Monday, January 18, 2010

Orthodontic Treatment for Children

For children who need orthodontic treatment, there is a best time to begin treatment in order to achieve the best results. For this reason, the American Association of Orthodontists recommends that all children be examined by an orthodontist by age seven, or earlier if there are indications of a problem.

Why age seven? By age seven, most children have a mix of primary (baby) teeth and permanent teeth, and your orthodontist will be able to spot even subtle problems with jaw growth and emerging teeth. Whether your child has an inherited predisposition to a "bad bite," such as crowded teeth or unequal jaw growth, or an acquired orthodontic problem, such as from thumb sucking or an accident, the advantage of early diagnosis and treatment is that some orthodontic problems are easier to correct if they are found and treated early, during the years that the treatment may work in conjunction with your child's natural growth spurts. Waiting until your child's permanent teeth have come in or until her/his facial growth is nearly complete may make correction of some problems more difficult.

If an orthodontist recommends that your child needs treatment now, then s/he should be able to answer these questions for you:
• If we begin treatment now, will we avoid extracting permanent teeth?
• Will beginning now simplify the treatment that will be needed later?
• Will my child have to wear braces, and if yes, will treatment now reduce the time in braces later?
• Will beginning now influence the growth of my child's jaws in a positive manner?
• Will treating now eliminate a problem that could do damage if it's not treated?
If the answer is yes to most of these questions, there are the three types of treatment that your orthodontist may recommend…
• Preventive- Intended to keep a bad bite or crooked teeth from developing in an otherwise normal mouth and to provide adequate space for permanent teeth to come in.
• Interceptive- For problems that, left untreated, could lead to the development of more serious dental problems over time. This could include correction of thumb- and finger-sucking habits, tooth removal or resizing to guide permanent teeth into correct positions, or using a space maintainer to hold space for permanent teeth.
• Comprehensive- Involves problems with the alignment of your child's teeth, how his/her jaws function and how her/his top and bottom teeth fit together. The goal is to correct the identified problem and restore your child's bite to its optimum condition.
A check-up may reveal that your child's bite is fine and that he or she doesn't require treatment. In many cases, your orthodontist may simply want to watch your child and his/her orthodontic condition, doing periodic examinations to "keep an eye" on development. Any of these diagnoses ultimately will give you the peace of mind of knowing that you're doing the best for your child.

Email: dr.gordon@stroledds.com
Tel: (817) 732-9341
Website: www.fwkidsdentist.com

Friday, January 1, 2010

“Does Your Child KNOW You Are Listening?”

by Linda M. Manning, RN, LPC-S, RPT-S, RDA
Registered Nurse
Licensped Professional Counselor-Supervisor
Registered Play Therapist-Supervisor
Registered Dental Assistant


This article addresses how to show your child that you are listening and that you understand their point of view. Kids can be very verbal in terms of vocabulary although their cognitive functions are not the same as an adult. Children think and see the world differently than adults. Showing your child that you hear and understand is as simple as repeating back what they said to you. You can also state what you see them doing. This works beautifully with young children. Your older child will look at you funny and ask why you’re talking weird! Your responses have to be more refined to communicate in this way with an older child. Still, acknowledging what your child is saying and telling you lets them know that you "get it".

Of course everyone of any age feels you are listening when your body language shows that you are. That is, stop what you are doing, make eye contact and face your body fully to your child. This indicates that you are truly “present” with them. When your child is telling you something, allow them to get it out in their own way. Then state it back to them. When emotion is expressed, do not hesitate to state what the feeling is. Many parents are tentative to acknowledge a child’s feelings because they fear that it will make it worse. The opposite is usually true. Acknowledging a feeling in a calm, normal tone of voice, lets the child know that you understand and you “get” what they are trying to communicate to you. Just the fact that you “get” it and acknowledge it verbally helps the child feel understood and thus feel better.

Parents first response is often to "fix" the problem or "change" the child's feeling. This will ultimately shut communication down, as seen as the child grows and begins to not feel comfortable telling the parent what they feel. Children have to learn to regulate their own emotions. They do not learn to regulate their feelings when others are always telling them not to feel the way they do. As parents, we tell children not to be sad, angry, hurt, etc. and we think we are helping. In truth, we are usually helping our own feelings. We want to feel needed and helpful and don't want to see our children experience any "negative" feelings. We also don't want to have to address our child's difficult behavior so we attempt to change it.

Remember that acknowledging an emotion does not mean that you agree with that feeling. It is merely a statement showing understanding of what the child is expressing. It is listening. Accepting an emotion also does not mean that you accept all behaviors that go along with it. It’s OK to be angry. It’s NOT OK to break things, hurt or yell at people. Future articles will address setting limits on unacceptable behaviors, while accepting feelings.

So now let’s say you are going to show you are really listening. Let’s say your child brings you a drawing or painting that she has done. The usual adult response is “Oh, that is so pretty”, or “You’re such a good artist”, etc. Adults are usually taught that children need praise to build up their self-esteem. The trouble is that it is overdone and it is NOT what builds a child’s inner sense of worth. These statements do not give the child any constructive information. This only tells the child what YOU like and consequently the child will think it is only safe to show you what you want to see.

Try it this way. Your child brings you a drawing or painting she has done and you begin to describe the drawing with an interested tone of voice (use a normal voice as you would when you are interested in what an adult is saying). “Oh, look, you drew these lines here and you used lots of colors here.” Describe whatever you see in the picture. You can also say, “You decided to use this color”. You don’t have to name the objects in the drawing or ask the child what it is. As you describe it in a simple way, the child will begin to fill in the information about the picture for you. Then you can reflect what they tell you, which shows your interest in their ideas and point of view. And the child will describe the picture from their perspective instead of what they think you want to hear.

Children feel valued and important when you communicate with information and interest in their drawing instead of “What a pretty picture”. When you describe what they have done in the drawing a child gets a sense of accomplishment, “I can do it” or “I did it myself”. This builds a healthy self-esteem based on the ability to do something and to make decisions. Children want to have their abilities recognized. Self-esteem is developed by experiencing your own abilities and having a sense of being valued. When a parent shows understanding, with interest, from the child’s perspective and accepts the child, the message sent is that you are important to me and I am here to listen.

As stated above, accepting emotions and the child’s perspective does not mean that you accept all behaviors. Setting limits and clear boundaries will be addressed in future articles.


Send all parenting and dental questions to Linda at dr.gordon@stroledds.com

An Exciting New Service!

We now have the capability to cut the time in half that patients experience numbness after a dental procedure. When your child’s mouth is numb, there is the risk of the child biting their tongue, lip or inner cheek. Children will also scratch or pick at the site because it feels “funny”. When the numbness time is reduced, the chance that the child will harm him/herself is decreased.

FDA approved OraVerse™ is given after the local anesthetic to shorten the active time of the numbing effects by half or more. Children 6 years of age or older can be given OraVerse™. If you are interested in this new service, let us know. We are also happy to answer your questions concerning treatment options with OraVerse™.

Saturday, December 19, 2009

How to Keep Stress from Ruining the Holidays

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


From Halloween through New Years our stress is heightened because of an increase in shopping, parties, baking, family get-togethers, etc. These holiday times can be very enjoyable, difficult or both! Too much stress damages our health, relationships and overall well being. One of the first things that comes to mind during the holidays is that expectations are often unrealistic. We often want to do more than is possible. We add on extra things to accomplish onto our already overwhelming schedules. And we want everything to be perfect! Without realizing it we often project these feelings and false expectations onto our children. This takes a toll on our relationships as the stress of the extra activities during the holidays makes us exhausted and emotional.

To begin with, it is helpful to be aware of what your expectations are and to keep those realistic. What is it you expect and want? Acknowledge your feelings. The holidays can elicit many feelings from the past and present. People often have a mix of feelings both positive and negative. It is common to feel excitement, anticipation and hopefulness as well as disappointment, guilt, loneliness and depression. Allow yourself to be aware of these feelings and find a way to express them that is helpful and does not hurt yourself or others. Acknowledging your child’s feelings by clearly stating what those feelings are in a normal tone helps your child feel understood and experience feelings as a normal part of the human experience. Focus on problem solving under stressful circumstances rather than reacting emotionally. How you express your feelings will influence your child’s acceptance and expression of feelings. Keep in mind that acknowledging feelings does not mean you have to act on them.

Reach out to others, even if it is just to ask for a hug or for help. Social support is something we all need. Be careful not to disclose emotional information to friends that are not able to understand or accept what you are experiencing. Revealing too much may put you at risk of feeling guilty or embarrassed later. Seek those who can really accept you and help you.

Be realistic about what is really important. Learn to say “no” when you cannot do something without adding more stress to your routine. Keep the healthy habits that you may have. Don’t abandon your exercise routine or the few minutes you have for yourself in the morning. Stick to a routine as much as possible especially if you have young children in your household. Stress is reduced when a predictable routine for sleeping and eating can be maintained.

Plan ahead and do what you can in a timely fashion to avoid last minute rushing as much as possible. Take a breather if you need to. Always ask, what is more important? And how will this affect my relationships with my spouse and my children in the long run? Take the time to stop and really be in the moment with your child and spouse. Being fully present emotionally brings a heightened sense of satisfaction. This means keeping our thoughts from being stuck in the past or racing towards the future. It means not dividing our attention into doing too much at once. Young children are present in the here and now and do not interpret why their parent seems distracted, tense or even angry. If the adult is just trying to do too many things at once, the child will see that as not being interested in them and therefore not caring. Attention and love are synonymous to children. Set aside at least 30 minutes to be present with your child without distractions or interruptions. Build lasting happy memories associated with the holidays.

With so much going on and so much expected it is easy to become overly stressed and tense during this time of year. I hope this information and these few suggestions are helpful for you to improve your most valued relationships and your feeling of contentment during this holiday season and throughout the year. Merry Christmas and Happy New Year to all!

Friday, December 18, 2009

"Why See a Pediatric Dentist?"

by Dr. Gordon Strole, Jr.

If you use a pediatrician for your child’s health care, doesn’t it make sense to use a pediatric dentist for your child’s dental health? Pediatric dentists are trained in dental problems that are specific to children and adolescents and keep themselves informed and updated in the most recent advances in dental procedures for kids.

Children are not miniature adults. They have their own needs and conditions that the pediatric dentist specializes in. In addition, pediatric dentists are experienced and knowledgeable in how to make children feel comfortable and gain their cooperation. The pediatric dentist studies child psychology in order to understand the normal emotional and psychological growth and development of children. The office design and staff trainings are all geared toward working with children. Part of this extensive training includes providing quality dental care for physically and mentally disabled individuals.

Growth and development from infancy to adolescence is rapid and extensive and the child’s dental needs undergo changes during each developmental stage. I recommend a child’s first visit to be no later than age 18 months or even earlier if dental problems are noticed. The child goes through various psycho-social, physical and dental changes that the pediatric dental team is prepared to manage. This means that emerging problems can be caught early and treatment less extensive than waiting until the damage is irreversible. The pediatric dentist takes advantage of the child’s growth.

Even though many advances have been made in the practice of dentistry, prevention and early treatment are still the best defense against dental problems. Dental problems affect growth and development of the growing child in many ways. So just as you choose a pediatrician for your child’s medical care, be aware that the pediatric dentist is the best choice for your child’s dental care.

Tuesday, December 15, 2009

Child's Play and Toys

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


Children use play as an expressive language. It is a means of expression of what they experience and what they are exploring. Play is a central activity of childhood and is universal and natural to all children. It occurs at all times and in all places. Play also facilitates both physical and psychological development. Play crosses all language and ethnic barriers. If play is a language, then toys are like words.

Toys symbolically express what a child is experiencing or thinking. They give the child a way to communicate more complex feelings and ideas than they may be able to do with words. Children are more comfortable with symbolic expression through play, stories and pretend games than they are with sitting down and “talking it out”. Adults are comfortable sitting down to discuss a situation or issue at length. Children are not. Plato said “You can discover more about a person in an hour of play than in a year of conversation.” This symbolic language can reveal what a child has experienced, the reactions and feelings to those experiences, what the child wishes, wants and needs and the child’s perception of self and others.

What kinds of toys are best for children? In the holiday season there are long lines and parents getting up very early in the morning to get THE toy that is all the rage. Children are influenced very easily by the commercials they watch. Up until the age of 8 years, children do not distinguish between commercials and entertainment programming. Advertisers know very well how to instill a desire to have a certain toy. They also know that parents want to please their children and see their joy on Christmas morning. Love and gift giving are interconnected in our minds. Too often; however, that perfect toy is abandoned after a short time and something else needs to take its place. But I digress. What types of toys are beneficial and useful to children in terms of development and symbolic expression through play?

Toys that the child can manipulate or use their own imagination with are toys that benefit growth and development the most. Electronic toys and games may be fun, but they do not afford the child any expression of their own imagination or creativity. Toys that require batteries and have an on-off switch will limit the child’s use of imagination, especially if the toy only does one thing when switched on. Toys that are spin-offs of movies or cartoons are also limiting for the child’s expression because the child will “play out” the movie or the role of that toy instead of imagining their own scenarios. This is not always the case; however, the tendency is to re-enact the character as it is in the movie or cartoon.

Toys can be classified into different categories, such as aggressive toys, nurturing toys, role-play or fantasy and mastery toys. Toys and spontaneous play are helpful for children to explore their environment, learn to problem solve, increase their creativity and flexibility and is a window to the child’s inner world. So there is purpose to child’s play and it’s also lots of fun!

Ruth Hartley, who co-authored The Fundamentals of Social Psychology with her husband, said, “To read the language of play is to read the hearts and minds of children.” Observing child’s play that is driven by the child, is like listening to them express their inner thoughts. Keep in mind that it is natural to play out many different types of themes and types of play that are developmentally normal. When choosing toys for your child, think about what your child can do with the toy, not what the toys does to entertain the child. Giving them a selection of toys that can be used to express a variety of emotions and experiences is useful. In addition, providing too many toys is overwhelming and not productive to the child’s development and well-being.

Monday, November 16, 2009

Communicating through Play

Holiday time is especially stressful with so much going on, high expectations and time is short. This is a great time of year to devote a little time to focus on the moment, play with your child and bring down the stress level. This article gives you some guidance and hints in how to play with your child that will build a stronger relationship.


“Communicating through Play”
by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


Play is a natural way for children to express what they think and feel. Children do not have to be taught how to play. It is an important part of their world. Play helps them learn about the world, themselves and others. It helps them practice new skills and improve their coordination. Child’s play is not goal driven. The outcome is not as important as the actual process of play for young children. Play goes hand in hand with growth and development and learning. In fact, non-goal driven, child’s play is essential to normal development.
In general, when parents engage in play with their children, they tend to teach, ask questions and lead the play activity. Adults usually have an end result in mind when playing. The parent wants to teach the child what the animals say, question to elicit what the child knows to meet the needs of the parent. Instructing is an important part of parenting yet we need to stop the teaching sometimes when playing in order to build a close relationship and have fun with our children.
Through normal growth and development children will begin to separate psychologically from the parent. We begin as dependent on everything from our parent and adults around us and gradually learn to be more self-sufficient and care for ourselves independently. But relationships are always important in happy, normal development. Inevitably, problems crop up in the parent-child relationship because the need to separate creates power struggles, misunderstandings and hurt feelings. How can play help with this all important relationship between the parent and the child?
Begin with understanding that play is an essential part of the child’s world and is enormously important in their expression of feelings and view of the world. The play I am referring to is not the electronic toy world or the video game universe. Play with ordinary toys and objects that can be manipulated by the child and his or her imagination are what children need to be expressive and creative in their play activities. The human child is born with the ability to develop all human emotions and potential. Keep in mind that children will express all kinds of emotions through play. Play is symbolic of what the child feels.
As often as you can, set aside a 30-minute play period for you and your child that will NOT be interrupted. Children need to know that they are important to you and can have your undivided attention. The following skills when practiced regularly will go a long way in helping you develop and maintain a healthy, close relationship with your child. It will also help your child develop self-control and self-regulation of feelings and become a more cooperative and happy child in general.
In the last newsletter article, I talked about how to show your child that you are listening by reflecting back to the child what he has said or is doing. This listening skill is very valuable while playing with your child. Instead of asking questions or teaching, describe what you see your child doing and repeat back what they say to you. Children under 7 years of age especially love this because they know you are getting what they are expressing and it empowers their sense of themselves. Allow your child to choose what toys he / she want to play with. Do not direct the play. You follow, let your child lead. Allowing your child to lead gives you a great opportunity to reinforce their ability to make decisions. “You decided to play with ….” is a great statement for a child to hear. You are validating her ability to make decisions and this goes along with growth and development. “You decided to feed the baby” is a much better statement than “Is the baby hungry?” or “What a good girl you are!”. These comments are subjective for the parent and not helpful to the child/parent relationship. If you consistently say “What a good girl (boy) you are!” the child learns to please YOU rather than learns about their own abilities. “You know how to take care of that baby” is a statement that recognizes and communicates your confidence in the child’s ability. The child will experience your praise through your tone of voice and acknowledgement of what he knows.
“You decided to color with those colors” will usually elicit the names of the colors from the child without asking “What color is that?” and it gives the child credit for making the decision. It opens communication because the child will usually feel comfortable telling you more. Asking “what color” will only get you the name of the color. Here’s how an exchange could go:
“You decided to color with that color.” (parent affirms the child’s ability to decide)
“Yea, that’s blue” (child – knows the name of the color and likes to show you)
“Oh, you know that name of that color.” (parent acknowledges the child’s knowledge)
“Yes, it’s my favorite color.” (child gives more information about himself)
“You really like that one.” (parent acknowledges and accepts child’s preferences)
“The water is blue and so is the sky.” (child feels comfortable and wants you to know what he knows)
“You know what things to color blue.” (parent gives child credit for knowing what he knows – young children especially do not usually hear comments like this)
“Uh-Huh. Sometimes I color flowers blue and sometimes I color
other things blue.” (child gives more information and feels comfortable expressing own likes and dislikes)
“You use blue for lots of things.” (parent is accepting – this is not a teaching moment – this is relationship building – you can teach lots of times)
In this exchange the parent is showing that she is listening, she gives credit to the child for knowing the name of the color and what to color with it AND recognizes the child’s likes. This exchange helps this parent and child feel closer.
If you only say to your child “What a pretty picture” you are only giving them YOUR subjective judgment. The only information children gather from this is that you only want pictures that you like so they will only try to please you. Not a bad thing to please their parent but it does limit your relationship if you child feels you are only accepting of certain things and you only love them if they can please you. The play activity becomes about the parent rather than the child. Use this play activity to learn about your child. Remember how you feel when someone really listens and accepts you. You feel cared about and connected that someone understands you.
There are a lot of opportunities in the daily activities with your child to teach them and they go to school where teaching is the focus. Take time to play with your child and build a close relationship where you communicate to your child that he or she is unique and valuable with abilities that you admire. Remember set aside a time you will not be interrupted; show you are paying attention by describing what the child is doing and restating what they say; allow the child to lead the play; do not teach or ask questions; acknowledge the child’s decisions and what he knows in your reflective comments. These skills will go a long way to build a communication style with your child that will nurture your relationship for life.
In the next article, I will discuss limit setting. Accepting your child, allowing him to lead in the play, and showing you are listening do not mean that you let your child get away with any behavior they feel like. Feelings are accepted because all humans have a range of emotions but behaviors are a different story and parents must impose limits and boundaries for children to grow up healthy.