Stop calling my wife, dammit.

Not you, weird dude from work. I’m talking to YOU, doctor’s office. The one who has been told multiple times that if you want to speak to a parent, try dad first.

My son has been through several rounds of examination and treatment with this doctor. My wife has never even spoken to him. For work reasons, she couldn’t make the parental consult meeting. She doesn’t go to these meetings because it is MY JOB.

The next appointment is in two days. And then I get the fateful text from the wife:

“Stupid doctor left me a VM again.” (I paraphrased for cleanliness.)

Listen, this isn’t even about making our lives easier. If you, a medical professional, want to help our children, you need to reach the primary caregiver. Not the working-her-ass-off, leaning-in, awesome-but-busy mom.

At least you aren’t alone. The school nurse still calls my wife, even after five years and two children. This is even though my name appears first on the contact card. I’ve even put an arrow to my number, reading “call dad first.” Still, every once in a while, I’ll get my wife’s “Did they call you instead yet” text. That means if the nurse doesn’t call me soon, I better call her.

The school office has finally learned. Of course, I think it took until I was elected PTA co-president for them to fully get it. The teachers, much to their credit, have understood from day one that this dad gets there a lot faster when there is a sick or paint-covered child. So there’s that.

I can’t imagine how they handle same-sex couples. If there are two dads, does no one get a call? If it’s lesbians, does it force the office assistant into some kind of Linda-Blair-esque, spinning perpetual-motion head spin, trying to decide which mom to call? Perhaps that’s our world’s solution for renewable energy.

Listen: In the grand scheme of things, this is clearly a First-World issue. And it’s not even the biggest one at that. But here’s what this assumption does: It reinforces the incorrect paradigm that men are unable to handle their children’s care and the unfortunate sociological expectation that women can – and will – drop everything in their lives for their kids. This hurts all men and all women.

If we want to live in a world where everyone contributes to their family and society as they see fit, we need to start respecting that, for the most part, almost any task can be done by anyone regardless of the contents of their pants.

Oh, and if you’re the medical professional that provoked the writing of this column and you figure it out, you can win a prize. Just call my children’s NEW primary caregiver.

About the author

Josh Kross is an at-home dad to his three kids. He is the former engineer and producer of The Modern Dads Podcast. He also produced the critically acclaimed Hip-Hop podcast, The Cipher (theciphershow.com).

This blog post, first published in 2014 for the NYC Dads Group blog and since updated, is part of the #NoDadAlone campaign. Fathering Together/City Dads Group, the National At-Home Dad Network, and Fathers Eve are joining forces to amplify messages that help dads recognize we are not alone! Follow #NoDadAlone on Instagram, and learn more at NoDadAlone.com. Photo by Moose Photos from Pexels.

I reclined on the bed of the CT machine, ready for a close-up of my heart. I’d been waiting for this moment since August when an ultrasound failed to determine if I had inherited my family’s history of heart defects. A better picture was needed.

As the machine spun around my chest, I hoped the resulting image would show nothing faulty with my ticker. After all, just three days prior, I had completed a 5K race, and last year, a half-marathon. If something was amiss with my heart, wouldn’t I have known by now, after nearly half a century of living?

The path to this moment began in June when my uncle was hospitalized. My mother started talking about our family history of heart disease and defects. I knew the stories of disease (mostly the result of lifestyle), but tales of abnormalities present at birth were news to me. She even casually mentioned she had an extra heart cusp, a disclosure that triggered my decision to get checked out.

It’s about your heart

I needed to know if I’d been born with a congenital heart defect known as a bicuspid aortic valve (BAV). As the Mayo Clinic explains, “The aortic valve is the main ‘door’ out of the heart. Blood flows through the aortic valve to exit the heart, and supplies oxygen and nutrients to the rest of the body.”

A normal valve has three leaflets or cusps. Some people are born with one, two or even four cusps (like my mother) on their aortic valve. But the most common abnormality is an aortic valve with two cusps—a bicuspid aortic valve. This condition occurs in about 1 percent of the general population and accounts for more premature deaths than all other congenital heart diseases combined.

For better or worse, we receive a multitude of inheritances from our family. Some take the form of heirlooms like an antique pocket watch, a well-worn family Bible, or vintage family photographs. Others are intangible yet no less real. Think cherished family traditions, oral histories, or the cultural rituals that tether us to our ancestors.

But there’s also the messiness of our genetic inheritance. This legacy passed down through generations includes physical traits such as eye color or height, as well as health conditions, like a congenital heart defect. This inheritance is a reminder that our bodies are not merely reflections of our own choices; they are also the result of a genetic lottery in which we have little say.

Searching for congenital heart defect

During the CT scan, a cool sensation enveloped my arm as a contrast dye coursed through the IV port in it. This technique would enhance the visibility of organs in the images. Soon after, a wave of warmth swept through my body, signaling the end of the procedure. That evening, I received the results.

My aortic valve was healthy, devoid of any signs of coronary artery disease. But there was a twist.

The genetic lottery had struck again; my valve was also bicuspid.

No one wants to hear there’s something defective about their body, especially when it involves a vital organ. My first reaction was a mix of emotions, from gratitude to having lived this long with no heart issues to a sense of concern about the implications of this diagnosis. Would I have to make any lifestyle changes? What’s my likelihood of requiring surgical intervention in the future? How soon should I have my daughter screened?

Thanks to a cardiologist (and the privilege of having access to medical care), I have answers to these questions.

Inherited condition not a destiny

In the meantime, it’s just a matter of wait and see. As I age, my defective valve could begin to degenerate sooner than expected. It may eventually leak and/or narrow causing my heart to work harder to pump blood to my body. If left untreated, this extra work could increase my risk for heart failure. But with regular check-ups and proper care, I can expect to have a normal life expectancy, as most people with this condition do. Genetic inheritance is not neccesarily one’s destiny.

At 49, I’m acutely aware of my own mortality. I’ve likely seen more days now than I may see later. I’ve witnessed friends fall ill, some recovering, others passing away. I’m watching my mother age gracefully and have shouldered the responsibility of caring for my father, who died in July. I take my recent diagnosis as another reminder to live fully in the moment, to not delay dreams and passions, to seize the present.

As fathers, we often reflect on the legacy we’re passing down to our children through our choices and actions. While we can’t change the genetic traits we’ve inherited, we can choose how we manage and navigate them. By staying on top of our health, we enrich our lives and set a profound example for our children, modeling the importance of self-care, resilience, and the determination to live to the fullest.

That’s an inheritance any child would be proud to receive.

Operating on congential heart defect photo by Olga Guryanova on Unsplash

Editor’s Note: We’re digging into our ample archives to find some great articles you might have missed over the years. This one comes from 2018.

An acrobat known as Red Panda has been a staple of basketball halftime shows across the country for more than 20 years. I once saw her at an NBA game years before I had children. I was stunned by her simple-in-concept yet seemingly impossible-in-practice act. In short, she rides a very tall unicycle, places an increasing number of bowls onto her foot and leg, flips the bowls into the air, and catches them in a stack on her head.

She never stops peddling her unicycle during this and she rarely ever drops a bowl. Her performances are mesmerizing.

But because I was a single, child-free adult when I saw Red Panda perform, I didn’t make the connection that she is the perfect metaphor for parenting. Especially when you have sick children.

As the dad of three children under age 7, I often feel like I am Red Panda. I’ve been an at-home parent for more than six years and, in that time, I’ve developed routines and methods that help keep the household running relatively smoothly. However, just like a momentary lapse in concentration or an unnoticed spot of perspiration on the basketball court could send Red Panda, her bowls and unicycle clattering to the ground, the slightest bit of misfortune can wreak havoc on a household filled with children.

Sure, the physical stakes aren’t as high for me. I rarely put myself at risk of a seven-foot plunge onto a hardwood floor. Except maybe when I’m climbing on the kitchen counter to hide snacks on top of the cabinets. The emotional stakes, though, certainly are.

My sick children bring out their vomit pots

Most recently, a seemingly routine bout of illness set our bowls (and bowels) trembling. It was perhaps the most dreaded of common illnesses: a stomach virus.

My 4-year-old brought it home with him from preschool. (For those with kids starting preschool soon, beware. In the first few months, your child will bring home lots of paper with smaller pieces of paper glued onto it and germs. Both are nuisances. The germs are probably slightly more disruptive.)

The first of our sick children, little Patient Zero, erupted late on a Sunday evening, just before bedtime. For someone only alive for four years, he has an impressive resume when it comes to vomiting. His tendency to vomit at the drop of a hat is unfortunate for him and was for me, at first, but it does have its advantages. Namely, he already has exquisite timing and aim. He knows when he needs his trusty vomit pan and he hits the target with a precision that would make Katniss Everdeen jealous. Recently, he managed to spew into the pan while we were dropping his brother off at kindergarten. Didn’t get a drop on our new car’s upholstery! I’m so proud.

From the first sleepless night, which Patient Zero and I spent together on the couch on top of some towels curled around a large silver pot typically used for boiling spaghetti and vomiting into, the plague ran its all-too-familiar course. Mostly it’s a waiting game. We go heavy on mindless television watching with brief flurries of cleaning and disinfecting interspersed between Handy Manny episodes.

Soon enough, all I could think about was sickness. Who was going to succumb next? Was I ever going to do anything normal again? Like leaving the house, sleeping in my own bed, or watching a non-animated television show.

And what was really going on between Handy Manny and Kelly, the Sheet Rock Falls hardware store owner?

Once one bowl is off balance, there’s no stopping the ensuing cascade.

The next victim falls

Later, the disease struck our youngest. The great thing about 2-year-olds and stomach viruses: there is not a second of warning before the terror is unleashed. Two-year-old children with sick stomachs are not like volcanoes or hurricanes; they are like earthquakes and tornadoes.

In the end, a whole week later, I was lying on the couch on a Sunday morning waiting for my anti-nausea medicine to kick in while my finally healthy kids watched more television and scampered around our living room. Perhaps I was dozing off just a little. I do, however, distinctly remember hearing one of my sons saying something about his 2-year-old sister having markers. By the time I roused myself sufficiently to stumble across the room to investigate, the boring, white ceramic tiles surrounding our fireplace had been transformed into an array of little Jackson Pollack paintings. The 2-year-old’s appearance was similarly colorful.

Such is the life of a parent whose routine, monotonous world has been disturbed by the most mundane provocateur — a sick child, or three. When the bowls crash down, boy, do they make a great clatter. And more often than not, the parent takes the fall, too.

But, eventually, when the wave has passed and the normalcy and motivation begin to return, you just have to get back on your unusually tall unicycle, arrange some bowls on your legs, and start flipping them up into the air so you can balance them on your head again. Because that’s just what parents do.

Sick children photo: © Viacheslav Yakobchuk / Adobe Stock.

EDITOR’S NOTE: This Saturday is a rare event, Leap Day. It is also Rare Disease Day, an international campaign to raise awareness about the 7,000 under-the-radar diseases that individually affect few people but, as a whole, affect more than 1 in 10 Americans.

On my daughter’s birthday last year, I drove several hours to visit her at college. I brought her the local vanilla-bean glazed doughnuts she claims are “the best” along with several assorted goodies from home. We then spent most of our afternoon chatting and watching reruns of Friends while we waited for her latest five-hour drip of IV medication to finish.

For all but the first two of her 19 years, my daughter has dealt with juvenile dermatomyositis, an incurable autoimmune disease that affects muscles and blood vessels. Just three in a million children are diagnosed with it, so you probably have never heard of JDM before. Not even if you know my girl. Outside of our family and the phalanx of doctors and nurses who have treated her through two decades, she barely talks about her condition, especially not with her friends and classmates. It’s rare a child wants to be seen as different from her peers, and that is no different for a child battling a rare disease.

Someone else, though, has given a voice to people like my daughter.

Not long after our indulging in carbs and Chandler Bing’s antics, legendary rock guitarist Peter Frampton announced a farewell tour. The 68-year-old, best known for his 1970s megahit album Frampton Comes Alive, told the world his pending retirement is being hastened by inclusion body myositis, an adult variant of the rare disease my daughter has that is even less treatable and more damaging than her condition. It, too, has no cure.

IBM, as it is called for short, is a degenerative illness. It progressively weakens and lays waste to major muscles in the arms and legs. Worst for a skilled guitar player, it eventually affects strength and dexterity in the wrists and fingers.

Someone’s diagnosis with an incurable disease is never cause for celebration. However, Frampton’s prominence and openness with media and fans about his battle excites certain people. These are the doctors, researchers, caretakers and patients who have spent a significant portion of their lives dealing with or dedicated to conditions few others know about.

“I can’t begin to tell you how extraordinary it is and how generous it is on his part to reveal this,” Frampton’s doctor, Lisa Christopher-Stine, director of the Johns Hopkins Myositis Center in Baltimore, told the Global Genes website. “With rare diagnoses, we are all struggling to gain recognition for them in the public sphere. His disclosure brings potential funding, awareness and support. Not every disease has a celebrity spokesperson for it, but when it does, it accelerates progress exponentially.”

In addition to going public about the potential devastating effects of his disease, Frampton established a research fund bearing his name at the Hopkins center, one of a very small handful of medical facilities dedicated to these illnesses. One dollar from every ticket sold on his final tour will go to the fund, which is expected to receive many additional donations at a steady pace from fans, peers and many others during that June-to-October run, a Hopkins spokesperson told me.

As Frampton said about his diagnosis in a recent interview with CBS This Morning, “Look, it’s not life-threatening. It’s life-changing.” For my family, especially for my daughter, I hope his championing of the cause of myositis research does change many, many lives for the better. Her mother and I have spent much time and effort raising money and attention to the disease and its need for better treatments the past decade or so, but it will surely be a fraction of what a respected superstar like Frampton can bring the cause.

In the meantime, my daughter continues improving after the latest flare of JDM, a condition that once made it impossible for her to walk and almost impossible to swallow when she was a toddler. Her doctors are looking at tapering some of the many meds they had to reintroduce to her regime; she is looking forward to a spring season on her college’s tennis team. And, despite the many appointments, pills and IVs, she pretty much goes about her day as if she was any ordinary 19-year-old and not the rarity she really is.

Photo: Kevin McKeever

When was the last time you had a meaningful, constructive conversation with a physician about your health? When was the last time you had a meaningful conversation with ANYONE about your health?

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I want to live a long, healthy, happy life. Don’t you?

I want to stick around as long as I can for my family. I’m guessing you do, too.

So, hey, here’s an idea: Let’s take care of ourselves.

It really is that simple. And, it really is more complicated than that.

Here’s why it’s simple: You already know how to take care of yourself.

If not, look no further than the Movember Foundation, the worldwide men’s health initiative that turns every November into a mustache-fest. Here are five pieces of advice from Movember to help you take control of your physical and mental health and look after yourself:

• Check-in regularly with family and friends.
• Get moving.
• Talk about your health.
• Know your family medical history.
• If you notice something out of the ordinary, do something about it.

Simple, right? Common sense stuff.

Here’s why it can be more complicated to take control of your health than that: Failing to act on this common sense advice is how so many men fall short of being effective advocates for their own health.

We know what to do, but we don’t always do it.

“Men don’t talk, they don’t take action, and they die too young,” said Mark Hedstrom, director of Movember in the United States. “That’s really important to get out there. You have to be proactive, guys. You can’t sit back and wait for something bad to happen.”

You know this. You know that complacency kills. You know that when it comes to the leading causes of death among men – heart disease and cancer – steps for prevention and early detection could mean the difference between extended life and imminent death.

Yet, when was the last time you had a meaningful, constructive conversation with a physician about your health? When was the last time you had a meaningful conversation with ANYONE about your health?

This isn’t about marching off to your physician for a physical and blood work. In fact, recent studies have actually begun to call into question the need for an annual physical if you’re asymptomatic. This remains controversial, so if you are looking for a way to start a health-related conversation with a physician, here’s one hell of an ice-breaker.

That aside, being your own healthcare advocate is also about common sense. It’s about paying attention to your body and mind so you know how to recognize if something is not quite right, and about knowing what questions to ask when do go to the doctor.

It’s about speaking up on your own behalf – and not just with your doctors. Talk about your health with friends and family members. You might think they’d rather not hear about it, that you’d be perceived as a complainer. Or you might be one of those guys who thinks the quiet, stoic approach is the path to manliness.

Well, forget that nonsense. Your friends and family members want a healthy you. When you talk about your physical, mental and emotional well-being, you take control of your health.

This is particularly true in the examination room.

While your doctors might ask surface questions about symptoms and recent medical history, they usually don’t spend time trying to drag potentially vital information out of you. They have other patients to see in a limited amount of time.

That’s why you should use the time wisely. Pleasantries about last night’s game or the latest episode of that TV show can break the ice. But after that? Get down to business.

“It’s a little bit of a challenge because there’s a preconceived notion among physicians that men don’t ask those questions,” Hedstrom said. “You really need to start asking that question: What does that test result mean? Do I need a colonoscopy? That sort of thing. Men taking action and having a conversation about their health is going to change that.”

You don’t need a medical degree to know what questions to ask. The Agency for Healthcare Research and Quality suggests, among others:

• What is this test for?
• What is my diagnosis?
• Why do I need this treatment?
• Are there any alternative treatments?
• What are the possible complications?
• Do I need to change my daily routine?

The answers will not always be definitive. Cancer, heart disease and other physical conditions don’t always lend themselves to certainty.

But you want to live a long, healthy, happy life, don’t you? I know I do.

So, take control of your health, men. Let’s figure out what we need to do to make sure we’re around for families as long as possible.

“That’s the most important thing,” said Movember’s Hedstrom. “It’s quite frankly why I show up to work every day.”

Photo: FreeImages.com/Adam Ciesielski

My 4-year-old son has a bit of a cough, and it’s starting to interfere with his sleeping a little bit.  I don’t think it’s more than a cough (not running a fever, he doesn’t have a sore throat, he’s eating normally, peeing and pooping normally, and overall seems in a good mood. He’s just coughing a lot.

Yesterday morning he woke up extra early at 5 a.m. and was coughing quite a bit.  Dr. Dad (and by the way, this is an honorific title bestowed upon me by myself, with absolutely no training to back it up) prescribes a little Chestal, a kid’s confectionary cough medicine designed exactly for these purposes.  My wife, also not an MD, concurred with my diagnosis.

Only one problem.  Complete refusal of the drug.  My son is channeling Nancy Reagan, and is just saying No To Drugs.  He is running, kicking and screaming, saying “NO, NO, NO” in a tone usually reserved for nightmares about people who live on Elm Street

I wheedled.  I cajoled. I even yelled.  I promised chocolate treats and extra TV. I threatened the removal of privileges, including said TV.  I gave him a timeout so that he would listen better.  I threatened to throw out his bow and arrow and his cardboard box rocketship that he made in school.  I was getting ready to take away playdates with his best friend Miles.  I even went so far as to make a list of the things he would not be allowed to do in the future, including a  ride in his beloved Barbie car that resides at my wife’s aunt’s farm in Indiana, and is the highlight of his summer.  Nothing moves this kid.

Several times he agrees to try the medicine, and I get hopeful, and out came the spoon of honey-filled medicine, only for him to refuse and run away.  And now I have to put down the spoon, get him, and bring him back, and start the cajoling process all over again.  At least once I got so far as to smear the medicine all over his face in a vain attempt that the medicine will work by skin contact alone.  (a lot of it also landed on the floor, and my shoe has been sticky for a day now as a result)

After about 40 minutes of all this, I manage to get him to ingest a teaspoon (along with complaints that this stuff tasted worse than the worst stuff ever, that he prefers his mom, and that I was no longer a shoo-in for dad of the year )

And we are off to school.

By the time we are at school, he is once again a happy kid. The bad taste in his mouth (literally) is forgotten.

I, however, am dreading my next encounter as a drug-pushing dad.

Any helpful tips or best practices on how you lure your child into taking meds, I would highly appreciate (and I don’t mean HIGHly). Please post them in the comments.

This past August my wife, kids and I were at a playground, soaking in the sun and playing in the sprinklers. We got a call from my mother-in-law, some relatives who were in town to visit my father-in-law (as he was spending his final days in a hospice), who had purchased some cabinets for her kitchen. They needed help bringing them into the house. I was drafted to spend a very hot humid afternoon carrying cabinets up and down the flights of stairs. Consequently, it turned out to be a potentially life-saving event!

After the park, I dropped my wife and son at Target, while my daughter slept in her car seat. I drove up to my in-laws’ home and parked in the driveway. I went inside and brought down some cabinets without incident. It was very hot so my sunglasses slipped off my sweaty head. My wife’s elderly uncle and I carried the largest piece down through the cellar doors. Without my glasses I was flying “a little blind,” but that was OK. Once we got it in, I rushed back up as someone was trying to get past my car. I misjudged the height of the ceiling and SMASHED my head into it. I let out a loud expletive as I clutched my head. Instantly, it was swelling and my hands were covered with my own blood. My wife’s aunt brought me an ice pack and I put it on. Sort of in shock, I jumped into my car and went to pick up my wife and son.

By this time I couldn’t wear my baseball cap because of the growing bruise. She suggested that I go to the hospital. Not wanting to accrue the expense or show weakness, I tried to dissuade her and said I’d have a buddy who is an FDNY EMS take a look. I walked over to his house and as he opened the door, he didn’t see the bruise or anything but asked if I was feeling OK. I said that I was a little light-headed and showed him the bruise. Now, we were headed to the emergency room.

Luckily, we got fast-tracked into the triage department. While there they took my blood pressure and it was astronomically high! I was coming in at 190 over 110 (normal is 120 over 80). All of a sudden, the throbbing bruise on my head was the least of anyone’s worries.

I was given some meds to lower the BP and after an hour or so it lowered to the 170s, but that is still well above the normal range. For reference, the Mayo Clinic classifies BPs over 140 as Hypertensive. All of a sudden, flashing through my mind were thoughts about my kids at home, and how I can’t let them grow up without a dad.

Having grown up without a father myself (he passed away when I was five years), it was not a situation I wanted my kids to deal with for the rest of their lives. Granted, my father was in his early sixties when he died, and I am in my late thirties –  it freaked me out nonetheless. A doctor came to inspect my head, and I had a CT scan. I was ok, just a bad scrape and bruise, nothing to worry about, but I should take the prescription he gave me and see my personal doctor.

By the time I got to see my new doctor, my father-in-law had passed away and we were all scrambling to get the arrangements together. My BP was still high, but the doctor told me that I needed to get more active and eat better along with a second prescription.

My friends, who up to that time would spend late nights (after kids and wives went to sleep) watching TV and eating deli sandwiches, unilaterally decided to change our lifestyles. We downloaded the My Fitness Pal app for our phones. We weighed in and started taking long walks at night. That first night we walked for almost two hours, and every day we kept going. Our small group walks at least one hour a day and at least five times a week, though usually, it’s more. It doesn’t seem like working out. It’s like hanging out with your buddies but doing something good for yourself.

I recently went back to the doctor for a check-up. My BP had dropped dramatically to 130 over 90, all of my cholesterol numbers were down by significant amounts and I have dropped 12 pounds. And honestly, it feels amazing! And the benefits are real and contagious. My clothes fit better, I look and feel better but I know that I am a long way from my goal. And my wife is also on board with my new lifestyle. We are eating healthier, lighter meals at home, my wife is taking Zumba classes at church, and we joined a gym. Like it or not … hopefully, we are going to be around for each other for a long time.

I love sugary iced tea and snacks. When I want that kind of treat, I take them, but knowing full well that I will have to work those calories off! And that kind of responsibility is what my new healthier lifestyle is all about!

As a parent and public school teacher (on hiatus), I frequently use hand sanitizer multiple times per day to ward off germs. I even use it on my son’s (20-month-old) hands a couple of times per day, especially if we are on the go – can’t trust those subway railings! Yup, I am sure the alcohol being absorbed into his skin is probably worse than the benefit of the sanitizer killing germs.

What am I really trying to prevent? Fewer colds, the flu, and peace of mind. Thanks to Josh K. for sending me this sobering article on hand sanitizers. How To Sell Germ Warfare, written by Darshak Sanghavi on Slate, provides background as well as research on this focus question: Can hand sanitizers like Purell really stop people from getting the flu?

The article will be enjoyed by most parents, especially the germ-o-phobes. It was a learning experience for me, including this bit – “But we need to be realistic about what Purell can do to fight flu in the home and in public. To begin, the influenza virus mostly spreads via tiny droplets in the air (for example, from sneezes)—not by dirty hands or surfaces—which limits the role of Purell. It probably wouldn’t matter even if flu transferred through hand contact, which is how most cold viruses spread. Though Purell kills them in the lab, hand sanitizers don’t stop their spread in the real world. The average child touches his or her mouth and nose every three minutes, and both adults and children come in contact with as many as 30 different objects every minute. Even hospitals can’t get staff to use Purell before seeing patients; it’s impossible for daycare staff, parents, or teachers to wash a child’s hands 20 times each hour.

We interviewed our pediatrician before our son was even born. He visited us in the hospital a few times the week after our son was born to give him several check-ups. Then, during our son’s first year, we visited our pediatrician’s office every few months for general check-ups, immunizations, and sick appointments.

Basically, we take our children’s pediatricians very seriously, but when are our kids supposed to go for their first dental visit? What happens at the first visit? These were valid questions a few of us concerned fathers had. So, we decided to do something about it, and get educated.

Josh K., who has a 5-year-old son that regularly visits a pediatric dentist, invited his pediatric dentist to join our NYC Dads Group for a “Pediatric Dentistry 101” session. Caryn Siegel, DMD (a Board Certified Pediatric Dentist of the American Board of Pediatric Dentistry) of NY Kids Dentistry was warm, knowledgeable, personable, and ready to tackle the issues and questions from the dads in our group. Nine dads with their kids were lounging in an indoor playroom where only 1 of the 9 had visited a pediatric dentist before. Dr. Siegel came prepared with a 3-page document detailing the most frequently asked questions (shared below), but we were dads … we could read it in our spare time. Thirsty for knowledge, we wanted to fire away the questions.

When Should Your Child Visit a Pediatric Dentist for the first time?

Dr. Siegel’s answer: “The American Academy of Pediatric Dentists (AAPD) recommends that the first dental visit should be at age one or within 6 months of getting their first baby tooth.” Many of the caring dads in the room, with children over a year old, looked around at one another — we realized we “dropped the ball” on this one.

The goal of NY Kids Dentistry is to encourage “anticipatory guidance” for parents so this becomes a “cavity-free” practice. I would like to impart some knowledge I gained:

• Cleaning a kids teeth will not harm them. We should be brushing their teeth twice a day (morning and night).
• Encourage them to brush on their own at an early age. Establish a routine, such as singing a song like “this is the way we brush our teeth.” Parents should take over at the end to make sure teethed get cleaned well.
• Do not use toothpaste or use paste without fluoride for young children.
• The 3 factors affecting your children’s teeth are diet, oral hygiene, and genetics.
• What happens during the first visit? The visit is MAINLY for the parents. During this 30-minute visit it includes an Oral Exam + Polishing Teeth + Putting some Fluoride on (this takes about 5 minutes). The child usually sits on their parent’s lap. NY Kids Dentistry is ok with the parent being in the room, unlike some other practices. The rest of the time is spent on learning best practices for healthy teeth in the future – how to handle cleaning all of he time, how to do it safely, and how to avoid accidents. Appointments for children under 2 years-old usually happens in the mornings because it goes more smoothly.
• Dr. Siegel recommends children to be off their pacifier or thumb sucking by age 4. The frequency, duration, and intensity of using a pacifier is what causes shifting, and might even impact short-term speech. After 6- 9 months of not using a pacifier/thumb, most dental shifts correct themselves so this is recommended after all of the baby teeth are in place & before the big teeth occur.
• Even though babies have their baby teeth cutting through at an early age, the permanent teeth buds are also in development at this time.
• A dry mouth could speed up the cavity process, so use lots of water – your children should drink water after meals to assist in cleaning their teeth & drink lots of water throughout the day to keep their mouth moist.
• When should our children be brushing their teeth on their own as daily habit & routine? They should be independent tooth brushers by age 6 – 7, when they are able to tie their own shoes.
• The biggest oral hygiene “no-no” – breastfeeding or bottle feeding your child to sleep because then the sugars of the milk or formula remain on the teeth while they sleep. Dr. Siegel suggests using a wet washcloth and wipe the teeth or gums before sleeping.
• How often should children visit their pediatric dentist after their first visit? Similar to most adults, “every 6 months”
• Can you give a ballpark on the cost of a pediatric dentist visit? A visit to NY Kids Dentistry is approximately $200 – $225

Please take all of the information in this posting as general guidelines. Your pediatric dentist or pediatrician might suggest otherwise. NY Kids Dentistry is just one of the numerous pediatric dentistry practices in NYC.

Below is the “Pediatric Dentistry 101” Document shared with our NYC Dads Group by Dr. Caryn Siegel, DMD on behalf of NY Kids Dentistry. With her permission, I am posting this resource for other parents:

PEDIATRIC DENTISTRY 101
Caryn Siegel, DMD
Board Certified Pediatric Dentist of the American Board of Pediatric Dentistry
http://www.nykidsdentistry.com/

FIRST DENTAL VISIT: AAPD recommends that the first dental visit should be at age one or within 6 months of getting the first baby tooth

What happens at first visit?

Treatment: Examination, cleaning (dental prophylaxis), topical fluoride application, x-rays if needed

Discuss: growth and development, age appropriate oral hygiene practices, dietary recommendations, non-nutritive habits, caries prevention, oral trauma and injury prevention, fluoride issues, teeth grinding, future need for orthodontics

GROWTH AND DEVELOPMENT:
20 primary (“baby”) teeth: 1st tooth at 6 months of age
Central incisors: 6 months
Lateral incisors: 9 months
1st molars: 12 months
Canines: 18 months
2nd molars: 24-36 months
Primary teeth develop in utero, permanent teeth develop after birth
Color differences
Spacing is desired
Exfoliation (“falling out”) of primary teeth: girls: age 6 years old, boys: age 6.5 yrs old; last tooth can fall out as late as 12.5-13 years of age or later
All 20 primary teeth fall out and get replaced by a permanent tooth, 6 yr and 12 yr molars
Decay (“cavities”):IF PRIMARY TEETH DEVELOP DECAY THEY HAVE TO BE TREATED (in most cases)
Risk of decay: oral hygiene, diet, genetics

ORAL HYGIENE: must effectively remove plaque buildup on all surfaces of teeth
AM and PM brushing by a parent, proper brushing technique
Flossing if needed
Non-fluoridated toothpaste if unable to spit out
Fluoride mouth rinse if indicated

DIETARY RECOMMENDATIONS:
minimize the length of time sugary substances are in the mouth
Bottle/breastfeeding: not as child falling asleep, not “at will”
Water vs. milk: lactose is a sugar
Avoid foods with high sugar content that stay in the mouth for an extended period of time: sticky consistency or sucked on: dried fruit, raisins, Skittles, Starburst, fruit snacks, ice pops, and lollipops
Snacks and sweets which are better: chocolate, cookies, chips, ice cream

GENETICS: bacterial content of parent’s oral cavity passed on directly to child
Magnitude
Type/species

NON-NUTRITIVE SUCKING HABITS:
Pacifier and finger sucking
Can change position of teeth: top front teeth flare and pushed up, narrow palate, change posterior occlusion
Stop by age 4
Thumbguard, cemented habit appliance

GRINDING:
common in children
Not related to stress (as in adults)
usually a subconscious response to falling in and out of deep sleep
Flatten edges of teeth, usually not a concern with primary teeth, usually not a problem with permanent teeth
Usually children “grow out of it” around age 8-9

INJURY PREVENTION:
Age 2-4, Age 8-11
Mouth guards, helmets

DENTAL EMERGENCIES:
· Only true dental emergencies are:
1: avulsion (tooth out of mouth) of permanent tooth
2: luxation (tooth in wrong position) of permanent tooth
· Chipped teeth: size of fracture determines treatment needs: no treatment, smooth out the tooth’s chipped edge, repair/bond chipped edge, root canal?

FLUORIDE: a naturally occurring element
Topical: over the counter toothpaste, mouth rinse (ACT), dentist application twice a year
Systemic: NYC tap water

o Substituted into the enamel matrix of developing permanent teeth during their development

o One of the top 10 health advances of the 20th century, significant reduction of decay rate

Supplementation?
Fluorosis

X-RAYS:
Taken to visualize surfaces unable to see clinically
Assess proper growth and development
Rule out pathologic conditions
· AAPD recommendations

ORTHODONTICS:
Earlier treatment
2 phases
Genetic predisposition

PREVENTION:
Sealants on permanent molars
appropriate fluoride recommendations
x-rays taken appropriately
routine dental visits

Websites:
http://www.aapd.org/
http://www.ada.org/
http://www.nykidsdentistry.com/
http://www.thumbguard.com/

Here is a guest blog post by Edward D., who shares his concern & frustration over the H1N1 availability for babies and toddlers…

Shouldn’t the swine flu shot be made MORE AVAILABLE for babies and toddlers first? After all aren’t they the people who need it most?

On Thursday, Jan 21, the point was made on CBS’ The Doctors TV Show, that the H1N1 virus prevention shot is widely available. A CVS pharmacist was on hand making this announcement – great news! The show made the point that the shot is available at CVS (which it might be)…but I have a 24 hour CVS down the block, and the last time I went there, I didn’t see any reference to the shot being available. I did see a reference to the shot being given at Walgreens, which is also in close proximity to my apartment. I waited 1/2 an hour, and got the shot for myself…but, what about my son Zachy! For the record – I am a stay at home dad so I was able to get it during the day (unlike many of the working folks), but still had to wait 1/2 an hour.

Anyway, back to my point. Yes, the H1N1 shot is available at Walgreens and CVS, but it’s not available for infants, babies and toddlers. Recently, I went to my son’s pediatric doctor for his second flu shot. I asked the doctor about the availability of the Swine flu shot for him as well. She said that “yes, the shot is available for some people, but it’s not available for the people who need it most, babies – whose immune systems aren’t well developed yet, and are very susceptible to getting illnesses and viruses.”

Shouldn’t the swine flu shot be made MORE AVAILABLE for babies and toddlers first? After all, aren’t they the people who need it most?