April is Oral Health Month. So we asked dentist and allergy mom Jyoti Parmar how to make sure a dentist appointment for a child with food allergies is safe and low-stress. She kindly agreed to share the inside scoop (and some great tips!) with us.
As every parent of children with food allergies knows, careful preparation is involved for each activity our food-allergic children participate in. Going to the dentist is no different.
The Canadian Dental Association recommends taking your child to the dentist by 12 months of age or within 6 months of the first tooth erupting. This may seem early, but it’s the best way to prevent dental problems like early childhood tooth decay and a great way to familiarize your child with the dentist.
The first visit
At your little one’s very first dental visit, the dentist or hygienist will briefly look at their teeth and gums, but will spend more time speaking with you about their diet and oral hygiene. They will show you strategies to brush your baby’s teeth (which for many can be a struggle) as well as discuss with you how to prevent early childhood cavities. At younger ages, dental appointments focus more on building a relationship and helping the child get comfortable having their teeth examined. If there is a need for dental treatment based on the examination, the dentist will discuss with you the best way to treat your child depending on their age and ability to cooperate.
As a food allergy parent used to checking every item that goes into your little one’s mouth, it can be daunting to stand back while a dental team uses unfamiliar items to do a cleaning. As both a food allergy mom and dentist, I am here to help you prepare for that first dental visit, and hopefully ease any anxious feelings you may be experiencing.
Here are 3 tips to help make your child’s visit to the dentist a little less stressful.
1. Find out if the clinic has allergy-friendly policies.
When you call the dental office to make an appointment, let them know that your child has a food allergy. Ask them what their policy is when it comes to eating in the waiting area and treatment rooms.
The practice should be adhering to the Royal College of Dental Surgeons of Ontario (RCDSO) Professional Practice Guidelines, which state: “The consumption of all foods and beverages should be restricted to designated areas (e.g., lunch area, staff lounge) or outside of the dental office. Eating and drinking in operatories [treatment rooms], instrument processing areas and in-office dental laboratories should be prohibited.”
Dr. Priya Kothari, pediatric dentist at Kidsworld Pediatric Dentistry, says “this policy is strictly enforced at our office. Signs are posted on the door outside the office. We do provide coffee, tea, and water at a beverage station in the lounge but parents are not permitted to bring any liquids in to the back where the operatories are located. All of my staff are well-trained on this policy and there are no exceptions.”
If you aren’t comfortable with your clinic’s policies regarding food allergy accommodation, you can always search for a new one online. You may end up calling or visiting several dentists before you decide on the best fit for your family.
2. Don’t rush through the medical questionnaire.
At the first appointment, you will be asked to fill out a detailed medical questionnaire for your child. Be sure to list all of your child’s allergies, including allergies to foods, medications and/or latex. And don’t forget to note if your child carries their own rescue medications, like an epinephrine autoinjector and/or an asthma inhaler.
Dr. Kothari says her team reviews medical histories with all parents prior to seeing their child for the first time, and they update their records every six months. She asks that parents “consistently keep us up to date so that we are not missing anything.” So keep that in mind if your child develops a new allergy or outgrows an old one.
When your dentist goes over the medical questionnaire with you, let them know that you would like to ensure that all products which go in to your child’s mouth do not contain their allergens. Dr Kothari notes that “parents usually indicate on the medical history form if the child has allergies or sensitivities to mints, dyes or fruits. We document this and ensure that we are catering appropriately to that child.”
3. Ask about allergen statements.
The dentist may or may not recommend a cleaning depending on the results of the dental examination. The cleaning may include a scaling (the removal of plaque and any hard deposits on the teeth) and/or prophylaxis (the polishing of teeth to remove stains).
A prophy polishing paste will be used to remove stains from the teeth. This paste usually contains an abrasive material, a binder, a colouring agent (dye), flavouring agent, and preservative. Most prophy pastes do not include an allergen statement; however some brands, like Nupro, will specify they are dye free and/or gluten free. Sparkle Free by Crosstex states it is free of dyes, nuts, soy, milk, eggs, gluten, aspartame, sulfite and corn products. If you prefer your dentist not use the flavoured prophy paste, you can request a pumice paste (a sand-like cleaning agent that contains no flavourings, oils or fluoride) instead.
Dental materials used for dental sealants and fillings do not typically contain food allergens. However, if you are concerned about any of the materials to be placed in your child’s mouth, do not hesitate to ask the dentist or hygienist if you can see the list of the ingredients.
Dr Kothari explains that, as per “RCDSO guidelines, we are obligated to keep a binder of all materials being used in the office and thus we have the safety data sheet information available.”
After the cleaning, the dentist or hygienist will apply a fluoride varnish to increase the strength of the outer layer of the teeth (i.e., enamel). Some fluoride varnishes contain hydrogenated pine rosin, which is derived from pine oil. The chemical composition of the rosin is different from the pine nut protein and is therefore safe for those with pine nut allergies.
There are some fluoride varnishes on the market which explicitly specify they are free from allergens. For example, the brand Duraflor Halo by Medicom states it “does not contain tree nuts, peanuts, sesame, corn, shellfish, egg, soy, dairy products and gluten.”
If your child is allergic to milk, confirm with your dental team that they are not using any material with Recaldent as an ingredient, as it contains casein.
Communication is key
The best preparation is communication, so be sure to communicate any concerns you may have about the cleaning or proposed treatment with your child’s dentist.
And don’t feel awkward asking questions! Your dental team wants to provide a safe and comfortable experience for you and your child.
A final note: If a medical concern arises while you’re at the dentist’s office, be assured that all dentists are trained in emergency first aid and are required to have stock epinephrine in their emergency kit.
About the Author
Dr. Jyoti Parmar received her dental degree from the Columbia University College of Dental Medicine in New York. She completed her post-graduate residency in General Dentistry at Mount Sinai Hospital in Toronto. Dr. Parmar has worked for over 15 years with Toronto Public Health as a general dentist and for 4 years as manager of their dental department. She is also the co-founder of the Walk for Andrea which fundraises for the Sick Kids Food Allergy and Anaphylaxis program in honour of Andrea Mariano. She and her husband Peter Deboran are the proud parents of three lovely children. Two of her children have multiple food allergies. She is passionate about children’s health and advocating for the safe inclusion of food-allergic individuals in everyday activities.
Friendly. Supportive. Encouraging.
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