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hvparent.com n Hudson Valley Parent 29 by the time children are two and their baby teeth have grown in, kids should begin dental visits. "This is a quick exam and the child can sit on Mom or Dad's lap and be comfortable," said Duggal. "They may learn a little about the toothbrush and mirror the hygien- ist or dentist will use, but the main objective here is to begin a relation- ship with the dentist's office and to prevent dental phobia. There may be a little exam or cleaning." Duggal said these early, easy interactions help form a trust and comfort level that will make future care a positive experience, even if more involved treatment is needed. "Mom and Dad are the most cru- cial part in all of this," Duggal said. "They can be part of a routine visit and take tools home to use." Fluoride, said Duggal, can help slow the rate of decay. The chronic disease occurs in one-in-four chil- dren who do not have access to fluoridated water or other readily available sources of fluoride. "They can miss school, have speech delays and poor nutrition because dental health is preventing them from eating," Duggal said. "It's all intertwined." With February being National Children's Dental Health Month, Duggal plans to go into local schools and daycares, including her son's preschool, with an educational program on dental care. She's also working with the Monticello school district to provide programs for mid- dle- and high school-aged students. "Middle school students are not getting enough education on dental health," she said. "They still need reminders. Parents may think their kids know at this point, but they don't, or they need a reminder." Healthy dental habits come down to a long-standing relationship with your dentist, said Duggal, including dental hygiene practices that become a part of kids' routines. "You want the child to have trust in their dentists and not be trauma- tized," she said. "If you don't come back for two to three years, that's when problems can arise." And, for those teens that don't have good dental habits or a positive relationship with a dentist, Duggal re-introduces them to the right way to brush their teeth and reminds them that their teeth are the only set they're going to have. Important, said Duggal, are brushing twice a day, seeing the dentist twice a year, and getting the appropriate amount of sodium fluoride to help prevent cavities and support enamel formation. "We'll talk about juice and candy and other sweets," she said of the relevance of diet. "For instance, an apple is better than apple juice." Hygienist tips. Greenville resident, Liz Brown, a hygienist at Wurtsboro Dental and mother of two grown children said when it comes to getting up to speed on dental care, it's about education. "When I started out, I didn't always realize the right way to do things," said Brown, talking about raising her children before she worked in the field of dentistry. Nowadays, she's seeing more parental concern about their child's teeth and dental health. For in- stance, making time for a six-month check-up and cleaning that includes removing tartar (dental calculus) which can trap bacteria helps pre- vent gums from getting inflamed. As well, children's floss picks are available and, if needed, parents can help with their child with flossing. "As regular floss can be awkward, (electric water flossers like) Water- pik are another good tool, as is an electric toothbrush," said Brown, adding that they can bring efficiency and fun technology to the process. For young children that don't have the coordination to brush properly, Brown said parents can start them on the brushing process, then let the child finish for a sense of accomplishment. Also important is fluoride's part in dental care, with fluoridation in most counties in the Hudson Valley specific to a town or area, such as a housing development (find out if your water district is fluoridated at https://nccd.cdc.gov/DOH_MWF/ Default/WaterSystemList.aspx). Dentists, said Brown, will look at how much fluoride a child is getting from available sources and proceed from there, possibly prescribing fluo- ride vitamins. "It's important to start at a young age with drops or chewable vita- mins," she said. "Fluoride toothpaste isn't swallowed and isn't enough. Vitamins with fluoride will help pro- tect the baby teeth but it also goes into the adult teeth that are being formed so it's a dual purpose." The back teeth (pre-molars) main- tain the space for adult teeth that come in around ten years old and the front baby teeth do the same for permanent teeth come in between five and seven years old. Many dental teams offer nutri- tional counseling, including brushing after eating sweets. For example, products such as fruit roll ups and gummy vitamins stick to the teeth, said Brown, leaving troublesome res- idue on them if they're not brushed after enjoying the treats. She also advised against using a bottle with milk or sweet substanc- es with the child overnight. "That causes problems," Brown said, since long exposure to the sugars in these products allows them to pool around teeth and increase the incidence of tooth decay. Olivia L. Lawrence is an editor for a news organization. She likes to spend her free time outside gardening or otherwise enjoying nature.