up at the clouds during practice, you know they don’t have the attention span to stick with an entire game. The ability to sustain focus comes with age, not experience, so it’s better to wait until your kids mature.
5. Get the concept of teamwork and taking turns. Playing organized sports means sharing the spotlight and giving everyone their turn at bat. Hogging the ball – and everyone’s time and attention – won’t make your kids very popular.
6. Get along with other kids. If your kids have trouble navigating social situations or working in a group at school, they’ll have an especially tough time with the dynamics and competitive nature of a team. Give them more time to build up those skills off the field.
7. Can handle losing without losing it. Winning is easy; losing can be devastating. If your kids tend to cry or get angry when they lose at sports or board games at home, they are probably not ready for a graceful defeat in public.

Organized sports are a great learning experience and an excellent way for kids to stay fit – but they’re also supposed to be fun. Your kids will enjoy themselves more when they’re ready for it.

Should Your Child Wear a Mouth Guard?

Last updated on August 29th, 2015 at 03:16 pm

Playing team sports are a wonderful experience for children. There are many physical and emotional health benefits.

There can also be safety and protection issues. Any sport can increase head and mouth trauma. Injury can not be completely eliminated but damage can be lessened. Mouth guards can decrease the potential for harm by up to 60%.

Besides preventing permanent loss or disfigurement of the most visible, front teeth, mouth guards can prevent a concussion.

The younger your child starts wearing a mouth guard, the more likely they are to continue wearing it through their sporting career. Custom fitting mouth guards allow your child to speak and breathe more comfortably, performing with the greatest confidence.

Benefits of a mouth guard:

• You increase the chance of damaging your teeth 60x if you don’t wear a mouth guard while playing spots
• Injuries to your teeth can result in permanent disfigurement of your most viable front teeth
• It is estimated that a lifetime dental costs to a tooth that is knocked out can be up to $20,000

As stated earlier, the habit of wearing a mouth guard is developed at an early age.  Make sure you talk to your dentist about the best type of mouth guard for your child. There are several different types available to you.

Be safe this sports season!

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