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Wet Mops to Couch Potatoes: Tips to Keep Kids Healthy

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Duke Health News 919-660-1306

Information to chew on

Question: What do dental floss and a wet mop have in common?

Answer: Besides being stringy, they both require a certain amount of coordination to clean the surface .

"I always tell parents, 'You shouldn't trust children to floss or brush their teeth on their own until you'd trust them to wash your kitchen floor,'" said Dr. Martha Ann Keels, a pediatric dentist at Duke University Medical Center. "You don't just want to hand them this string and brush and tell them to go to it," says Keels. She recommends waiting until about age 8, when they're in the third grade, to let them brush and floss without adult supervision. "Parents should make it a family affair, brushing and flossing with the child," Keels says. "Tell, show, do."

When do you begin brushing? Keels recommends that parents begin a tooth cleaning regimen as soon as the first baby tooth appears, but a washcloth will do just fine until there are enough teeth to brush.

"When a child is bottle- or breast-feeding, the teeth should be wiped down afterward, because the deposits of milk that make your teeth feel fuzzy need to be removed," Keels says. There's really no need to see a dentist until eight teeth have come in, says Keels.

When do you begin flossing? Keels says the right time is when the gaps between your child's teeth have begun to close, around the age of 4 or 5. Until then, the food particles that grown-ups would have to work out with floss can be removed in a child with supervised brushing.

The type of floss and how often it's used differs for adults and children, too. For young children, a thicker, fuzzier, flavored floss is the best choice. Adults, whose teeth are more tightly grouped, favor teflon floss. Kids should ideally floss every day, just as adults, but enforcing that rule can be difficult, at best. So Keels tells parents they shouldn't let a week pass by without flossing the child's teeth.

Why baby those baby teeth? Why all this fuss when the baby teeth are going to all fall out eventually anyway? Three reasons, says Keels.

First, baby teeth act as 'parking spaces' for the adult teeth, helping them to come in straight, Keels says. Cavities in baby teeth make them lean out of place and closer together, creating the potential for troublesome (and expensive) orthodontics problems later.

Second, Keels observes, those teeth can affect how children feel about themselves among their peers. "The smile is the window to your face," Keels notes. "Other children notice if someone has holes in her teeth, and it can start to affect your child's self-esteem."

Finally, parents shouldn't forget that baby teeth probably won't fall out until the child is 12 years old.

"They need to serve you for a long time," Keels says. "If I told you that you needed to keep and use your current car for 12 years, you'd take good care of it, too."

Brushing up on some household safeguards

The same fluoride toothpaste that protects children from cavities can be dangerous if they are left alone with it, says Dr. Sandy Stopford, assistant clinical professor of community and occupational medicine at Duke. All the efforts to improve the flavor of toothpaste for children may have made it a little too tasty.

"There are literally hundreds of incidents nationally each year where children have been poisoned after eating fluoridated toothpaste," Stopford says. "The results range from an upset stomach to a situation that's hazardous to the child's life. It's not appropriate to let young children use fluoridated toothpaste by themselves." Like other medications, the toothpaste should be stored in a place that's inaccessible to kids, he says.

On a less dangerous note, Keels says that young children who eat fluoride can cause permanent discoloration to their adult teeth, even if those teeth haven't erupted yet. She recommends that children use unfluoridated toothpaste until they're old enough to spit out the paste, around the age of 3. Is anything really childproof?

Alec may only be 3 years old, but he's a quick learner and very bright -- maybe too bright for his own good, sometimes. He's already figured out how to remove the kind of "childproof" cap on medicines and other bottles that requires him to press down before turning.

In fact, just because household substances that can be highly toxic to kids if ingested -- aspirin, bleach or anti-freeze, to name a few -- have childproof caps doesn't mean that parents can leave them lying around and feel safe, Stopford notes.

"A childproof cap means that the container should also be kept out of reach of children," he says.

Kids like Alec can learn how to undo the cap if they're around it often enough.

"If you look at the statistics from the American Association of Poison Control Centers, deaths for kids aspirating kerosene and other petroleum distillates are still common," Stopford says. "The containers do have childproof caps on them, but parents still need to lock them in a cabinet."

The art of playing it safe

Maggie's only 4 years old, but she already loves to paint. She's not always choosy about where she does it -- her parents' walls have sprouted some impromptu murals from time to time -- but her mom and dad need to be choosy about the artist's materials that she uses.

It's important to read labels. Federal law requires that all art materials, whether intended for kids or for adults, must be labeled for potential dangers to children -- as must any item or substance that poses a possible danger to kids.

All art supplies such as paint or crayons should also be labeled "Conforms to ASTMD4236." This means the American Society for Testing Materials has evaluated the supplies for safety and toxicity. "If you don't see that label, don't buy the art material," Stopford stresses.

Maggie's folks should look for warnings about age appropriateness if any small parts that might be aspirated and cause choking are included. These typically say: "Contains small parts. Not meant for use by children ages 3 years or younger." Items to watch out for could include something that seems as innocuous as the small plastic cap on a squeeze bottle of glue or paint. No need for blind panic

Not all hazards are as acute as poisoning, Stopford notes. Her parents need to be aware of what Maggie may be breathing as well as swallowing.

A good case in point is vinyl mini-blinds. Although potential health problems arising from imported blinds made of a plastic called polyvinylchloride (pvc) have been solved -- and there never were any recalls -- the case illustrates how long-term exposure to household items could pose hidden risks.

The pvc that some imported mini-blinds were made of contained lead, Stopford says. Prolonged exposure to sunlight causes minute amounts of the lead to mix with dust particles on the blinds. The dust particles could then become airborne, and be inhaled by children. This is an example of a chronic -- as opposed to an acute -- health hazard.

Although no conclusive evidence linked them to actual illnesses, mini-blinds containing lead traces are no longer manufactured or sold in the United States, Stopford says, for which parents can breath a sigh of relief.

An earful of advice for swimmers

With summer vacation officially underway, Zachary can't wait to take the plunge into the community pool. Unfortunately, all those cannonball dives into the water can aggravate a lot more than the adults he splashes.

Some kids who spend a lot of time in the water are susceptible to an inflammatory condition called "swimmer's ear." The problem is caused by the fact that, while a human ear normally has a low Ph level around 2, a swimming pool's water typically has a high Ph level of about 7. "The Ph in the water raises the Ph in the ear," says Dr. Dennis Clements, chief of the Division of Children's Primary Care at Duke University Medical Center. "That higher Ph creates a moist place in the ear for bacteria to grow more than normally, causing inflammation."

A simple solution is to put drops of dilute acetic acid in a child's ears after swimming, Clements says. "That keeps the bugs that can grow at bay." Some over-the-counter brand names include Swim-Ear and Auro-Dri.

A swim cap is not effective for preventing swimmer's ear, he adds, although ear plugs may help by keeping out most of the water.

Stay plugged into what kids are watching

Since most of us didn't grow up with computers as children, parents may wonder at what age their children should begin to hook up with a computer or begin exploring the many strands of the World Wide Web.

"I see no problems with any child who is interested in computers interacting with them," Clements observes. "My own children have used them at school from a very early age. The more computer-literate a kid is, the better he or she is going to do in the world. If they're going to be sitting inside, I'd much rather have them at the computer than in front of the TV."

Parents may still want to limit computer time and encourage other activities as well, and they should definitely supervise children using a computer or especially the Web, just like they would check out the videos and TV programs that they're watching.

"You need to know what your kids are looking at," he says. It may be tempting to use a computer the same way many parents use a TV -- as an electronic babysitter -- but this isn't a good idea. "Some of what we as parents do today is so we can have a moment to ourselves, but we've still got to supervise what our children do."

Keeping couch potatoes from taking root

Blake may be great at "hanging 10" on his computer keyboard as he surfs the Web with his fingertips, but his parents sometimes worry whether the first-grader is getting enough exercise.

New recent guidelines from the U.S. Surgeon General's office recommend moderately vigorous activity for adults for 30 minutes most days of the week. "I don't see any reason why kids need any less," says Dr. Deborah Squire, an expert in pediatric sports medicine at Duke University Medical Center. Thirty minutes of brisk walking almost every day meet such a requirement.

As soon as they hit first grade, Squire begins to ask her patients about their level of daily physical activity. Many states like North Carolina mandate that private as well as public elementary schools offer physical education programs.

However, many public high schools limit the amount of physical education classes that students can take to one to two years (two to four semesters).

"At a time when our adolescents are under maximum stress from the changes in their lives, we take away one of the few positive ways of reducing that stress," Squire says. That's why it's especially important for parents of high school students to encourage a regular program of moderately vigorous activity, whether in the form of exercise or sports.

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