How Mouthwash Can Benefit You and Your Family

A mouthwash is a mouthwash is a mouthwash – or so you may think. Sure, some may be green or blue or extra-minty, but really, how different could they be?

Turns out there’s a key difference: Some rinses help you more than others, and some even contain ingredients you should avoid, says Ingvar Magnusson, D.D.S., Ph.D., a research professor in oral biology at the University of Florida College of Dentistry in Gainesville. For example, many rinses have sodium lauryl sulfate, which tends to dry and irritate the mouth – especially if you suffer from canker sores. And some studies have found a link between rinses with a high alcohol content (25 percent or more) and oral cancers.

It’s smart to ask your dentist for rinse recommendations that suit your family’s specific dental hygiene needs. But in the meantime, here’s a cheat sheet for your next trip down the mouthwash aisle:

WANT TO …

Help prevent cavities?

• LOOK FOR….Fluoride. Its ability to prevent tooth decay is well-established.

Fight gum disease?

• LOOK FOR….Cetylpyridinium chloride (CPC) or chlorhexidine gluconate. Recent research has shown these ingredients help prevent gingivitis and dental plaque.

Moisten the mouth?

• LOOK FOR….Carboxymethylcellulose or hydroxyethylcellulose, both of which simulate natural saliva. Bonus points if the rinse also contains fluoride, since dry mouth contributes to cavities.

Soothe canker sores or mouth abrasions?

• LOOK FOR….Hydrogen peroxide. It’s a safe bet because it’s antimicrobial without being overly abrasive.

Freshen breath?

• LOOK FOR….Methyl salicylate and chlorhexidine gluconate. These antiseptics help fight the bacteria that contribute to bad breath. Additional herbs, scents and flavorings help mask odor.

Finally, remember that no rinse can take the place of flossing and brushing, which physically scrapes the plaque off your teeth. Rinses may have some impact on preventing gingivitis or tooth decay, but only if used as part of a solid dental-health routine, says Magnusson.

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Editor’s Note: Mouth rinses can be great for kids. Our pediatric dentist recommended adding a mouthwash to my 9-year old son’s dental routine for added protection, especially on those days when he rushes the brushing (because, hey, we know it’s happening!). But they specifically recommended a rinse like Crest Pro-Health because it contains the cetylpyridinium chloride (CPC) mentioned above. It’s working great for him and I’ve started using it too. It is quite minty/spicy, but he handles it by making it into a game – jumping or dancing after he’s rinsed, until the spice eases!

Kid-friendly Foods That Soothe

When children are under the weather, they usually turn to Mom for comfort. This season, be prepared with tasty treats that do double duty – they soothe symptoms and help speed up the healing process.

“Runny noses, coughs and intermittent fevers can all be soothed at home,” says Dr. Ben Lee, a hospitalist at Children’s Medical Center of Dallas and an assistant professor of pediatrics at University of Texas Southwestern, in Dallas. “The old adage of a bowl of chicken noodle soup does have some truth, as it provides necessary fluids and calories to help kids feel better.”

There are other options too. Here are a few unexpected, inexpensive and tasty treats to have on hand for your kids this cold and flu season.

Oatmeal Cookies

Every mom knows that extra sleep is key for sick children, but getting an unhappy child to climb into bed is seldom an easy task. Oats contain high levels of tryptophan, the amino acid best known for making you feel sleepy after eating a big turkey dinner on Thanksgiving. A bowl of oats may be a bit heavy on the stomach, especially for a sick kid, but eating one or two oatmeal cookies will produce the same effect and help kids settle down and get the rest they need to feel better.

100 Percent Juice Drinks

It’s normal for most kids to become mildly dehydrated while sick with the flu. Watch for signs, which include a dry or sticky mouth, dry skin, irritability and dizziness. “Liquids are important to prevent dehydration,” says Lee.

The right liquids make all the difference, though. Avoid caffeinated beverages and hydrate kids with 100 percent juice. All-natural juice drinks are fat-free and nutrient-dense, and are loaded with vitamins and immunity-boosting antioxidants that many of their sugary counterparts lack. If the juice is too sweet or strong, mix it with an equal amount of water to dilute the taste without washing away the nutrients. Kids younger than 1 year should hydrate with a beverage that contains electrolytes.

Ginger Ale or Ginger Candies

Many studies have shown that ginger curbs nausea and alleviates an upset stomach. The trick is to find foods and beverages that actually contain pure ginger. Look for the words “ginger” or “ginger extract” on the ingredient list. Some sodas, especially those available in natural food stores, are going to be your best bet. Ginger candies made from real ginger can also help provide relief for older children.

Ice Pops

A cool ice pop can numb irritated nerve endings to help soothe an inflamed sore throat and provide fluids to quell dehydration. Seek out ice pops made from 100 percent juice or fruit puree, and avoid unnecessary artificial sweeteners and additives. Ice pops made from 100 percent juice are loaded with healthy antioxidants, and those fortified with extra vitamins and minerals can give added boost to the immune system to help speed recovery time.

Honey

Honey is extremely effective at soothing coughs, according to research from Penn State College of Medicine. In fact, a small dose of buckwheat honey before bedtime reduced the severity and frequency of coughs and provided significant relief to participants in a recent study.

“Honey has been reported to reduce coughing by coating the throat to help reduce irritation,” says Lee. One to two teaspoons thirty minutes prior to bedtime should do the trick, he says. An important warning: Children under 2 years old should avoid this sweet soother to prevent the risk of a botulism infection.

Teaching Your Child The Fine Art of Swallowing Pills and Capsules

For any parent, getting children to take their medication can be a frustrating experience. The flavor of a liquid such as Prednisone may be off putting to a child. You worry about spilling liquid medications or dosing accurately. That’s why I find that teaching children as early as possible to swallow a pill or capsule to be a wise idea.

You may wonder “Why worry about teaching my child how to swallow a pill or capsule now?”

First, some medications only come in solid form. To be honest, there aren’t many but there are a few.

Second, pills and tablets are much easier to travel with and don’t require refrigeration. Think about toting around that bottle of antibiotic next summer on your next family trip. Not fun!

Third, you will never have to worry about spilling or dripping a liquid again. Plus the dosing on a pill is accurate. How many times have you gotten to the bottom of the bottle of liquid medication and not had the full teaspoon?

In my experience, children as young as age 3 or 4 can learn to swallow a pill. I taught my own daughter who was not yet 3 to swallow pills. While a few teens can’t seem to master the skill, children are quick learners and repetition and patience along with some simple tips can help if you start children young.

It’s also a good idea to teach your child these techniques before they really need them. A sick little child is not great student!

WHAT YOU WILL NEED

• Multi-colored round candy balls called mixed decors found in the cake-decorating section of a supermarket
• Tic Tacs (I think the fruit flavor works best)
• Mini M&M’s
• Reese’s Pieces or M&M’s

THE TECHNIQUE

• Start with the smallest candy ball from the cake decorating kit. Explain to your child that you are going to teach him a simple way to learn to swallow pills and that it starts with learning to swallow candy balls. (Now is a good time to explain that medication is NOT candy but that you are using candy because it is an easy substitute. Explain that you should NEVER take medicine without permission of Mom or Dad).
• Parent should demonstrate by putting a single candy ball as far back on your tongue as possible, use the straw technique, and take three gulps of water.
• Tell your child it’s their turn. Also tell them that if the candy doesn’t go down the first time, they have to try at least two more times. If it doesn’t go down by the third try, they can chew the candy ball and take a break before trying again.
• Repeat this until they get comfortable with a candy ball, usually about three successful tries. Then move up to a slightly larger candy (I like to use the bigger cake decorating sprinkles, then move up to mini M&M’s) and repeat the procedure until there is success at this level.
• After three to five successes with the mini M&M’s, move up to a larger candy like an M&M or Reese’s pieces. After they have mastered that, compare it to a pill size wise. At this point they should be able to swallow most pills with minimum problems.
• Remember to limit the “session’ to 15 minutes. This will be a Process that requires days, perhaps weeks depending on your child.

SOME TIPS

• Have your child take a few sips of water before beginning. It is very difficult to swallow a pill or tablet with a dry throat.
• These tips works best if your child is thirsty. He/She may be drinking quite a bit, practicing their pill swallowing technique.
• Session should last no more than 15 minutes and be fun.
• Room should be free from distractions. Leave toys in another room and turn of the television.
• Stay calm and positive.
• Be patient, this is a task that will require some time.
• Demonstrate pill swallowing to your child in matter of fact way. When they see you do it calmly they will want to emulate you.
• Use lots of Positive Praise! Avoid negativity. This is not going to motivate your child to learn to swallow pills/tablets.
• Be consistent.
• Have your child put the pill on his/her tongue. Then using a straw, suck down three big gulps of water. With a straw there is no pill floating around in your mouth like there is if you just try to swallow a pill with a big mouthful of water.
• If water isn’t working try milk, a fruit smoothie, Pediasure, a milkshake, or fruit juice or nectar. Thicker fluids create more bulk, making it harder for the pill to separate itself from the fluid during swallowing.
• Always end with a success. If your child has difficulty swallowing a large piece of candy, end by having him swallow a smaller piece or even a gulp of liquid. Always end on a positive note.
• When swallowing a pill, have your child tilt their head back slightly. With capsules (which float), you do just the opposite. Have your child look down at the floor and swallow the capsule while still looking downward at the floor. The capsule should just float to the back of his mouth and slide down his throat with his drink.
• Make sure you have your child place the pill or capsule in the center of their tongue rather than to the right or left, especially if they are going to be swallowing an oval-shaped pill. An oval-shaped pill should be placed so that the length is parallel to their throat. Otherwise, the pill may go into the throat “sideways” and create discomfort.

DON’T

• Don’t break a tablet in half if it is too large. When you do this the rough edges can be scratchy and even more difficult to swallow than a larger smooth tablet.
• Don’t take pills with a dry mouth. It’s more difficult to swallow when your mouth is dry, and capsules and tablets may even stick to a dry tongue.
• Don’t bargain or bribe your child. After all you don’t bargain or bribe your child to brush his or her teeth or comb their hair. This is a skill they WILL learn. It just takes time and patience.

The techniques I shared with you should help you, help your child become proficient at swallowing pills and tablets. This is a skill that is a necessary part of life and when learned early can really be a very handy tool for a child to possess.

Remember to be consistent, patient and use positive praise and these techniques will have your child swallowing pills, tablets and capsules in a reasonably short time!

Pneumonia, Bronchitis and Kids – More Common Than You Think

Pneumonia in kids is probably more common than we all realize. It represents an infection of the lung tissue which can be caused by viral illnesses, bacterial illnesses or a type of organism that is somewhere between a virus and bacteria called mycoplasma. The most common cause of pneumonia is usually viral, but viral illnesses can predispose lung tissue to become infected with bacteria. Other ways of acquiring pneumonia are by inhalation (this is unusual but certain illnesses such as tuberculosis and anthrax may be acquired in this manner).

The best way to diagnose kids with pneumonia is through a thorough history and physical exam that your doctor will perform on your child. Another way that can be used to diagnose pneumonia is through the use of a chest X-ray, but small areas of pneumonia or early pneumonia might not show up on X-ray. Your Doctor will be able to diagnose this early on by piecing together what you tell him and his observation and examination of your child.

One thinks of pneumonia as an illness with high fever and severe productive cough but this is not always the case and sometimes all that is seen are the symptoms created by the body to help compensate for the changes occurring in the lungs. If a large amount of lung tissue is involved and it becomes difficult for the gas exchange (oxygen in and carbon dioxide out) to take place then a signal is sent to the brain to increase the rate of breathing so that more air is forced in and more oxygen can be extracted. When it is even more difficult to breathe the child may use muscles not ordinarily used to help with breathing such as abdominal muscles and neck muscles and one can observe this. With further progression of the disease less oxygen will reach the body and mild blueness or cyanosis will be seen in the skin.

OK we’ve talked about the more severe problems with pneumonia but let’s get back to the beginning and restate that most pneumonia is mild and might very well be a natural progression of a cold. In a considerable amount of children with mild pneumonia the diagnosis might never be made because it is not severe. And because most of these are viral in nature, they will clear up as the cold clears without the use of an antibiotic, and the child never exhibits the signs and symptoms mentioned in the previous paragraph.

If your Doctor pieces together the parts of the history and physical exam and decides your child might have pneumonia, and if your child appears sick or ill, he might very well begin an antibiotic because the exact nature of the pneumonia might be difficult to determine. Most of the time pneumonia can be adequately treated at home without the need for hospitalization and he/she will recover fully without any subsequent problems.

Bronchitis is a wastebasket term describing what is thought to be inflammation and mucous collection in the tubes that lead from your nose and mouth down into your lungs due to many causes- again usually viral. Any cold with a significant loose cough probably represents some degree of bronchitis or tracheitis (higher up). Generally, it also does not necessarily need an antibiotic to “cure” it because bronchitis, like mild pneumonia, will also go away as the cold resolves. There are instances, again, when your child’s doctor might very well decide to use an antibiotic for your child and those would include when your child looks sick or ill (because significant bronchitis and pneumonia can look exactly the same) or if your child has any sort of chronic lung condition such as asthma or cystic fibrosis where the chance of bacterial infection is increased.

So, especially during the winter months, if your child is diagnosed with pneumonia or bronchitis, you needn’t panic or assume the worst. Just follow your child’s doctor’s advice and he/she will be just fine.

Childhood Asthma: Part II

In Childhood Asthma: Part I, I presented ways in which Asthma can present and exactly what was the nature of the disease. Today we will deal with the diagnosis and various means of treating asthma.

Asthma may present in early infancy but is very difficult to diagnose for the reasons mentioned in part one. Also the signs and symptoms of asthma in the very young child can be caused by many other issues. So it is when the symptoms are very severe or they continue beyond two to four years of age that one begins to suspect asthma.

Let’s assume for the purpose of this article that all the other causes have been ruled out and that it appears that your child indeed has asthma. The first thing to realize is that the symptoms may vary from very severe to extremely mild requiring daily close control or only occasional use of medications and treatments to keep your child comfortable and active. The goal in treatment is twofold: first to allow your child to remain active, socially oriented, and happy. The second is to prevent the permanent secondary changes in the lungs from longstanding uncontrolled asthma.

Early in the course of treatment, a child who presented to the emergency room or physician’s office with symptoms of acute asthma usually needed to be admitted to the hospital for a few days in order to get the symptoms controlled. As time went on, newer systems such as nebulizer treatments that could be performed at home were implemented and admissions to hospitals dramatically diminished. Today it is not uncommon at all to see a nebulizer machine in the home of a child with asthma. The other issues that were improved upon were the level of education of a family in which there is a child with asthma, and the greatly improved medications available to treat asthmatic symptoms with fewer side effects and greater efficiency.

As more becomes known about asthma, through research and observation, the efficiency of treatments increases dramatically. Since we know from the previous article that the underlying problems causing symptoms of asthma are related to constriction of the small airways, mucus production and inflammation, there was a body of research that tried to find out which of these causes were more important, and which specific medications could be used for each symptom. At one point or another each of them were implicated but recently the inflammatory process seems to be very important. Also inhaled medications seemed to give the best results without some of the bothersome side effects, both long term and short term.

With the development of better mobile delivery systems for these medications and the increase in knowledge that families now have about the disease, the disease can now be managed very efficiently at home. Fewer and fewer hospitalizations have been the result with a greatly decreased cost of delivering medical care to these children.

Your Doctor is very familiar with the armamentarium of medications available to use for children with various degrees of the disease. The two main issues with the treatment of asthma is the immediate treatment of the acute problem, breathing difficulty, and then the long term control of the recurrence of those symptoms. There are many medications, or combinations of medications, available to gain and maintain control over the symptoms of asthma and your child should be able to live a perfectly normal life style.

You as parents will shortly become, with the help of your Doctor, the “expert” when it comes to asthma in your child.

Are Your Children At Risk for Dehydration This Summer?

Welcome to summer, the kids are out of school, summer camps are in full swing, family trips all over the country have begun and just in case you haven’t noticed, it’s hot outside. It is turning out to be one of the hottest summers on record with temperatures reaching triple digits in many parts of the country. As it heats up, summer safety becomes a serious issue. With all this fun and traveling going on please don’t forget to ask yourself one very important question, “are my children hydrated well enough to handle this heat?” the answer is most likely no.

Thousands of children each year are admitted to hospitals with heat-related illnesses and most go home, but there are the cases every year where children end up overheating and dying because they were not hydrated properly. As I write this, it’s a beautiful 94 degree Saturday here in Miami with all the humidity you can handle and that means one thing for us here at the fire department. A huge increase in the amount of heat illness related calls we are going to run and most of them will be on children.

As parents when we think of dehydration, we think of our children being sick and having a bout of diarrhea and or vomiting, and the doctor tells us to keep them hydrated with plenty of fluids. That is all well and good and as good parents we make sure our little campers get plenty of fluids and are back healthy A.S.A.P., But the kind of dehydration I am talking about is the kind we as parents tend to overlook in the rush of our day to day lives and that is the everyday dehydration of our very active children. By the time a child says he is thirsty, he is already dehydrated, and with studies finding that 50% of children participating in sports activities were already dehydrated we need to be hydrating our children before, during, and after physical activity as well as keeping an eye out for the signs of heat-related illnesses.

Recommendations for hydrating children ages 6 to 12 include:

• 4-8 ounces 1 to 2 hours before activity
• 5-9 ounces every 20 minutes of activity
• After activity, replace lost fluids within 2 hours

Recommendations for hydrating young athletes ages 13 to 18 include:

• 8-16 ounces 1 to 2 hours before activity
• 8-12 ounces 10-15 minutes before activity
• 5-10 ounces every 20 minutes of activity

Being able to recognize the signs of heat-related illnesses is critical and should be done by us the parents as well as the coaches. A basic awareness of the signs of heat-related illnesses could make all the difference, so here are some key points to be on the lookout for as recommended by Susan Yeargin, PhD, ATC.

Types of heat illnesses

Athletes who exercise in hot or humid weather are particularly at risk of heat illnesses:

• Heat cramps
• Heat exhaustion
• Heatstroke

Symptoms of impending heat illness

In addition to educating young athletes about both the importance of hydration and the dangers of heat-related illness, ensuring that they are drinking enough fluids, and taking precautions to reduce the risk of heat injury in children in hot and humid weather, you need to watch your child for symptoms of impending heat illness:

• Weakness
• Chills
• Goose pimples on the chest and upper arms
• Nausea
• Headache
• Faintness
• Disorientation
• Muscle cramping
• Reduced or cessation of sweating

A child continuing to exercise when experiencing any of these symptoms could suffer a heat illness.

Heat cramps

Symptoms:

• Thirst
• Chills
• Clammy skin
• Throbbing heart
• Muscle pain
• Spasms
• Nausea

Treatment:

• Move child to shade
• Remove excess clothing
• Have child drink 4 to 8 ounces of fluid with electrolytes (sports drinks) every 10 to 15 minutes

Heat Exhaustion

Symptoms:

• Nausea
• Extreme fatigue
• Reduced sweating
• Headache
• Shortness of breath
• Weak, rapid pulse
• Dry mouth
• Rectal temperature less than 104?F.

Treatment:

• Move child to cool place
• Have child drink 16 ounces of fluid containing electrolytes for every pound of weight lost
• Remove sweaty clothes
• Place ice behind child’s head
• Seek medical attention, if no improvement

Heat Stroke

Symptoms:

• No sweating
• Dry, hot skin
• Swollen tongue
• Visual disturbances
• Rapid pulse
• Unsteady gait
• Fainting
• Low blood pressure
• Vomiting
• Headache
• Loss of consciousness
• Shock
• Excessively high rectal temperature (over 105.8F.)

Treatment:

• Call 911
• Remove sweaty clothes
• Immediate and continual dousing with water (either from a hose or multiple water containers) combined with fanning and continually rotating cold, wet towels on head and neck until immersive cooling can occur.

As parents we tell our kids to study and do their homework so they will be prepared, well we as parents need to do our homework as well when it comes to recognizing the signs of heat-related illnesses and staying on top of hydration. Luckily for those parents who live and breathe on their iPhone there is help. iHydrate is an app that reminds you to hydrate yourself and your children before, during and after activities. App or no app, stay alert, keep those children hydrated and please remember, when in doubt call 911.

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