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Pediatric Dentist Knows the Drill with Children

By Cindy Atoji KeeneDr. Amy Ala remembers going to the dentist as a child all too well. Her dentist was an old-school practitioner surrounded by scary looking steel and chrome dental equipment, and when he started drilling, he wouldn't stop. "I remember waving my hand during a filling, trying to tell him that it hurt, but he would just continue," said Ala, 40. "I was terrified."Tooth decay is one of the most common health problems among children, with nearly half of all children affected by cavities by age five. With the number of cavities increasing among preschoolers, the American Academy of Pediatric Dentistry, recommends a child's first dental visit occur by their first birthday. But said Ala, who eventually became a dentist herself, going to the dentist doesn't have to be a painful experience. "I swore I would never practice dentistry with that 'the sit-down, open-your-mouth, and let's get this done" approach."As a pediatric dentist at DentaQuest Oral Health Center in Westborough and Generations Dental Center in Beverly, Ala said that decay can progress more rapidly in kids' teeth because the enamel is thinner; extraction is also different than with adults, because roots are more flared. Most importantly, she keeps an eye on oral health and dental development - Is there decay? Are the teeth coming in properly? - and knows how to manage not just a child's anxiety, but more importantly, a parent's. "It isn't that much more difficult to work on kids; it's the parents who can pass on a lot of their stress."Q: It's not uncommon for you to see preschoolers with 6 or 10 cavities or more. Why are cavities becoming so common at such a young age?A: Sugar is pervasive today in food and snacks, including juice and sugary drinks. Cavities are also contagious, with cavity-causing bacteria passed from mom to child, if they share drinks or food. Anyone who has teeth can get cavities, including infants.Q: How do you ease a child's fear - and more importantly, their parents?A: Parents have good intentions, but when they tell a child, "The dentist is going to pull a tooth out," it doesn't sound so nice. I am honest with children but try to use language that they can understand and relate to. Instead of words like "drill," "hurt," "x-rays" or "shot," I'll say, for example, "I'm using sleepy juice to make their lip go to sleep." For the young ones in particular, I'll do magic tricks with my instruments, like making water bubbles with the suction device or blowing up my exam gloves into balloon animals.Q: What's the most unusual case you've seen so far?A: A 2-year-old girl had odontoma, or tooth-like substances stuck up her jaw. In a situation like this, I might refer a patient to a children's hospital for oral surgery.Q: Why did you decide to become a pediatric dentist?A: I was a middle school teacher, and then started looking for a career that incorporated my interests in arts, medicine, and research. I realized that dentistry had all these components. I really enjoy working with kids. They make me laugh and keep me on toes.Q: What's your dental horror story?A: Once I saw a child who was so uncooperative, he had been seen by 13 different dentists, none of whom were able to work with him. He was quite difficult to treat.Q: Your husband is also a dentist. Do you talk shop at home?A: Yes, he'll ask me for advice, or I'll bounce an issue off him for a second opinion. There's someone right here that I trust. It works well for us.

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