Important Oral Hygiene Tips for your Children from Dr. Mal Azar

Pictured Above: Dr. Mal Azar teaching young students at the Yeshivah of Flatbush the importance of oral hygiene.

Smiles for Miles Pediatric Dentistry is a one of a kind, enjoyable place to visit because it’s owner, Mal Azar, is not your typical pediatric dentist. Doctor Mal Azar opened the doors of his new practice in November of 2017. Mal studied at Rutgers School of Dental Medicine and graduated in 2014. He then completed a two year residency at NYU Lutheran in Brooklyn, NY where he became chief resident. What sets Mal apart is that he is a Diplomate of the American Board of Pediatric Dentistry and he exclusively treats children and adolescents.

Smiles For Miles Pediatric Dentistry is paperless, has digital X-rays, laughing gas, the newest isolation system (isolite), and silver diamine fluoride. In short, it has all of the conveniences and luxuries you could want from a modern-day dental office. Dr. Azar has many years of experience working on children of all ages and making sure each visit is as pleasurable and fun as possible. Many children, and even adults, experience anxiety when considering an upcoming dentist appointment. Mal prides himself on the ability to make those worries melt away.

Dr. Azar comforting a young patient with toys.

“When a patient walks in for the first time and is a little anxious, I just talk to them and explain what I’m going to do,” says Dr. Azar of the rewarding aspect of his job. “Sometimes I show them on their fingers to try to relate to them and alleviate some anxiety. Usually, by the end of the appointment they leave smiling and even telling their parents they want to come back tomorrow.”

The American Academy of Pediatric Dentistry (AAPD) recommends a patient’s first dental visit should be as soon as a the child’s first tooth comes in, or no later than their first birthday. This is one of the reasons Dr. Azar offers a complimentary first visit for children under the age of two years old. In this initial visit, Dr. Azar reviews the six key elements of anticipatory guidance.

This includes oral hygiene instructions, diet, habits, injury prevention, development, and fluoride intake. The specific questions that are most commonly discussed pertain to a proper well balanced diet, when to stop the pacifier, and when is the best time to ween off the bottle. Parents who obtain this knowledge early on can make a big difference in the outcome of their child's overall oral hygiene and health.

Dr. Azar with two happy young patients.

Dr. Azar’s approach to pediatric dentistry is very different from how the field was in the past. Dr. Azar does not agree with holding down patients, nor does he put patients to sleep for dental treatment. Instead, he uses less invasive atraumatic techniques with a few modern-day advances to treat his patients. If Mal detects a cavity on a patient who cannot emotionally or physically cooperate, Silver Diamine Fluoride (SDF) is applied to halt the cavity process. This is a quick and painless technique which effectively stabilizes the cavity, stopping it from growing.

Laughing gas is another technique Dr. Azar uses to help his apprehensive patients comply. Although laughing gas, or nitrous oxide, is not a new tool in pediatric dentistry, Dr. Azar’s approach is a little different.

Dr. Azar treating a young patient.

If he notices a patient who’s particularly apprehensive about a procedure, he first puts the tool which expenses the gas in the vicinity of the child and talks to them for a little while. As the gas slowly creeps into their nostrils and they become more relaxed, Mal then moves the nose piece slowly up their face until it’s reached its proper place secured on the patient’s nose. Once it’s in place, the patient is usually relaxed enough to allow the dentist to do his work.

Practicing proper oral hygiene techniques from a young age can help patients become accustomed to the dental environment and are much more likely to cooperate for future visits.

Being a specialist with children in his field, Dr. Azar always has the answers to parents’ most pressing questions in the world of oral hygiene. Here are some awesome tips to help your young child’s oral hygiene from an experienced professional.

1. When is it appropriate to stop using the pacifier and the best techniques of doing so?

Pacifiers can aid in preventing SIDS (Sudden Infant Death Syndrome) up to a child’s first birthday. Once a child turns one, the pacifier can begin to make changes to the mouth and eruption of teeth.

Dr. Azar recommends to ween off the pacifier at this age. A good technique is to poke holes in the pacifier. By poking holes, the child will suck the pacifier but will not receive the same therapeutic sucking as an undamaged pacifier.  

If a child is older, Dr. Azar recommends removing the pacifier when the child is introduced to a new stage in life. For example, moving houses or returning from vacation.

2. When should I brush my child’s teeth and what toothpaste should I use?

A child should brush their teeth twice a day, once in the morning and once at night. Any toothpaste with fluoride your child enjoys will do the trick.

Under the age of three, a tiny amount of fluoridated toothpaste should be used. The amount is consistent with the size of a grain of rice. Once a child is three years old, you can increase this amount to the size of a pea.

An electric toothbrush may be used if that’s what excites the child to brush, but supervised brushing is still recommended.

3. When should I ween my child off the bottle and how should I do it?

At the age of one, it is recommended to ween the child off the bottle. Many children will fall asleep with a bottle that contains milk, which is crucial to cavity progression. While the child is sleeping, their saliva flow is diminished an extensive amount. Since milk has sugar, this sugar is remaining on the surfaces of your child’s teeth, which may lead to cavities.

Dr. Azar understands that many babies rely on bottles to aid them in falling asleep, so he recommends to titrate the milk from the bottle. This is done by decreasing one ounce of milk every few nights, while increasing the water in the bottle simultaneously. By doing this, your child will still be given the same ounces of fluid, but by the end of the month, solely water will remain in the bottle.

4. What would be the proper diet that will help with my child’s oral hygiene in the long run?

Children are notorious for having a sweet tooth and snacking frequently. Most parents know to limit sweets and sugar intake, however Dr. Azar says that even high carbohydrate snacks like pretzels and potato chips can harm your child's teeth.

Teach your children proper snacking habits from a young age which means replacing typical snacks for fruits and vegetables, decreasing cavity risk. Try sending your kids to school with nutritional snacks like baby carrots and hummus or grapes. Whatever their favorite fruits and vegetables are, always keep them in stock!

To learn more about Smiles for Miles Pediatric Dentistry and Dr. Mal Azar, check out  their Instagram @SmilesforMilesPD or their website. Their practice is located at 1636 E 14th Street, Suite 114 Brooklyn NY 11229 and you can call 718-440-1288 to make an appointment.

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