Category : Pediatric Dentistry

Dr. John featured in BendOr Magazine

August 12th, 2016

Check out this amazing six page spread in the August 2016 issue of BendOr Magazine featuring the adventurous life of our very own Dr. John Frachella!



What the pediatric dentist says: Fluoride and your child

February 20th, 2014
A recent post on social media from a parent questioning the toxicity of fluoride prompted a detailed response from Dr. Cate.

A recent post on social media from a parent questioning the toxicity of fluoride prompted a detailed response from Dr. Cate.

A few days ago we shared a link via social media to a New York Times article regarding new guidelines from the American Dental Association recommending the use of fluoride toothpaste at an earlier age. One of our wonderful, bright and involved parents responded immediately, posting: “But fluoride is TOXIC! Or is that hippie propaganda?”

We love it when our families are engaged and asking important questions!  Here is what Dr. Catherine Quas posted in response:

“Great Question! Fluoride isn’t toxic except in extremely high doses and it isn’t hippie propaganda — I think that the answer to the question lies in the quality and quantity of fluoride. Fluoride, like many things, is beneficial in moderation. A little bit is good, a lot-a-bit is not better and can in fact be worse.

There are many sources of naturally occurring fluoride that make tracking the quantity of fluoride consumption difficult. For example, there are certain baby food formulas that add fluoride. If you then add in other sources of fluoride unknowingly, a young child can be exposed to excessive fluoride amounts. These amounts can be far from toxic but still produce tooth development challenges in the integrity of the tooth surface.

The maximum benefit of fluoride is in its topical (or surface acting) ability to strengthen the tooth surface. In essence it makes the tooth surface or enamel less able to be eroded by the acid produced by cavity causing bacteria.

In scientific lingo, fluoride lowers the dissolution Ph of enamel and renders the outside of the tooth more resistant to decay. The benefit of fluoride in toothpaste is that it is topical, much more consistent and very localized in application. People may forget vitamins, but tooth brushing is a highly consistent behavior across populations.

What is really nice in the article is that the ADA and the New York Times are differentiating in the size of the appropriate dose of fluoridated toothpaste. We used to routinely say “pea” size. That is way too much toothpaste for young children, particularly when we are advocating that the parents do a touch up course of brushing once the children are in their beds. A smear of toothpaste is a more appropriate representation of the minute amount necessary to provide the teeth with a protective benefit at night while we sleep.

It is important to remember that this is for kids who are not on systemic fluorides in drops or tablets. In fact, at Bluefish we do not advocate for systemic fluorides because the true benefit of fluoride is topical, meaning on the teeth not in the stomach.

The take home here is moderation. I encourage everyone to research the information with an open mind. Beware of the evangelical opinions on both ends of the fluoride spectrum. If at the end of the day, you are still uncomfortable with fluoride toothpaste, then I recommend that you understand thoroughly how cavities form so that you can take aggressive stances in other areas to reduce the risk of cavities. This could include eliminating juice, goldfish crackers, gummy bear vitamins, natural fruit roll ups, dried fruit, soda, vitamin water, etc. from the diet. It could include incorporating zylitol into the diet to combat the virulence of cavity creating bacteria.  Generally speaking, reducing fluoride tends to require an increase in effort on multiple levels. Not an impossible task, but it does necessitate a number of go-arounds.

I hoped I helped. Please know that I am always available for other questions — on or off Facebook.”

For those interested in learning more about fluoride, we recommend starting with a review of the ADA publication, Fluoridation Facts.  The booklet is in pdf format and includes more than 350 scientific references. Another great resource is this Guideline of Fluoride Therapy for parents and practitioners published by the American Academy of Pediatric Dentistry.

As always, everyone here at Bluefish Dental & Orthodontics welcomes your thoughtful questions and comments.




Tricks for handling Halloween treats

October 16th, 2013
The Halloween season is a good time of year for parents to reinforce the importance of brushing and flossing!

The Halloween season is a good time of year for parents to reinforce the importance of brushing and flossing!

Most people might think that Halloween is a pediatric dentist’s nightmare, but that is not necessarily the case. “I know that kids are going to eat candy–and probably lots of it–at this time of year,” said Dr. Cate Quas. “The real trick is to not let the treats get the upper hand.” Dr. Cate (and the American Dental Association) recommend a few simple tips for parents to consider as Halloween draws near:

1. Make sure your child eats a full meal before heading out to trick or treat. A full belly may reduce the amount of candy consumed as the evening progresses. And try to eat candy and other sugary foods with meals in the days following Halloween as well. During meals saliva production is increased, which helps to neutralize acids and rinse away food particles.

2. Try to avoid hard candies and other treats that take a long time to dissolve in the mouth. The longer the sweet stuff is in your mouth the longer your teeth are exposed to the acids that increase your risk for tooth decay.

3. Stay away from the sticky stuff. Gummy bears, taffy and other sticky candy cling to teeth and take longer to get washed away by saliva, and can increase your risk for developing cavities.

4. Drink lots of water.

Dr. Cate also advises monitoring your child’s access to candy. “Don’t let your kids stash their candy under their bed,” said Dr. Cate. “It’s actually better for your teeth to eat the sweet stuff all at once versus over a long period of time.”

Wondering what kind of candy a pediatric dentist recommends handing out to trick-or-treaters? “Chocolate,” said Dr. Cate. “It dissolves quickly and doesn’t stick to teeth.”

By following these few simple tricks, parents can help their kids enjoy their treats without worrying too much about scary cavities.

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