Brushing My Child’s Teeth: How Can I Help?

By: Amy Requa, MSN, CRNP

Did you know that October is National Dental Hygiene Month? It’s actually good timing, especially since children will be chowing down on their fair share of candy this weekend! The extra candy gives us an even better reason to think more about brushing teeth! Many parents of young children ask: “What is the best method for brushing my child’s teeth?” Well, often a picture is worth a thousand words, so here are a few photographs of different positions and methods that parents and caregivers can use to help young children with toothbrushing!  

Photos courtesy of Joanna Douglass, BDS, DDS

In the photo on the left, the adult sits in a chair while brushing the child’s teeth from behind. The child stands and leans back on the caregiver’s lap, using the adult’s legs for balance. See how the adult carefully stabilizes the child’s head, gently lifting or lightly pressing the lips away from the teeth with one hand, while brushing the teeth with the other? This actually makes it much easier for the adult to brush all surfaces of the teeth while the child still feels secure and won’t squirm away. Looking down at the child’s mouth from behind makes the child’s teeth more accessible to the brush, especially at the gum line where sticky plaque is most likely to build up in that space between the teeth and the gums. The plaque is the build up of sticky germs mixing with food/drink on all the surfaces of the teeth. Plaque eventually breaks down tooth enamel if it is allowed to stay on the teeth. The plaque on the surfaces of the teeth needs to be brushed away twice a day: in the morning and at night, right before your child goes to bed.

In the photo on the right, this toddler is allowed to stand up, probably on the couch, while the mom holds the child’s hands during brushing. After all, who says you have to brush your child’s teeth standing in front of the sink in the bathroom? You don’t! Use a very small amount of fluoride toothpaste and your child does not need to spit it out, so you can brush your child’s teeth anywhere in your home, maybe when your child is sitting in her highchair, playing in the bathtub, or joining you on the couch. 

Here are the most current guidelines from the American Dental Association: 

• For children younger than 3 years, caregivers should begin brushing children’s teeth, with a soft child-sized toothbrush, as soon as teeth begin to come into the mouth. Use a fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. 
• Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. 
• For children 3 to 6 years of age, caregivers should apply no more than a pea-sized amount of fluoride toothpaste to the soft toothbrush.  
• Adults should assist with toothbrushing until age 7 or 8.
• Replace toothbrushes when bristles appear worn (usually after 3-6 months)

How old were your children when you started to brush their teeth? Did they enjoy it? Have any tips to share on how you brushed their teeth?

References: 

Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. J. Timothy 
Wright, Nicholas Hanson, Helen Ristic, Clifford W. Whall, Cameron G. Estrich and Ronald R. Zentz, JADA 2014; 145(2):182-189. 

Fluoride Toothpaste Use for Young Children, American Dental Association Council on Scientific Affairs, JADA 2014; 145(2):190-191. 

About the Author: Amy Requa, MSN, CRNP, CPNP-PC, is a board certified Pediatric Nurse Practitioner. She has 20 years of experience in public health nursing, maternal and child health, family and community health promotion and has extensive health expertise in oral health, childhood obesity prevention and child nutrition. Click here to learn more about Amy.

Cultivating a Sense of Belonging to Help Combat Bullying

By: Kristan Kostur, 

Co-Founder of Proudtree Empowered Learning

October is National Bullying Prevention Month. If you Google “bullying prevention” you’ll get more than 1,000,000 hits addressing this issue. You’ll find everything from eye-popping statistics to what some say are questionable statistics, and posts from those who believe this is simply sensationalism to heart-wrenching accounts of children who felt the only way out was to take their own lives.

We are often asked at Proudtree if our products are for anti-bullying. While they can be used with this intention, our focus is on helping to empower children with a sense of purpose and value—to help them build a strong principled foundation from which they can grow with respect for themselves and others. Our hope is to reach the child before circumstances arise that cause him or her to bully others, and to equip those being bullied with a sense of personal competence, resiliency, and control over their world so they have the confidence to transform it.

We begin with what we believe to be one of the most important aspects in a child’s healthy development—belonging. A sense of belonging—feeling valued, connected to others, and a part of something greater—gives children the emotional strength to overcome challenges and difficulties that emerge in their daily experiences.

The most important place for your child to feel that he or she belongs is at home. The feeling of belonging begins when you establish an emotional connection with your child, making sure he or she feels valued, safe, and loved. When children feel like they belong, they are more likely to perform better in school, make friends, and overcome roadblocks.

Here are some ideas you can use at home to support your child’s sense of belonging:

Let’s Read! - Storybooks are wonderful tools to use with children to help them understand their feelings. As your child watches and listens to the storybook, he or she will make a connection to the characters who share many of the same concerns and problems. This helps your child feel included instead of alone, and helps to develop a sense of belonging. As you read the story, ask questions such as:

• What is your favorite part of the story and why?
• What do you think the character is feeling?
• Have you ever felt that way?
• What does that feel like?

You can also have your child describe the characters—the color of their hair, for example, what they like to wear or things they like to do. Explain that meeting characters in a book can be like making new friends. Then ask which character your child would most like to have as a friend and why.

Family Ties - Support your child’s need to belong at home by trying some of these tips:

• Give your child uninterrupted, one-on-one playful time with you
• Take a genuine interest in what’s important to your child and support those desires
• Smile when your child enters the room
• Express your love freely and show plenty of affection
• Include your child in family matters and decision making
• Plan a family party with your child and include family traditions such as special foods, games, or stories

Just how important is it for children to cultivate a sense of belonging? How big of a role can it actually play when a child is being bullied? How likely is it for a child with loving and secure connections to engage in acts of bullying? Consider the invaluable words of author and research professor, Dr. Brené Brown: “We’re hardwired for connection—it’s what gives purpose and meaning to our lives. The absence of love, belonging, and connection always leads to suffering.”

What are some of the ways you support your child’s sense of belonging?

About the Author: Kristan Kostur is co-founder of Proudtree Empowered Learning, an educational company dedicated to developing unique materials and programs to help instill in children a sense of personal competence and internal worth—attributes which help them learn to expect success for themselves in school and beyond. To learn more about Proudtree Empowered Learning visit http://www.proudtree.com.

Music on My Mind

By: Dr. Linda Carson

When my father was progressing through the stages of Alzheimer’s disease, I was a very emotional witness to the long goodbye. It was painful for my family to watch someone we’ve loved and known for so long retreat gradually to a place that included the destruction of memory, thinking, language, and behavior patterns.

But something intriguing was also happening at the same time. As my father’s memory loss and confusion progressed, eventually he was only able to recall childhood songs! Yes…songs! I actually had fun singing along during visits with him even though he did not know me. Eventually, that pleasant luxury faded too, but during that brief stage, we sang children’s songs and nursery rhymes over and over!

It made me wonder what is it about music that remains wired into our brains so deeply that it can be recalled even when all other memories have disintegrated. I’ve learned that there is amazing research being conducted by neurologists at the Boston University Alzheimer's Disease Center to study music memory and ways to use it to improve the lives of those with profound memory loss. Watch this dramatic video to see the effects of “neural nostalgia” on Henry, an elderly man with dementia. You will be amazed!

I wish now that I would have sung childhood greeting songs to my Dad, or tried singing songs from his teenage years when he courted my Mother because the research is yielding information about how the emotions attached to our early music may play a profound role in awakening and accessing memory and emotion. So what’s next? Well, music therapy may be commonplace when we need nursing home care as we age. Plus music may be used for creating memories instead of focusing on recall. For instance, the allied health staff may sing directions to us about medications or various therapies!

To return to the present, when our young children hear, sing, and dance to music, they are literally building neural connections by using a variety of areas in their brains. The childhood songs that they listen to repetitiously and that bring such great joy can literally be a quality of life enhancer once again decades later! What a concept!

With that in mind (get it?), I’d like to encourage you to play lively, fun-filled music in your homes, cars, and classrooms and enjoy it to the fullest in the present, knowing that at the same time, you’re building a store house of pleasant, loving memories for use on the other side of the pendulum swing of life.

A perfect music CD for this playful assignment has just been released by Choosy Kids called My Wiggle Makes Me Giggle. This CD has fast paced and upbeat songs that get everyone dancing and laughing together. Children can learn movements from listening to the words in the songs and just like Henry in the video above, may remember the motions for years to come!

I’d like to share with you a free download of the title track from My Wiggle Makes Me Giggle so that you can enjoy this music with your family. I hope that music of all kinds enables you to build lasting and fond memories.

What has been your personal or professional experience with this music phenomenon?

About the Author: Linda Carson, Ed. D, is the founder and CEO of Choosy Kids, LLC, and the Ware Distinguished Professor Emerita at West Virginia University. An award winning, nationally recognized expert, Dr. Carson has devoted her career to promoting healthy preferences for young children and the adults who make decisions on their behalf. Click here to learn more about Linda.

Helping your Child Thrive at the Pool: It’s a Year-Round Event!

By: Dora Gosselin, PT, DPT, PCS, C/NDT

We are now a few weeks into fall. The leaves are changing, the temperatures are cooling and our family activities may change as we spend less time outdoors and more time indoors. Many health professionals encourage us to remain equally as active during winter months as we were in summer. During the month of October the American Physical Therapy Association recognizes the impact that physical therapists and physical therapist assistants make in restoring and improving motion in people's lives.

With these two “events” happening, I have been reflecting on what we did outdoors as a family this summer. We typically spend as much time as possible at the pool. As parents, pool safety is critically important, but there is another very significant part of pool culture – the play and social interaction that happens between children when they are in the water.

Now you may be asking “why are we talking about the pool in October? It basically does not exist in our life until mid-to-late May.” Here’s the answer: in the spirit of physical therapy month and summer 2016, let’s use the “off-season” to develop our children’s movement skills so they can get to the next section of the pool with their friends next summer!

For children to fully participate in the pool environment they must have the movement skills that allow them to be safe while keeping up with their age-matched peers. For children with sensorimotor or other disabilities, the pool may not be a refuge for endless play but rather a scary and isolating experience.

Our pool, like many others, is divided into sections. There is a shallow section that is lined with parents ready to leap into the water to save their precocious toddler; a deeper part, about five feet deep, that hosts the most diverse group of swimmers from very new swimmers keeping their head above water just enough to prevent a lifeguard from jumping in for the save to very skilled swim team members flipping and diving about; and lastly there is the diving well – the home of the diving boards – a spot that is reserved for the most highly skilled swimmers.

Many of you can relate to this description of a community pool. You can likely recall the swimming (movement) skills of children in each section of the pool. What I would like to call your attention to is the play and social interactions that happen in each section of the pool. The shallow end is generally filled with toddlers and kindergarten-aged children doing what they do – playing with plastic toys and dunking their face under to show their parent for the umpteenth time. Interactions between children in the shallow end are less; many children are very fulfilled with experiencing their own movement and there is less peer play here. In the deeper sections of the pool the social interaction and play is more variable and is a much more significant component of the pool experience. Children interact with one another with swimming races, using goggles to retrieve dive toys thrown by one another and of course the jumping and diving activities. They also just carry on conversation as they tread water or wait in line to go down the slide or off of the diving board. If children live in an area that has seasons, the skills they learn and practice during three months of the year may not carryover between seasons. For children who have a disability and need more practice swimming, seasons and lack of access to an outdoor pool are exponentially troublesome for skill carryover.

The most obvious solution here is to find a pool that your family can utilize all year round so that your child can practice and continue to develop skills over the “off-season.” If this resource is not available in your community or is cost prohibitive, here is a list of suggestions to get your little fish ready to swim and play next year:

• Get in the water as early as you can in the spring. Even swimming just a few times before pool season 2016 will give your child an advantage and a level of comfort when your community pool does open.
• Demonstrate for your child some strategies for peer play they can do in the pool. For example, for a rising kindergartner, the “hot skill” may be jumping in the pool in tandem with a friend or doing a handstand. Take on these skills outside of the pool to help your children develop the movement and play skills they need  to participate with their peers.

When you do finally get into the water for the first time in the spring, follow these tips to get your children acquainted with the water again:

• Swimming requires integration of the right and left sides of the body. This requires coordination as well as strength and endurance. Putting this all together is difficult. A great tool for lessening the task demands on your children is to use a simple kickboard. With the kickboard, children can practice using their legs symmetrically or they can hold the kickboard with one arm and practice coordinating three extremities. 
• Practice, practice, practice! Motor learning theory tells us that internal feedback is the most valuable tool for learning a skill. If your children are frustrated and scared as they practice swimming, it is impossible for them to learn from their own bodies what movements they need to do to attain and sustain swimming skills. You will be most helpful by identifying the components of movement your children do well by proposing something that they should practice. For example, “I love the way that you are kicking your feet fast. This time can you also try to keep your bottom up while you kick?” 

Growth in one area of pool proficiency (movement or social) may spur growth in the other. If your child continues to be resistant to practice or is having difficulty attaining better skills, you can always focus on the social opportunities. Many pools have rules banning most flotation devices; however, some pool managers may be amendable to your child using a U.S. Coast Guard approved flotation device. Having the safety of a flotation device may provide your children with the confidence that they need to cross the lane line and explore the games and interactions that happen in the deep end.

In conclusion, the challenge of swimming demands integration of both sides of the brain and body in a coordinated and sustained way.. Hopefully this blog has reminded you that swimming has two parts – movement and social – and that both of these parts need to be practiced so that your children can thrive and participate safely at the pool. I also hope that it has allowed you to consider what your strategy will be for ensuring a positive 2016 pool season. Start thinking about your game plan now, not on May 1st!

About the Author: Dora Gosselin, PT, DPT, PCS, C/NDT enjoys her combined clinical and academic roles at Duke University. She is board certified in pediatrics and certified in Pediatric Neurodevelopmental Treatment. She has also completed her Advanced Baby training through the Neurodevelopmental Treatment Association. Dora's most meaningful professional accomplishments always occur when a family and child share joy when a new skill is acquired and when physical therapy students, in the clinic or the classroom, grow their passion and skills. Outside of physical therapy, Dora (and her husband, Ben) can usually be found watching their seven-year-old do some sort of performance in the living room.

Why Enforcing Rules Makes a Difference

By: Emily Murphy, Ph.D.

When I reflect on my childhood, I remember certain instances that I would say to myself, “I will never turn into my mother.”  Well guess what, I was wrong.  Don’t be mistaken, I love my mom more than the world itself, but as a head-strong child and adolescent there were certain things that I was convinced that my mom (and dad for that matter) had no clue about.  Below are a few examples of some of these things.

As a very involved and active child, my parents had a rule that both my sister and I were only allowed to be enrolled in a maximum of two organized activities at any one time.  So I was tasked with deciding between field hockey, cello, piano, softball, etc. At the time, I did not see any purpose for this parental decision being forced upon me. The only explanation that I could see through my child lens was that my parents were being mean and selfish.  Boy was I wrong.  Fast forward 15 years to the time when I became a parent myself and the reasons behind that rule now appear crystal clear. My parents developed and enforced this rule because they knew that family time was equally, if not more important than, a multitude of structured activities.

In our busy world today, many parents think that in order for their children to be successful they must get them involved in as much as possible.  But in reality, families need quality time together to be creative, to be physically active together, and to simply enjoy time together.  I often tell parents that I encounter through the various programs that I teach, that being overscheduled does not necessarily translate into having a healthy, happy child.  Many times, being overscheduled mean that children spend a lot of their spare time in a vehicle being transported from one activity to the next, eating fast food in the back of the car, and standing on a sport field waiting for a ball to be hit to them or their turn to play.  Unstructured family time can be filled with family-friendly physical activity like walking the dog or simply playing tag in the backyard. It can be spent preparing meals together, having a family game night, or a variety of other activities. 

Another thing that my parents always made us do when I was growing up was to sit down at the kitchen table and eat dinner together as a family most, if not all, days of the week.  Compared to my closest friends and neighbors, my family was one of the only families that had this ritual.  I used to think that my friends who were allowed to make themselves something to eat, or eat their meal in their bedroom or in front of the TV were so lucky.  Yep you got it, I was wrong again. 

Family mealtimes are important for many reasons.  Family meal times allow family members to connect and talk about important things that are going on in each other’s lives.  Eating meals as a family has also been shown to improve various health outcomes like more healthful dietary patterns (Larson, Neumark-Sztainer, Hannan & Story, 2007). In a study done in 2007, families who ate dinner together every day consumed an average of 0.8 more servings of fruits and vegetables compared to families who did not eat dinner together (Rockett, 2007). These families also had higher intakes of important nutrients such as dietary fiber, calcium, folate, vitamins B₆, B₁₂, C and E, and iron, and they were less likely to eat unhealthy fried foods and drink soda (Rockett, 2007).  In addition, children from families who eat together on a regular basis are more likely to have family support, positive peer influences, and positive adult role models (Fulkerson, Neumark-Sztainer & Story, 2006). 

I am sure glad my parents were right and that I was wrong about many rules that they had as I was growing up. In fact, most of those rules, including the two examples above, are now rules in my own household.  And yes, I am sure that my kids sometimes think that I am mean when I tell them to turn off the TV and put their cell phones away when we sit down together for a meal as a family, but I also know that when they look back at their childhoods they too will realize that my husband and I had these rules because we wanted what is best for their overall well-being. 

About the Author: Emily Murphy is an Obesity Prevention Specialist with the West Virginia University Extension Service.  By trade, she is a Pediatric Exercise Physiologist and her passion is promoting physical activity for kids and families.  While her daytime job is working as a faculty member at WVU, her most important, most rewarding and hardest (at times) job is being a mom to two amazing, creative and loving children.  

A state and national leader in childhood obesity prevention, Emily has nearly 15 years of experience helping children, communities and families get active and healthy.

She holds Bachelor’s, Master’s and doctoral degrees in exercise physiology from WVU. She served as an Extension specialist with the Family Nutrition Program from 2003 – 2005. She then joined the CARDIAC Project at the WVU School of Medicine where she helped implement and gain funding for new programs, like West Virginia Games for Health.

Murphy’s approach to better understanding and helping to resolve obesity issues is to begin by looking at the barriers unique to West Virginians.

To contact Emily, e-mail emily.murphy@mail.wvu.edu, or call 304-293-8589.