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My child has cavities, now what?

August 22, 2018

Dr. Karen Benitez, founder & designer, board certified pediatric dentist at Chevy Chase Pediatric Dentistry will be writing a series of guest posts related to adolescent dentistry and questions she frequently receives from patients that may be of interest to you. If you have a topic you’d like to see her feature, leave it in the comments.

The first post was one that many parents wonder about; whether it is necessary for your child to visit a pediatric dentist and how the experience will differ from just taking them to the dentist you see. The second post addresses the topic of why x-rays are important for your child to have. The last post explained why your child may be referred to an orthodontist at what may seem like a young age.

Upon learning that your child has cavities, most parents want to learn what the next steps would be towards treatment. The variety of treatment approaches is a complex subject matter because it varies vastly per patient and situation, as well as within a family. These options are specific to each child and as we all know, our kids can be different.

As a general rule, I prefer not discussing cavities in the presence of your young or nervous child. Some kids are upset by the news of cavities and to alleviate this, we maintain a distance in the conversation and phrase their upcoming visit in very friendly terms.

I begin by outlining possible treatment approaches. Some common options include: deferred treatment (with or without fluoride varnish or silver diamine fluoride), treatment with or without nitrous oxide (laughing gas), mild sedation or general anesthesia.

The first step is determining if we should take an active role in treating these cavities in the current time or monitor them. Monitoring of cavities is often used if the cavities are smaller in size. Starter cavities are called incipient cavities. Depending on the number of incipient cavities seen, I may have your child be seen every 3 months to monitor.

If the cavity grows in size but perhaps your child is not yet ready for the steps involved in restoring the teeth, another option is proposed. In select situations such as these, where the rate of growth of cavities can be controlled, I propose deferred treatment. This option does not suggest that we are never going to restore the cavities, but that we are tracking your child’s development, as well as cavity growth, to determine a better time in the near future to approach treatment. I schedule your child for limited exams every 3 months until a more definitive plan is made.

Deferred treatment can involve the use of materials proven to slow down the growth rate of the cavity-causing bacteria. These materials include fluoride varnish or silver diamine fluoride (SDF). The latest option of silver diamine fluoride (SDF) is of increased discussion and use with larger cavities in a child not yet ready to undergo dental treatment, because it is proven to be more effective than fluoride varnish. It is a clear, liquid material, similar to the bonding agent used for white fillings, that helps to stop the growth of the cavity. One caveat in the use of this material is that it turns the lesion black and yes, it is noticeable, but effective for its intended use! It is generally followed with the application of fluoride varnish. The use of SDF is often used to gain time for the child to develop to better tolerate treatment at a later time.

For kids who are on path to receive dental treatment my first line of treatment is to determine whether nitrous oxide (laughing gas) would be used or not. Some kids are fully prepared for no agent to be used to modify their tolerance of treatment. These kids bypass the use of nitrous oxide, whereas others would benefit from additional support—introducing nitrous oxide.

So what is nitrous and why is it used? Nitrous oxide is a common inhaled gas used in dentistry because of its ease of use and tolerance by the vast population. It’s an air that is breathed through a nose piece connected to the source of the mixed agents of nitrous oxide and oxygen. It is used as a mild to moderate sedative because of its potential to be titrated (increased or decreased for effect), with caution. It is proven to have both analgesic (numbing) and anxiolytic (anxiety-reducing) properties, so it works great in cases with moderate treatment needs. In some cases, the analgesic component is sufficient enough to not use local anesthetic, however, be aware that we are talking limited situations of small cavities. Nitrous oxide is not metabolized by the body, so at the end of treatment 100% oxygen is breathed in, as the effects of the nitrous oxide are being eliminated. Unlike medicines, nitrous does not go through the digestive system, being excreted in hours to come. It is the easiest, least invasive option in helping kids tolerate some uncomfortable procedures.

If your child is neither a candidate for treatment with or without nitrous, and would benefit from additional support for their dental treatment, a step up in my “tool box” is a mild sedation. I offer this option when I find that your child is a good candidate for it. Not all children can be given an oral sedative, based on their age, medical history and cavity presentation. The goal of a mild sedation is to protect the child’s mental awareness of the treatment and most certainly to maintain a safe measure for treatment. The options vary per dentist, but this option utilizes a weight-based dosage of sedative medications targeted for a MILD response. A mild sedation functions by suppressing the central nervous system, allowing relief of anxiety to your child, providing a timely treatment option. Some children are exceptionally nervous for treatment and without using further agents to make them more calm and comfortable, even treatment with nitrous is not accepted by them. I have had children who will not even sit in the dental chair but have cavities beyond the size of monitoring or deferring treatment. Having the option of an oral sedative has truly helped these children, and their parents, who are not ready for the most advanced option of general anesthesia. Your child IS NOT ASLEEP with an oral sedative. In fact, I am very clear, that the dosage is provided to suffice a mild effect. The goal is for your child and I to remain in conversation about what is happening and to alter their perception of what they imagine is going to happen. I often find that my patients who have had favorable dental experiences in this manner really do better tolerate dental treatment in the future with less apprehensions. Their confidence is elevated in their successful treatment!

Keep in mind that the more advanced routes now being discussed do carry increases in risks. When medications are administered, the risks involve respiratory (breathing) and cardiac (heart) function. A sedation uses nitrous oxide, in most cases, as well as monitoring of your child’s heart rate and breathing via a pulse oximeter with capacity to include carbon dioxide monitoring and a precordial stethoscope. All medications used have a reversal agent and all calculations are prepared beforehand. Safety margins are maintained through the appropriate selection of medications, adherence to dose recommendations, as well as the assessment of qualifying patients. As a Pediatric Dentist, we receive training in mild sedation as an alternative for your child to tolerate treatment. In order to provide mild sedation as a service in my office, both myself as a practitioner and my office are licensed by the Maryland State Board through an oral exam and site assessment. Again, not all children are candidates for this option, or perhaps still require a more advanced method to tolerate their dental needs, hence another option is available.

For children who are unable to receive dental treatment in the most straightforward of manners (with or without nitrous oxide), nor a candidate for a mild sedation, there exists the option of general anesthesia. This is a treatment option in which your child is fully asleep and is routinely performed in a hospital or surgical center by an anesthesiologist. It is the greatest depth of sedation that can be provided and is my last alternative in most cases, with various exceptions. This treatment approach is generally considered the most advanced due to the depth of suppression of the central nervous system. Only qualified doctors or nurse anesthetists provide this medical care. It is an environment in which very limited persons are allowed. Only the anesthesiologist, the dentist, the dental assistant and the surgical nurse are in the operating suite, working together to ensure a safe and prompt procedure for your child. In the case of general anesthesia, our practice philosophy is generally to provide any and all treatment needs to avoid further dental needs in the dental office setting. In other words, some providers are more in line with treating even smaller cavities that would grow over time.

Neither a mild sedation nor hospital dentistry are a provider’s first choice of treatment, however, given the significant rise in cavities seen in younger and younger patients, we all have experienced an increasing need in such options for children to be able to restore their teeth.

Many in the general population ask, “But they are just baby teeth, won’t they all fall out?”. It is true that most baby teeth are shed to be replaced by a permanent tooth, but this occurs over the course of approximately 6 years, beginning around 6-7 years age. Not all permanent teeth formulate, hence maintenance of the baby tooth is more critical to the child, and the number of cavities seen does increase the risk of baby teeth becoming infected, causing pain and early loss. Younger children are seen with cavities as well. I really wish to change the thought that baby teeth are not so important because they really are and keeping your child cavity-free or minimal cavities, is my primary goal. These options discussed are for managing already existing cavities, or other dental needs, that if left untreated, can cause pain and infection for your child.

It is my hope that this helps you to understand steps involved in the decision-making process of how to provide dental treatment for your young ones. Furthermore, I hope that this helps to realize the importance of regular check-ups and establishing a relationship with a dental provider that you can really learn from and grow together in best interest for your child. These early habits of prevention are learned just as much as other hygiene and dietary practices are. Help us grow strong, healthy kids, with smiles designed to last a lifetime!

We at Chevy Chase Pediatric Dentistry welcome your child to come in and have a look. It would be our pleasure to have you!

You can also find us as Bethesda Magazine’s Face of Pediatric Dentistry, view our Top Docs video and read our stellar reviews on Yelp, GoogleandZocDoc. Follow us on Facebook to learn more about what Chevy Chase Pediatric Dentistry is all about…Focusing on your kids.

-Dr. Karen Benitez, DDS

Location: 8401 Connecticut Ave #650 Chevy Chase, MD. 20815
Phone: 301-272-1246

Water you waiting for? RETHINK Kids Water is a lunchbox game changer

August 8, 2018

I find it incredibly annoying when we go out to dinner with our kids and the server comes by and asks them directly if they want apple juice or chocolate milk with their kids meal. Anyone else? Did you know kids consume an average of 21 teaspoons of sugar a day or nearly ten gallons of sugar a year? We are not as strict as we once were with the amount of sugar our kids get, however, juices and sodas are not purchases we make. Instead our kids drink water and milk on a daily basis are are perfectly fine with that.

The city of Baltimore recently put into effect an ordinance that bans restaurants from offering sodas and sugary drinks on kids’ menus – the first city on the East Coast to make this change. Enter the Maryland-based RETHINK Kids Water, whose sole mission has been to reduce children’s sugar intake. In fact, RETHINK Kids Water is the only boxed water line for kids that’s zero calorie, zero sugar, and zero sodium.

The recipe is the first of its kind, made only of purified water and USDA approved fruit essence, and comes in four fruity flavors: Organic Apple Water, Organic Berry Water, Organic Fruit Punch, and Organic Orange Mango. RETHINK is innovating the kids beverage industry by creating the perfect alternative to juice, and something parents can feel good about giving their kids.

Overall, juice + soda consumption has been in decline and the beverage industry isn’t keeping up with the shift in consumer mindset, especially ignoring a huge (rather untapped) group. With the invention of Punchy, the Hawaiian Punch mascot, in 1962, juice makers figured out that the way to sell sugar to moms was to sell it to their kids. Now, RETHINK has figured out how to get their message across to the market that needs to hear the message the most: the kiddie set.

RETHINK (the brand just announced $6.7M in funding) about the importance of going sugar-free and how RETHINK is disrupting the beverage industry. It’s that important. So next time you pack the lunch, add RETHINK, when it’s your turn to bring drinks to the soccer game, toss RETHINK to the players, picnics + bbq’s are another great place to pack the cooler full of RETHINK.

Sold at over 11,000 stores nationwide, in our area you can find RETHINK at Safeway, Target, Walmart, Shoppers as well as on Amazon.

Why an Orthodontic referral for my seven-year-old?

August 1, 2018

The first post was one that many parents wonder about; whether it is necessary for your child to visit a pediatric dentist and how the experience will differ from just taking them to the dentist you see. The second post addresses the topic of why x-rays are important for your child to have. This third post explains why your child may be referred to an orthodontist at what may seem like a young age.

Keeping in line with Why do my kids need x-rays? post, it seems only fitting to introduce the subject of an orthodontist. Most kids approximately 7-8 years old will be advised to have a radiograph taken: the panoramic image. This is the image I mentioned in the last blog; used to determine the development and angulations/eruption paths of the permanent teeth. It is a key tool in a pediatric dentist’s treatment plan consideration to determine dental age, cavity treatment options and whether your child is advanced or delayed in the exfoliation process.

The panoramic image is also a key radiographic tool for both the pediatric dentist and orthodontist to collaborate and devise a treatment plan for your child to maximize growth and development potentials. I know what you are thinking—”It seems rather young for my 7-year old to be looking into braces, doesn’t it”? Well, let’s clarify that this referral is not met with all children in this age group beginning in braces following this referral. Collaboration with orthodontic colleagues helps to make sure a critical growth period is not missed in aiding for best overall arch and skeletal tooth orientations.

The age group of 7-10 is one of significant changes. Children will have teeth in transition. Some very obviously loose baby teeth with varying eruption levels of the permanent teeth. Pronounced, serrated edges of the newly erupted, less pristinely white, permanent teeth and non-scalloped gum lines, rather rounded and bulbous, call attention to many parents in a worrisome manner. This is the typical appearance for your young child newly entering what we call the early transitional dentition stage. Some parents note that there is a gap between their top and bottom arches where it appears that one jaw is significantly shorter than the other. A cross-bite may become more evident, be it a full side or a single, front tooth. For all of these visible growth and skeletal variations that may be more evident to a parent now, I provide a friendly reminder that this is truly normal and is the age of orthodontic evaluation precisely to address such variances.

This age group of referral to see the orthodontist generally is in consideration of jaw growth patterns, compromised angulations of permanent teeth as seen on the panoramic image, any habits that may be potentiating a jaw discrepancy, tonsillar/adenoid and tongue posture concerns that may be affecting the arch structures and breathing/snoring intertwined. Most children are prescribed the use of a functional appliance or limited braces. Treatment time is of a shorter duration and maintains an annual assessment into later years to evaluate for comprehensive braces, if needed. The practice of early orthodontic correction also includes the hope to decrease treatment time in the future, if needed.

There also exists a practice of myofunctional therapies, where exercises are used to activate muscles groups (yes, all the cute cheeks, lips and chin are muscles groups!) to correct a soft tissue imbalance to allow more fluid, passive growth potentials of the arches and tongue posturing that might have been stunted by their additional force or compression.

The discussion of all the varying options would be endless. I have selected a few commonly seen images below. These are of the more pronounced clinical observations I would certainly refer for. The appropriate treatment options are not shown, as this is respectfully not my specialty. The determination of treatment options is more complex of a selection process than this forum could erroneously reflect. I leave that discussion up to my orthodontic colleagues. This blog subject calls attention to the reasoning for an early referral and only to show select images of what a parent would recognize as a situation needing treatment.

The first image is that of an isolated cross-bite. A single tooth of the top and bottom arches is in incorrect position, compromising the gum line of the lower, more narrow tooth. Isolated cases of a cross-bite, may be early signs of further underlying concerns and really should not be overlooked.

This image demonstrates a deep overbite (Class II malocclusion) in which the top teeth fully cover the bottom teeth.Skeletal assessments would be performed using another radiographic image pertinent to an orthodontist, a lateral cephalometric imae.

This image is of an anterior open bite. Your child may develop this based on genetic background or due to prolonged sucking habit once permanent teeth are coming in. You can recognize that the back molars are in occlusion, but there is a gap in the front teeth; an opening.

The final image shows an underbite. This is when the lower arch is in a more advanced, forward position than the top arch. It is clinically referred to as a Class III malocclusion.

I hope this helps you better understand why I suggest a visit with my friendly orthodontic colleague. We all share in the interest of best results for your child! Keep an eye out for the fourth blog post: “So My Child Has Cavities. Now What?”

We at Chevy Chase Pediatric Dentistry welcome your child to come in and have a look. It would be our pleasure to have you!

-Dr. Karen Benitez, DDS

Location: 8401 Connecticut Ave #650 Chevy Chase, MD. 20815
Phone: 301-272-1246

Why do my kids need x-rays?

July 18, 2018

The first post was one that many parents wonder about; whether it is necessary for your child to visit a pediatric dentist and how the experience will differ from just taking them to the dentist you see. The second post below addresses the topic of why x-rays are important for your child to have.

Why do my kids need x-rays?

I have chosen to follow the first blog subject; Why a pediatric dentist with the subject of x-rays since they are closely related. The primary goal of our specialty is prevention and yes, x-rays aid in this goal. Any dental exam is composed of two parts: a clinical and a radiographic exam. The same would apply for your child’s exam. When it comes to recommending x-rays, it is mostly a matter of when, under what circumstance and at what interval. So how do I begin an exam and what does it all include, upon leading to the discussion of x-rays?

My clinical exam begins upon my first meeting with your child, either in the waiting room or in the dental chair. Initially, I am gathering information on their emotional acceptance of the office and who I am. How do they respond upon meeting me? Am I able to chat with them making eye contact? I am assessing if your child is drawn further into you, when I approach them or if they engage in conversation with me with ease. I am also visually assessing their external self as a part of my dental exam: their stature and body build, their facial shape, their facial symmetry, their mouth posturing and of course, any visible cavities.

Once we are in the hygiene area where our exams mostly take place, I show your child all the fun parts of the experience designed to put them at ease. Do they see their name featured as our new patient on the board? I show them our stuffed dinosaur we use for teaching. They explore the selection of superhero sunglasses and pick out a fun, new, animated toothbrush. There are even numerous toothpaste and vitamin flavor selections to be had. Which character will “tickle” your teeth today? All this BEFORE they even get into the dental chair. We try to engage them and enthrall them in all the autonomy we have offered them for their best dental experience. It really is all about them getting to touch my dental toys, become familiar with what we use and who I am, before laying back in the dental chair.

All this playful interaction helps me to understand how your child responds to the immediate environment, if there are any anticipated dental concerns and how to approach their exam or even how far I think we will be able to go for the visit.

You are asking, so how does this tie into my child needing x-rays? Well, the answer is that my recommendation of x-rays is NOT automatic. There is much knowledge to gain about your child in the time before I say “open wide”. When it comes to x-rays in the pediatric dental world, there exists a concern that dentists are requesting x-rays on young children and they don’t understand their necessity, especially since their teeth will “all fall out”. This blog subject is to address the WHY behind the request. Also, to share just how I am assessing what I need before I request it.

A medical history is always discussed, as well as a family dental history. Any medications taken may heighten cavity risks, or even grinding. A history of snoring or apnea is important in determining approach to treatment, if any needs are found. A family history of numerous cavities or variations in the teeth are critical in my clinical exam of your child and a predictor of needed x-rays.

Most parents will automatically question me if I see any cavities as soon as I begin their cleaning. I do not begin my initial inspection for cavities so promptly. So why am I not quick to address the question of cavities as soon as your child opens? First, most children would become alarmed if my first engagement with them centered around the calling out of cavities. Children are just as sensitive as adults about these concerns and I am conscientious of this. Second, I am largely assessing their overall hygiene. By assessing their cavity risks through learning more about their routine: Is brushing and flossing for the most part done twice daily? Are parents taking active roles in the brushing and flossing? Is there visible moderate to heavy accumulation of plaque and redness of the gum tissues? What is their diet like? Not only should parents learn of a cavity diagnosis, but where to make modifications. I only see you twice a year, which is not very often. Educating my parents on what changes I recommend to better achieve oral home care and improved diet is more important than the initial diagnosis of cavities. Even when treatment is performed, fillings and advanced treatment needs still require good maintenance, so aiding parents in making changes is critical for me in the fight against high cavity risks in kids.

The recommendation of x-rays do follow a general guideline for the purpose of early diagnosis. This may be the diagnosis of cavities, possible injury sustained to the teeth or any variation of normal, an anomaly.

Here are the common x-rays pediatric dentists request and the approximate ages:

Ages 3-4: OCCLUSAL X-RAY (cavity checking & for permanent teeth coming in) and BITEWING X-RAYS (baseline set for cavity detection). I consider these a baseline to see what risks there are or if there are already cavities that could be treated with the most conservative and cosmetic treatment of a white filling. The occlusal films help to show if any cavities exist between the front teeth or any permanent teeth are missing or show extra teeth.
Ages 7-9: PANORAMIC X-RAY (angulations of teeth, exfoliation, accounting for teeth)

Most bitewing x-rays are taken on an annual basis. The panoramic x-ray is repeated every 3-5 years and is also used by orthodontists during braces to manage the alignment of tooth roots. We discuss this x-ray again in later teen years to discuss wisdom teeth.

I’ve included a few x-rays that show situations I most commonly see with some explanation to each.

This panoramic image below demonstrates my concern about symmetry. Clinically, a 7-1/2 year-old should have all the permanent molars coming in. The variation in that the noted lower left molar was not at all clinically detected in the mouth warranted further investigation. An oral surgeon can prompt (luxate) this tooth to come in since it shows nearly fully formed roots.

Again, this image is important starting at approximately age 7-9 years age to determine that all permanent teeth are developing and the angulations of such teeth. In children with numerous, large cavities or extraction needs, we request this panoramic x-ray to determine if the permanent replacement tooth is in development or not—agenesis/congenitally missing. Many conversation points may follow this image considering the findings.

Below are bitewing x-rays of a younger child who otherwise presented with clinically intact teeth. Only shadows were noted in some of the molar regions. The bitewing x-ray taken shows treatable cavity sizes in red versus incipient lesions (starter, non-treatable size) in green.

The red lesions are ones I would recommend fillings, whereas the green arrows indicate areas to monitor. Some variations in this may occur according to age and patient tolerance. Each case varies based on numerous reasons. It is important to note that not every x-ray diagnosis warrants immediate treatment.

Sometimes the ectopic molar remains caught on the back-side of the baby molar ahead, causing significant damage, as seen in both images below. The difference in the molars depicted below is that the top left molar self-corrected it’s path, whereas the top right did not. Either way, significant resorption was caused on the baby teeth, lending to extraction needs. Correcting the forward position and numerous missing teeth requires a multi-disciplinary team.

It is my hope that you have been enlightened as to the importance of x-rays prescribed during the examination of your child and perhaps even answered any questions you may of had regarding your own child’s x-rays. There is not enough room for all the variations of anomalies that may be detected in x-rays, but the above examples serve my most common findings.

Once again, we are pleased that you have taken an interest in our blog topics. Keep a look-out for our next topic: Why an Orthodontist for My 8 Year Old? in two weeks.

We at Chevy Chase Pediatric Dentistry welcome your child to come in and have a look. It would be our pleasure to have you!

You can also find us as Bethesda Magazine’s Face of Pediatric Dentistry, view our Top Docs video and read our stellar reviews on Yelp, Google and ZocDoc. Follow us on Facebook to learn more about what Chevy Chase Pediatric Dentistry is all about…Focusing on your kids.

-Dr. Karen Benitez, DDS

Location: 8401 Connecticut Ave #650 Chevy Chase, MD. 20815
Phone: 301-272-1246

Bookroo: A curated book subscription service for children

July 11, 2018

Bookroo is a monthly subscription for kids ages 0-10 that helps them fall in love with reading by combining the excitement of opening a gift with the discovery of a new, wrapped, treasured book! Their mission is to enable and empower parents to build their children’s book collections in an affordable and exciting way through curated monthly book deliveries. They believe in the power and impact of the written word in the life of a child, and believe it’s never too early to start reading to children.

Bookroo‘s books are reviewed by a panel of families attending Stanford University.
The company is women founded and run, by three sister-in-law.
They offer board, picture, and chapter books.
Boxes with picture books come with 2 hardcover books. Boxes with board books come with 3 books. Boxes with chapter books come with 2 chapter books.
If you are sent a book you already have, Bookroo allows you to send them a picture of you giving the book to someone else and they’ll give you $5 off your next subscription.
Order month-to-month, 3 box, 6 box or 12 box.

How does Bookroo decide which books to send?

For the board and picture book boxes, the goal is to send hidden gems rather than classics. The books are extensively reviewed by a panel of 12 families attending Stanford University and their combined 22 kids. They rate each book on a 7 point scale and on its re-readability. Books that emerge as clear winners are sent out in our Bookroo boxes. For more details on the review process, check out Bookroo Review Process. To see past boxes visit the What’s in a Box page.

For the chapter book box, they send one hidden gem and one admired favorite per box. Books are chosen by in-house early reader expert in consultation with librarians, parents, and kids alike to help your child build their library, discover new books, and fall in love with reading. Plus, each box includes information and talking points to help you know what your child will be reading. You can relax, knowing we’ve carefully selected kid-friendly books! To see past boxes visit the What’s in a Box page.

Get 50% off your 1st board & picture box or 40% off your 1st chapter box using code: BELTWAYBAMBINOS

Related Posts:

Baby Ventures

Subscription boxes for children

Why choose a pediatric dentist for your child?

July 3, 2018

The first post is one that many parents wonder about; whether it is necessary for your child to visit a pediatric dentist and how the experience will differ from just taking them to the dentist you see.

Why a pediatric dentist?

As a board certified pediatric dentist, this is a question I’m often asked here at Chevy Chase Pediatric Dentistry. Most families will be quick to notice a difference in the environment of pediatric dental office specific to kids, much like a pediatricians office would be. The primary elements of a pediatric dental environment are visual, sensory, emotional and tactile acceptability.

At Chevy Chase Pediatric Dentistry, our office is different and you will see and feel it from the moment you enter through our door. Our entire office was designed specifically to build the most comfortable atmosphere to meet the needs of our young patients. It is alive with colors, toys and even a separate nook just for kids to explore and play during their short wait. A trip to the dentist should be fun, after all!

Beyond the aesthetics and environment, as pediatric dentists we are educated in the unique needs of children and adolescents, and children with special needs. Our studies extend an additional two to three years beyond our general dental school education in pediatric growth and development, orthodontic development and behavior management techniques and more. We are dedicated to the dental needs of even the youngest of children and it is ALL. WE. DO.

Parents will often ask me at what age to bring their child in. To this I say, earlier is better! Our first few exams after your child’s 1^st birthday are aimed at a familiarity with brushing approach, technique and frequency. Your child is cradled between our laps in what is called a knee to knee exam. During this exam, I evaluate for the sequence of teeth that are erupting and guide you on best measures for providing comfort. I like to demonstrate with my parents even the amount of fluoridated toothpaste with a direct visual. Many parents express hesitations towards brushing, and a surprise when I mention flossing, yes, flossing! I am here with you from the beginning to provide guidance on a very important task. As a mother of three, I offer relatability and experience and I like to share my observations.

Here at Chevy Chase Pediatric Dentistry, we understand good vibes! We encourage our patients to touch, feel, ask questions and share feedback. All this in the interest of introducing the entire dental experience in the friendliest of manners. We introduce our language for all dental instruments in terms kids just get. We “tickle teeth”, use “power washes”, spit into “magic straws”, make “silly smiles” and wear “silly masks”. You get the picture!

As your child grows with us, we will address various subjects. Cavities themselves are the number one question parents express. I like to share with my families any patterns I see that may lend to higher risks. My parents often sit in close-proximity to their child as I am very much an educator! I like to have parents fully engaged in the exam to visually understand any concerns I might have. Kids benefit from this as I only see them twice a year…really, that’s not often.

Crowding is the second runner up in the matter of parental concerns. Yes, I do agree, we all go through a time-period where our child’s appearance begs the question of how all these big teeth could possibly fit in their mouth! I like to assure my parents that kids will grow three dimensionally and that what is more important is a balance between the dental arches, the path of eruption of the teeth and the possibility of early loss of proximal baby teeth. We often work with orthodontists for an early assessment.

Hygiene and dietary habits are other common concerns. Our mouths are the entryway to the rest of our bodies and our beautiful, pearly-white teeth certainly take the brunt of all our food choices. I like to guide parents in what food choices, per age group, are most prevalent in high risk patterns, as well as teaching guides to help your youngster understand what a successful brushing session achieves.

Our dental needs evolve with each decade and we as pediatric dentists are focused on the early, most impressionable ages, to establish a familiarity with oral health practices that carry confidently into their adult lives. Kids are not adults and we cater to their unique needs and approach. It is important to me that my patients feel at home in our office and with the staff. I am delighted that my parents do feel so welcome in my office. My goal at Chevy Chase Pediatric Dentistry is that our families feel they are family. Our enthusiasm in what we do cannot be curbed. IT. IS. PALPABLE.

We welcome your child to come into our office and have a look. Please, stop by and check us out!

You can also find us as Bethesda Magazine’s Face of Pediatric Dentistry, view our Top Docs video below and read our stellar reviews! Follow us on Facebook to learn more about what Chevy Chase Pediatric Dentistry is all about…focusing on your kids.

-Dr. Karen Benitez, DDS

Location: 8401 Connecticut Ave #650 Chevy Chase, MD. 20815
Phone: 301-272-1246

Pirate Adventures on the Chesapeake

June 19, 2018

Pirate Adventures on the Chesapeake has been in operation since 2003 and consider themselves to be a premier attraction for families with young kids in Maryland, DC, and Virginia while being conveniently located in Annapolis with parking! The program has been tailored over time to keep kids engaged and immersed in an incredible adventure at sea. They are family owned and operated and their biggest asset is their incredible crew, some who have been with the ship for over 10 years. Their ability to bring out the personality in all their young charges is what keeps people coming back year after year and contributes to the reputation as a family-friendly destination. The Pirate Adventure is a great time for kids but also makes for an enjoyable boat ride for grown-ups. The cruise includes views of the Naval Academy and historic downtown Annapolis. We were treated to an amazing afternoon aboard ship and brought along our friends to enjoy the adventure together. Photos are courtesy of Stefanie Harrington, DC area photographer.

I can attest to the fact that they specialize in family fun and even more so just plain old fun for kids. The experience began with customized pirate themed face and body paint for the kids, a quick lesson in pirate talk and mateys dressing to the part if they so choose all before climbing on board. Once on the ship, kids learned they needed to find the map in order to start the cruise to find the treasure. No child needed the attention of their parents the entire hour and a half cruise. The crew kept them completely entertained; adults might as well have been back on land. It was a chance for parents to just watch their Bambinos interact and take part in the fun interactive adventure while siting back and taking in the views from the boat, which let’s be honest, we don’t get to do very often.

They also host field trips and groups, birthday parties as well as families. The indoor party room completes the experience at sea with a pirate ship theme and pizza and cupcakes can be delivered to keep the party going after the trip.

They set sail seven days a week, six times a day from mid-April through Labor Day and weekends only through Halloween.

Ticket prices are $22 per person, $12 for children 2 and under and they offer discounted tickets at certain sailing times and for special events.

Location: 311 Third St. Annapolis, MD. 21403 (Less than an hour from DC!)

(Photos taken by Stefanie Harrington)

Washington, DC’s newest coworking playspace: Workafrolic

June 6, 2018

I had the privilege of meeting Naomi Rasmussen, founder of Workafrolic, a unique coworking playspace w/ flexible childcare and classes back when her idea was coming to fruition. She now has an amazing space located in between Eckington & Shaw which boasts three stories; top floor is a coworking space with everything you need to work successfully, main level includes a kitchen, lactation room and a separate space for childcare and a basement for older kids, classes and conference calls you may need to take.

Below is a q+a that will allow you to understand what Workafrolic offers and how you can use all it has to offer to your advantage.

How did the concept begin?

At first, my idea was to build an indoor playspace for infants and toddlers. When my son was too young to enjoy the playground, there weren’t many indoor places outside of my apartment where he could safely explore new surroundings and I could relax knowing it was acceptable for him to be crawling around putting everything in his mouth. As the concept developed, the amenities I had in mind for the parents grew until it was a space that was equal parts for kids and adults. I ended up creating my ideal place as an urban working parent!

Explain what coworking is.

Coworking is when individuals who don’t work for the same organization work side by side in the same office space. It’s often a financially smart arrangement for businesses of all sizes since the overhead costs necessary in managing an office can get expensive. For individuals who would most likely be working from home in isolation, the coworking model has created a valuable opportunity to work in an office setting where they get access to professional networking, printers, and meeting space. The coworking model has been around for a few decades, but there has been a sharp increase in its popularity over the last several years and is now common globally.

What’s unique about Workafrolic?

Workafrolic is unique not only because it is a coworking space that has on-site child care, but because of the flexibility our version of this model affords parents. They can see availability and book child care by the hour weeks in advance or right up to the minute before they arrive. We have long hours during the week (8am-7pm) and weekend (10am-7pm) to accommodate a variety of schedules. We have monthly memberships, but we also welcome non-members to use our services on a drop-in basis. We also host classes that families can participate in together during the week and weekends, like music and family yoga.

Another unique aspect of Workafrolic is that in addition to work space we offer a convenient place for adults to take time for themselves to participate in fitness and wellness classes while their child is being looked after. Parents—and especially moms—often sacrifice their own personal time for work and family responsibilities. Not that we need a reason to have some alone time, but evidence shows that exercise makes people more productive and creative. Self-care also puts parents in a stronger position to care for kids. Integrating this element into the same space with work and family and providing child care makes it easier to fit it all in to the day since time is the reason so many of us don’t get to it.

Workafrolic’s playspace is designed for children from birth to age 6 with toys and activities that engage children at each developmental stage. We believe free play encourages creativity and independence and our playspace gives children materials and space to feed their vivid imaginations and innate desire to learn and grow. The playspace is available as an indoor area for parent-supervised play (Open Play) on the weekends and after 4pm on weekdays. We also rent out the space for birthday parties.

Can a Mom come to Workafrolic if she is nursing? What about if a child needs to nap?

Absolutely! In fact, one of the benefits of Workafrolic is that mom and child can spend the day in close proximity and can continue their nursing routine as long as they’d like. Our rocking chairs in front of the large windows overlooking North Capitol St are a prime spot for nursing. We also have a comfortable lactation room if you’d like more privacy to nurse or pump.

Most of the children who come to Workafrolic nap here. One side of our main child care space is dedicated to napping and a gate keeps wandering children from bothering the nappers. We have cots, cribs, infant swings, bouncers, and a rock ‘n play, so your little one will certainly find a comfy spot to settle into!

What can those using the working space expect?

Expect to be productive!

Workers can expect a comfortable and inviting space with everything they need at hand to tick things of their to do list. We serve complimentary hot and iced coffee and tea and sell snacks from local food businesses to munch on while you work.

You can also expect to see a lot of Dads! Many people assume moms are the parents using Workafrolic, but our clientele is pretty much half and half so dads should feel very welcome to come work here.

Location: 1707 North Capitol St NE Washington, DC 20002
Phone: 202-506-2770