A Guide to Oral Health Servicesfor Philadelphia’s Children and Adolescents

A PUBLICATION OF:

Philadelphia Citizens for Children & Youth

Oral Health ResourcesFor Children & Adolescents

WHERE TO GO FOR HELP

INTRODUCTION

Cavities are the most common preventable disease among children and is fivetimes more common than asthma.Tooth decay has been called a “silent epidemic” by the U.S. Surgeon General, who stated that more than 50 percent ofAmerica’s children have tooth decay. Each year, children lose more than 51million school hours due to pain and illness related to tooth decay.

The good news is that tooth decay is preventable and treatable by practicinggood oral health habits at home and by seeing a dentist regularly.

In Philadelphia, there are manydentists and other oral healthproviders available to servechildren. Look on pages 7 - 14for a list and map of some oftheir offices.

For a more complete list ofdentists, you can call yourinsurance plan for moreinformation. The phone numberis on your health insurance card.

Medical Assistance is requiredby law to provide free dentalcare to all children insured byMedical Assistance.In Pennsylvania, children insured

through the Children’s Health Insurance Program or CHIP also get dental care forfree. Even without insurance, help is available.

www.pccy.org

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WHY DO I HAVE TO TAKECARE OF MYCHILD’S BABY TEETH?

Baby teeth are very important! Babyteeth first appear at about 5 to 7months of age. Most children willstart losing their baby teeth whenthey are 5 or 6 years old. By 11 or12 years old the last baby teeth willfall out. Baby teeth are replaced bypermanent teeth. Baby teeth areimportant because:

• Baby teeth help your child chew and eat solid foods.• When learning to talk, baby teeth help children pronounce different sounds

and speak clearly.• Baby teeth hold the space for the permanent teeth that follow after the

baby teeth are lost. When baby teeth arelost too soon, other teeth may shift intothat space, or the permanent teeth maygrow in crooked or crowded.

• An infected baby tooth can destroy adeveloping permanent tooth.

• Healthy teeth are important for yourchild’s appearance and self-confidence.Missing teeth, decaying teeth or badbreath can lead to your child gettingteased by other children.

• Baby teeth are important to the overallhealth of a child. Mouth and tooth paincan disrupt sleep and keep kids fromeating and drinking and they may stopgrowing. Untreated dental infection canresult in illness and missing school.

Baby teeth areimportant to theoverall health of achild. Mouth andtooth pain can disruptsleep and keep kidsfrom eating anddrinking and theymay stop growing.Untreated dentalinfection can result inillness and missingschool.

HOW DO I TAKE CARE OF MYCHILD’S BABY TEETH?

Begin cleaning baby teeth as soon asthey appear, and be sure to clean thegums too! Use a soft cloth or a child-sizetoothbrush to clean away food afterevery meal and at the end of the day.Using a soft-bristled brush and water,move the brush back and forth gently and be extra careful around the tendergums - and don’t forget to brush the tongue!

WHEN SHOULD MY CHILD FIRST SEE A DENTIST? -AND HOW OFTEN AFTER THAT?

The American Dental Association recommends taking children to the dentistaround their first birthday.This gives dentists an opportunity to spot thebeginnings of tooth decay and teach parents how to care for their child's teeth. Atthe first visit, the dentist will help your child feel comfortable by allowing him orher to sit in the dental chair, touch certain instruments, and by counting teeth andcompleting a simple exam.

The best way to guarantee a healthy smile is to build a relationship with a dentistto care for your children.The American Academy of Pediatric Dentistryrecommends a dental check up at least twice a year for most children.Yourdentist can help you decide the best schedule for your child to follow.

QUESTIONS YOU MAY WANT TO ASK YOURDENTIST OR ORAL HEALTH CARE PROVIDER:

• How long have you been practicing?• Can I schedule an appointment for my child so I don’t have to miss work?• At what age do you take x-rays? (X-rays should first be taken at 3 or 4

years old or sooner if the dentist sees any problems).• How do you work with a child who doesn’t sit still? (The dentist should

discuss different options such as: tell-show-do, positive reinforcement,laughing gas, sedation in the office, or general anesthesia in the operating room).

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HOW DO I GET DENTAL CARE SERVICES FOR MY CHILD?1) Get your child health insurance.

Call Philadelphia Citizens for Children and Youth at 215-563-4828 x17 forhelp with insurance for your child. If your child is not eligible for healthinsurance, look at the list on pages 8-14 for places that accept uninsuredchildren.

2) Contact a dentist or oral health provider in your neighborhood toschedule an appointment.See pages 8-14 of this guide for a map

and partial list of dentists in the City.Thelist in this guide includes larger practicesthat accept Medical Assistance.To findother dentists, please call your HMO’smember services.Their phone number ison your health insurance card or seepages 19-20 for the phone numbers.

WHAT IS TOOTH DECAY ANDWHERE DOES IT COMEFROM?

Tooth decay starts with bacteria or germsnaturally found in the mouth.The bacteria form“plaque” - a sticky film that covers the teeth.These bacteria change the sugaryand starchy food we put into our mouth into acids.The acids then cause toothdecay and can make holes in your child’s teeth which are called cavities or caries.

WHAT ABOUT PUTTING MY BABY TO BED WITH ABOTTLE OF FORMULA, MILK OR JUICE?

When your child is sleeping, the sugar in the bottle of formula, milk or juice collectsaround your child’s teeth and can cause serious tooth decay. Most experts agreethat babies should not go to sleep with a bottle of milk, formula or juice. Puttingwater in your baby’s bottle while sleeping will not harm your baby’s teeth.

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HOW CAN I HELP MY CHILDREN BRUSHTHEIR TEETH?

Until your children are seven or eight years old, you'll need to help them brushtheir teeth. Use a soft toothbrush, and once your child turns two, use a pea-sizeddab of fluoride toothpaste. Evenwhen your children start brushingon their own, they will still needyou to supervise until they turn 7or 8. As long as you're standingthere, why not pick up a brushand join your kids? Foaming atthe mouth together is fun, andyour children will pick up on yourgood habits!

WHAT IS FLUORIDE?

Fluoride is a mineral added to Philadelphia’s drinking water and is found in mosttoothpaste. Fluoride makes teeth stronger and helps slow the growth of bacteriathat causes cavities.

The American Dental Association and the American Academy of PediatricDentistry don't recommend using fluoride toothpaste until your child is two yearsold, and then you should only use a pea-sized amount, making sure your childspits it out and doesn't swallow it.

COULD MY CHILD BE GETTING TOO MUCH FLUORIDE?

Young children who swallow large amounts of fluoride toothpaste can developfluorosis, which leaves harmless but unsightly white patches on teeth. Fluorosisonly strikes teeth that are still forming under the gums, so it mostly affectschildren age between 6 months and 5 years. If you're careful about using only apea-sized portion of toothpaste and make sure your child doesn't swallow, yourchild will probably not get fluorosis.

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As long as you're standing there, why notpick up a brush and join your kids?

DOES MY CHILD NEED TO FLOSS?Children need flossing as soon as they have two teeth that touch together. Manychildren under 6 will need help. After your child's teeth are brushed, wrap thefloss tightly around two of your fingers, and guide it between your child's teethusing a gentle rubbing motion.

WHAT ARE DENTAL SEALANTS?Dental sealants are thin, plastic coatings “painted” on the teeth that form a shieldover your child’s back teeth that help prevent cavities. Getting sealants put on isa simple and painless procedure; they last up to 10 years. Most dentists will offerto put sealants on when your child’s back teeth or molars appear at around agesix.

WHICH SNACK FOODS ARE TOOTH-FRIENDLY?The best snacks for a healthy mouth are low in sugar and starch.That's becausesugar and starch mix with bacteria (germs) in your mouth to make acids. Overtime, the acid eats away at the teeth, leading to tooth decay and cavities. Starchyand sugary foods like candy, soda, pretzels, crackers, and raisins are more likelyto leave bits of food that stick to the teeth and make plaque.

The good news is that if you brush your teeth or even rinse your mouth aftereating crackers, raisins, and other sticky snacks, you get the benefits of anutritious snack and cut the risk of cavities.

Mouth-Healthy Snacks

• carrot sticks and other raw vegetables • plain yogurt• cheese• nuts (such as almonds and walnuts) • fresh fruit (such as grapes, apples, oranges, bananas)

Snacks to Avoid

• soda• juice• candy• potato chips• raisins and other dried fruits

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Where to FindDental Health Centers

KKeeyy ttoo CChhaarrttss oonn FFoolllloowwiinngg PPaaggeess

AC = Americhoice, HP = Health Partners, KM = Keystone Mercy, AT = Aetna, KHPE = Keystone Health Plan EastMany of the practices also take private insurance. Call to see if they accept your plan.

**The Elwyn Dental Clinic is scheduled to open in spring, 2007.

^These offices only provide services to individuals with special health care needs.

+Phoneline = District Helath Centers provide translation for all languages via phone service.

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Finding A DentistFor Your Child

11

- KEY -1 University of Pennsylvania Pediatric Dental Clinic2 Doc Bresler’s Cavity Busters3 Pediatric Dental Associates4 Doc. Bresler’s Cavity Busters5 St. Christopher’s Hospital Pediatric Dental Clinic6 Ronald McDonald Care Mobile7 Kids Smiles II8 Pediatric Dental Associates9 Temple University Pediatric Clinic10 John J. Del Gaiso, D.M.D.11 Pediatric Dental Associates12 Kids Smiles13 Broomall Pediatric Dentistry & Orthodontics14 Upper Merion Dental Associates15 District Health Center #316 District Health Center #417 Elwyn Dental Clinic18 Gentle Dental19 Dentex Corporation20 Advanced Family Dentistry21 Dental Office22 Lawncrest Medical Center23 Trieu & Trieu, D.M.D., P.C.24 District Health Center #525 Vaux Family Health Center26 Dental Clinic - Kensington Hospital27 11st St. Family Health Services28 District Health Center #629 Kenneth J. Soapes, D.M.D.30 Special Smiles, Ltd.31 Fairmount Primary Care Center32 The Community College of Philadelphia,

Dental Hygiene Clinic 33 Quality Community Health Center34 Gentle Dental35 Maria De Los Santos Health Center36 Peach Dental37 Dwight Dental Care38 Family Dental39 Gentle Dental40 Trieu & Trieu, D.M.D., P.C.41 District Health Center #942 District Health Center #243 Gentle Dental44 Dentex Dental Group45 Family Dental Center at Snyder Avenue46 Peach Dental47 Thomas H. Lam, D.M.D.48 Absolute Smile49 District Health Center #1050 A-1 Family Dental Care P.C.51 A-1 Family Dental Care P.C.52 A-1 Family Dental Care P.C.53 Hart M. Dixon, DDS Dental Clinic

12 www.pccy.org

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HOW CAN I HELP PREVENT MY CHILD FROMGETTING TOOTH DECAY AND CAVITIES?

Remember, there are several important steps you and your child can take:

1. Brush your child’s teeth twice a day. Use fluoride toothpaste afteryour child turns two years old.

2. Floss his/her teeth daily.

3. Eat a well-balanced diet and limit between-meal snacks.

4. Visit your dentist twice a year for cleanings and oral exams.

5. Get dental sealants placed on your children’s back teeth.

www.pccy.org 15

SPECIALTY SERVICES: BRACES

HOW DO I KNOW IF MY CHILD NEEDS BRACES?

Sometimes teeth don't grow in evenly.Your child’s teeth might be crooked orhis/her upper and lower jaws might not be the same size.Your dentist maynotice a "bad bite" and recommend that you see an orthodontist to determinewhether your child needs braces. For children with Medical Assistance,the orthodontist has to prove the braces are medically necessary. TheCHIP program does not cover braces.The dental clinics at Temple Universityand the University of Pennsylvania offer discounted braces on a paymentplan. For more information on how to find an orthodontist, see the followinglist.

16 www.pccy.org

www.pccy.org 17

HOW DO I FIND HELP WITH BRACES?

Albert Einstein Dept. of Dental Medicine5501 Old York RoadPaley Building 2nd FloorPhiladelphia, PA 19141(215) 456-7130

Mankad Dental Associates, PC1420 Walnut Street Suite 518Philadelphia, PA 19102(215) 567-5949

Pediatric Dental Associates, Ltd.6404 Roosevelt Boulevard Lower levelPhiladelphia, PA 19149(215) 743-3700

Episcopal Hospital (Pediatric Dental Associates)100 E. Lehigh AvenuePhiladelphia, PA 19125(215) 707-1030

Prem Gulati, D.D.S.4001 Lyman Drive(215) 637-6300

Specialty Management Consulting626 Snyder Avenue Suite 200Philadelphia, PA 19114(215) 940-0301

University City Dental Associates5338 Baltimore AvenuePhiladelphia, PA 19143(215) 476-2122

University of Pennsylvania School of Dental MedicineOrthodontic Department(215) 898-8982

Temple University School of DentistryOrthodontic Department(215) 707-2866

Temple and Penn Dental schools provide braces for children for a discounted price with a payment plan.

18 www.pccy.org

WHAT SHOULD I DO IF MY CHILD HAS A DENTALEMERGENCY?

If your child has a toothache orother mouth pain – or hasbroken or knocked out a tooth,you should call your dentistimmediately. Here are othersteps you can take in differentemergency situations.

ToothacheRinse the mouth with warmwater. Carefully use dental flossto remove any food that mightbe trapped between the teeth.Do not place aspirin on theaching tooth or gum tissues. Ifyour child’s face is swollen, usea cold compress or just ice.

Knocked-Out ToothFind the tooth if possible andhandle it only by the top (notthe root). If it is dirty, rinsegently under running water. Donot scrub or remove anyattached tissue fragments. Ifpossible, gently insert and holdthe tooth in its socket (you can have your child gently bite down on a cleangauze or cloth). If this is not possible, place the tooth in a cup of milk or coolwater. Go to the dentist immediately (within 30 minutes if possible). Rememberto bring the tooth. Quick action is important.

If your child has a toothacheor other mouth pain – or hasbroken or knocked out atooth, you should call yourdentist immediately.

www.pccy.org 19

Broken ToothGently clean any dirt from the injured area with warm water. Put a cold compressover the injured area. If possible, try to find the tooth fragments. Go to the dentistimmediately.

Bitten or Cut Tongue, Lip or CheekApply direct pressure to the bleeding area with a clean cloth or gauze. If there isswelling, apply a cold compress. If the bleeding doesn’t stop after 15 minutes orisn’t controlled by simple pressure, go the hospital emergency room.

HOW DO I PAY FOR CARE FOR MY CHILD?

Children who haveMedical Assistance(MA) can get “allmedically necessary”oral health services forfree. Children whohave CHIP (Children’sHealth InsuranceProgram) also get oralhealth services for free,except for braces.

For a more completelist of dentists in yourarea, call your insurance company’s member services. The phone numbers arelisted below.

Medical Assistance • AmeriChoice 1-800-321-4462

• Health Partners 1-800-553-0784

• Keystone Mercy Health Plan 1-800-521-6860

Continued on following page

20 www.pccy.org

Children’s Health Insurance Program (CHIP)

• Aetna 1-800-822-2447

• AmeriChoice 1-877-707-5437

• Caring Foundation/Keystone/Blue Cross Blue Shield 1-800-464-5437

CAN MY CHILD GET DENTAL CARE EVEN WITHOUT HEALTH INSURANCE?

Children and adults who do not have insurance can get free or low-cost dentalservices at many practices throughout the city. Look under “discounted servicesor no fees” on pages 8-14 for free or low-cost dental care.

But remember – most childrenin Philadelphia can get healthinsurance. Call PCCY at 215-563-5848 x17 for help applyingfor health insurance.

Colleen McCauley-BrownSeven Benjamin Franklin Parkway

Philadelphia, PA 19103Phone: 215.563.5848 Fax: 215.563.9442

email: info@pccy.orgwww.pccy.org

For supporting this project, special thanks to: Aetna Foundation

Eagles Youth PartnershipWilliam Penn Foundation

PCCY acknowledges The Cartographic Modeling Lab, University of Pennsylvania

for assistance with this guide

For more information contact:

20072007