Mediaplanet: How do you hope the Affordable Care Act will facilitate improvement in children’s oral health in the coming years?

Warren Brill: I hope that several things happen: the first is that states are realistic about their Medicaid budgets. With the estimated increase of 3 million Medicaid eligible children across the country, I hope that states allocate appropriate resources so that dentists will be able to participate. In the end, children may have coverage, but no access to care.

For those with private insurance, preventive care must be covered 100 percent, and for embedded plans, the deductible for dental services be separated from medical. As it stands now with embedded plans, the high deductible (in the thousands of dollars) must be met before any coverage ensues. This essentially means that as many as 25 percent of those children in these plans may never have real dental coverage. That being said, if the unintended consequences are corrected, and we are working with members of the house and senate to make them aware of these facts, better oral health can result.

"For those with private insurance, preventive care must be covered 100 percent, and for embedded plans, the deductible for dental services be separated from medical."

MP: What do you feel are some of the biggest misconceptions new parents may have about pediatric oral care?

WB: There are two big misconceptions: one is that they are "baby" teeth and will fall out, so they don't require any treatment. The second is that a child need not be seen until all the primary teeth are in the mouth at about age 2. Research has shown that when a child is seen by age one or the eruption of the first tooth and a dental home is established, the information the parents get from the pediatric dentist and staff helps them to avoid or significantly minimize their child's decay experience.

MP: What are some creative ways to get kids motivated when it comes to their oral healthcare routine?

WB: Make oral hygiene at home enjoyable—play games, have reward systems and use toothpaste with a flavor the children like. As for toothpaste, research has shown that starting immediately with a fluoride toothpaste is beneficial: for children up to the age of two, a small smear of toothpaste on the brush; age 2-5 a rice sized amount and after age six, a pea sized amount.

MP: Why do you think the statistics about pediatric oral health are so poor—with dental caries being the number 1 childhood disease?

WB: Unfortunately, parents and caregivers don't know or follow the advice I gave above. Also, putting the child to sleep with a bottle, letting the toddler walk around with a sippy cup and giving the youngster candy and other sweets more than three times a day all contribute to tooth decay. For sweets, it is not how much, but how often.

The germs in the mouth use the sugars in foods to make acids that cause the enamel to dissolve, resulting in cavities. Therefore, a piece of taffy stuck in the grooves of the tooth can cause more damage than quickly drinking a sugar-containing soft drink. In all cases, after a sweet, if you cannot brush and floss, take a drink of water and swish it around, then swallow. Lastly, to reiterate what I said before, establish a dental home with a pediatric dentist as soon as the first tooth erupts so that parents and caregivers know exactly what to do for their children.