SMILE IS WORTH A THOUSAND WORDS

Crowe put braces on Kelsi Henderson Monday.

An ounce of prevention is worth a pound of cure, especially when it comes to early childhood dentistry. Teeth begin forming in a baby even before birth. All 20 primary (baby) teeth are present in the jawbones at birth. The lower two front teeth are usually the first to break through the gums, sometimes as early as six months after birth. All primary teeth are usually present by the age of three which is the time by which David Kaelin, a family practice dentist, likes to see young children. Susan Sheets and David Johnson, both pediatric dentists, prefer to schedule a patient's first visit even before that."We can do the first exam on Mom's lap if we need to," said Sheets who will celebrate her 20th year in dentistry in the year 2000. Even before that first visit, there are steps parents can take to decrease the risk of tooth and gum problems. Just as brushing after eating should be standard practice for older children, wiping an infant's mouth after each feeding reduces the risk of gum disorders."A warm moist cloth should be used to wipe over the gums," said Sheets. After the first tooth erupts, a soft-bristled brush can be added to the cleaning routine. Sheets suggests not using toothpaste until the child is old enough to realize the toothpaste shouldn't be swallowed. Johnson, who was Cape Girardeau's only pediatric dentist when he started here 25 years ago, says that many of the problems he thought would disappear with time are still around. One of those problems is "baby bottle tooth decay." Constant nursing on milk, formula or sugary juices, especially before bedtime or naptime contribute to the problem.

A safer alternative is a bottle of plain water or giving your baby a safe pacifier before putting the infant down for a nap or at bedtime.

Fluoride in the water has been a definite boost to healthy teeth and gums. If the water you use is not treated, fluoride tablets and liquid are available from your dentist. Fluoride treatments given at the dentist office help to strengthen the enamel of the teeth. "The fluoride that is ingested helps strengthen the teeth as they develop," explained Johnson.

Sealants are another preventative to tooth decay. Improvements in products and procedures have resulted in longer lasting sealants. The whirring of the drill and the sight of large needles and other instruments often keeps adults as well as children from going to the dentist for regular check-ups. Pediatric dentists realize that the visits must be as pleasant as possible so children will not dread their check- ups. There are a variety of high-tech instruments available today to lessen the pain associated with dentistry. The use of air-abrasion when preparing a tooth for filling can lessen the need for numbing of the area. Laser dentistry can be used for minor surgery and also for preparing teeth for fillings.

Pediatric offices are equipped with furnishings scaled to the size of the patients. Waiting areas are filled with "fun" items. Even the traditional white coat associated with the medical field has given way to more colorful attire. "I dress in fun clothes," said Johnson. All these things combined make going to the dentist a lot more fun.

The earlier a child begins regular dental visits, the earlier orthodontic problems can be addressed. "A general dentist needs to have a good knowledge of growth and development of the jaws and teeth," said Kaelin. This way potential problems can be caught at an early age which often makes treatment much easier. Children who are in their teens and make an orthodontic visit for the first time may face a much longer period of corrective measures than if their first visit had come around the age of seven."Many of the teeth problems are actually jaw problems," said David Crowe who has been an orthodontist for 20 years. Crowe appreciates the referrals from dentists who have noted potential problems early. Crowe's basic philosophy is to work with Mother Nature and let growth help to correct certain problems."The exciting thing about orthodontics is the challenge of finding the source of the problem and devising appropriate techniques to address the problem efficiently," he said.

Early recognition do not always result in early treatment. "Sometimes it's just best to wait and see how the mouth develops," said Crowe.

Correcting early alignment of teeth, eliminating adverse habits such as thumb-sucking and tongue thrusts, correcting crossbite and tooth grinding are all interceptive treatments which may eliminate the need for more drastic measures at a later date. By correcting jaw problems and allowing the teeth to shift naturally, Crowe has seen a decrease in the need for extractions to correct problems.

As the time for trick-or-treating approaches, parents need to monitor their child's intake of all those sticky, gooey, sugar laden-treats."It is better to let a child have sweet treats as a desert with a meal when the saliva is already flowing," said Sheets. If a child is limited to the number of pieces of candy to be eaten, it is often better that they be eaten at one sitting instead of a piece at a time. "The frequency sugar attacks teeth seems to have more of an effect than the quantity," she added.

There are numerous state and federal programs meant to educate parents and children to the necessity of proper dental hygiene. Teaching proper tooth care is included in the curriculum of many pre-school programs. Dentists have a variety of material available to help answer questions concerning proper dental care.