17. Creating a Positive Dental Health Relationship – Dr. Jill Lasky

Transcript

Hello and welcome to the If We Knew Then podcast I’m Stephen Saux

And I’m Lori Saux

And today we’re joined by Dr. Jill Lasky from the Lasky Pediatric Dental group in southern California – Studio City. We’ve known doctor Jill and her husband Michael since Sophia was a toddler

About 10 years.

Yes, ten years probably.

I don’t even remember the recommendation that led us to doctor Jill but what I find I feel like we say this about a lot of people in our life we’ve been really fortunate to have been led in the right direction and when it comes to dentistry and going to the dentist as a parent so overwhelmed by that thought because I know what my experience with the dentist does and the thought of my child getting a cavity and having to go through that process was really intimidating and not even what your experience is now a dentist but I think of what my experience was as a child noticed I’m talking about well yeah I mean as a child it was there wasn’t a pediatric dentist it was like my parents dentist who was just a guy who didn’t really know how to deal with the kids and just suck it up I’ve got these big hands on a put it in your mouth and we’re gonna dig around there and was like just deal with it and so meeting Dr Jill was just a gift because it came out of necessity when Sophia has some dental issues yet some dental issues and had to actually go through some surgery yeah now doctor jail has been great and her whole staff I mean she’s got a front desk people that are great the high Jenis there’s a gentleman that does the X. rays they’re always so attentive to the kids and how they’re feeling at that moment adjusting and I think we’ll talk about that a lot in this episode is just how you each child’s each person no matter what they’re all unique and you have to work in a unique fluid environment they made going to the dentist a non issue and as a parent let’s let’s face it it’s great not to have something be an issue she has an expertise in pediatrics and so she’s agreed to come talk to us I’m excited who ever thought I’d be excited to see the dentist let’s start yep here we go well thank you for joining us Dr Jill hello I’m so happy to be here today well we’re happy to have you maybe you could give us all inside and tell us a little bit about yourself and your practice of course my name is Joe Lasky and I am a pediatric dentist here in studio city California not everybody knows what a pediatric dentist is so after dental school you can specialize in braces or gum disease are root canals and there is a subspecialty called pediatric dentistry so I have extra training and the growth and development of strictly children from age zero to eighteen and and that kind of training you also learn from a lot of time learning about children with special needs and how to treat them and their unique challenges and advantages that comes with children’s dot have neurological differences so that’s what my practice specializes in as well as just kind of routine cleaning and fillings for kids of all ages yeah how does it look how how were you %HESITATION instructed about kids in all different spectrums of disabilities I personally did a two year residency at children’s hospital Boston and in that time we treated the greater Boston area and also there was a lot of clinics that craniofacial clinics that had to do with children with all types of syndromes and then there was also an special autism program at the hospital at the time and then we got a treat all the children are on the floor that were going through different surgical procedures have leukemia or any other pediatric cancers so it was just added tends to your training when I was just basically lived at the hospital as a resident I didn’t know you were you were at children’s in Boston that’s a fantastic hospital yes it was an association with Harvard Medical School so we also have some training at the dental school there as well it was it was at one a full time so an intense experience but it definitely prepared me and gave me the foundations for me myself to grow and learn and develop my own style in my private practice here in California well specifically to downsize or did you have any personal experience with with children yeah hi quite a few when I was a resident and then in my private practice now I have the honor of you know caring for Leon and a handful of other children with down syndrome a lot of what I do when I’m with the kids with down syndrome are similar to that other kids with you know letter like neurologically different it but at the same time a lot used to seeing what you do with everybody I think the core of my philosophy which treating any child is to kind of make that connection make that touch point with that now what ever level their ads and to try do you feel and build a trust with them because that’s the core of all treatment if you can gain trust and establish a connection you can go so much farther with anything you have to do especially you know the dreaded dental treatment that so many people are fearful out so try to make it a positive experience as possible well that’s one thing we’ve learned with Liam is just that we didn’t know when we when we he was born was just how normal things were going to be you know just how we were going to just treat him the same and you just kind of gauge each kid differently because everyone’s unique and that’s probably your practice as well like you said I mean you could have just dozens of typical kids that are just all different they’re just all over the place you have to you have to be precise and and individualize what your care a hundred percent I mean that’s you know a kid that might be a superstar socially you know just can’t stand going said the dentist I mean the the oral cavity is such a private area that you at the same time experience so much of life with I mean think about toddlers there always that our hands in their mouth and they’re exploring the world with our mouths so I have to basically invite myself into that private area and make sure that they’re comfortable before and make sure that account with me as a person feel like touch and you know where they are on there and understanding and where are they on their communication the all of that goes into the first few minutes and I’m needing the child I kind of have that you know ability to assess all of those things and then take it from there in addition it’s so important to make sure that the parents are comfortable what you’re doing because so much of a child’s especially zero to three but you know even older they gauge on the comfort but comfort level with that parents so it’s key in my practice to make sure that I understand what the parents concerns are because my concerns might not be what their concerns are to make sure that parents have a voice and if they feel comfortable their energy is that projects under trial that helps the comfort level and help settle the trial down before I have to do whatever I have to do yeah it is a very intimate relationship that you get in with your dentist and %HESITATION when do you advise that parents start to talk about the dentist and dentistry to their children so I think that’s important it’s critical to find a dental home is what we like to call it %HESITATION by the child’s first birthday because it’s for a for all children and I think that by age one if they have teeth or if they don’t have cheese there is some movement there scooting around they might you know them point out there walking the risk of having any kind of dental trauma increases you know them before when they were not when they weren’t mobile so no it’s it’s very stressful if your child falls down and has any kind of trauma to their mouth to vent scramble like where do I go in in honestly adore pediatricians but they don’t really they don’t get much education and medical school how to care for them out so that is you know not the first place to go to so if you’re already established a dental home or having a debt to something to go to that’s key the next thing is I’m skeptically children on that not all of that that’s especially once the down syndrome tend to get teeth later but you know not even an all children sometimes I’ll have a tooth by the first birthday but if they have a tooth you really should care for it so by that first birthday parents should have a checkup for their child but it’s really mostly for the parents and less about the child just so the parents can learn how to best care for their children’s teeth and most kids are more solid foods by dad and you know what food choices are past you know and also really they kind of have an idea especially kids with down syndrome get a basic idea of what to our parents have to possibly expect over the next six months well because for that is I’m twelve to eighteen months a lot of things do change and the parents if you understand have the knowledge it’s a lot more anxiety it reduces the anxiety levels if you have information and if you have a place to go in case something happens so by the first birthday for sure I remember it was I was thinking back at Liam’s first birthday and I know his teeth came in a little later than Sophia’s did but %HESITATION I I remember him having not sticking his tongue out sometimes not only just when he was concentrating but even just when you relax a little bit I think it was a low tone I think it’s something that’s common in children with down syndrome and I remember just get in this rhythm of just always just putting my finger gently and just pushing this his tongue back in his mouth just sand tongue in and just kind of encouraging that I that I had actually seen on the internet yesterday someone asking that question of what do I do %HESITATION for protruding tongue and I almost responded on Facebook with what I did maybe you could tell us as a professional is there a recommendation for a protruding tongues so kids with down syndrome definitely have larger talks that is that’s a very common and dental %HESITATION NASA station of the syndrome along with smaller T. narrow jaws and at low a larger lower jaw kind like the Bulldogs under bite look at a smaller upper jaw so the kind of combination of everything makes the tongue kind of stick out in some of the times it’s because of muscle tone like you’d imagine what’s Leon and trying to kind of you know work with if you hopefully have some other occupational therapy on that they can kind of help or language or anything you know where the other therapies as well to kind of help remind him date get the tongue and if the campus sometimes it’s physically some of the children their tongues don’t really fit in the mouth yet so decides the %HESITATION reminder with that you deal with your finger the next thing is to make sure that it’s kind of moist all the time on making sure the salivary flow is there and making sure that it’s clean because those are the those are the things that if they’re not clean and if they’re not moist you can get the problems but %HESITATION the reminder of it helps when they’re older there are some orthodontic appliances that they can kind of help or orthodontists %HESITATION depending on the cooperation level of a child that might need to intervene to help it does it really fit in the mouth better help you know why in the John do something so it’s kind of there’s many different factors but having the tongue kind of stick out is eight a typical %HESITATION I not even happened it’s just replacement of the tongue with kids with down syndrome so let’s say the mouth is dry what do you do about that so making sure the fluids are always there and also to make sure that all the solid very glands are working properly so that would be something that they haven’t visit the dentist and also if it is happens to be dried there are different like toothpaste and stabs it you can put on but again I would that’s something that the body usually does compensating keeps it moist but keeping it clean is probably the biggest thing that a parent can do at home and that I would do that by just taking out watch clock and white bean the tongue and wiping it from this far back as a trial can tolerate without gagging going outwards because that will make sure that all the bacteria and things don’t stay on the tongue Rockley wiping it out when you brush with a tooth brush it kind of swirls around so that’s not as beneficial as taking a washcloth or guys in just kind of wiping it out that’s a better way of keeping the town clean I kind of tongue scraping I guess exactly and you can use a scraper but is that a lot of times a lot easier to just use a wash cloth or some some little guys but that you can get the drug store and speaking of brushing the teeth and and that might Charis world things around %HESITATION we’ve actually William is great with freshness teeth I mean he he does as good a job as he can we we follow up with him but he’s very independent and doing it and and for for listeners out there we’ve had so many more problems with Sophia’s teeth then Liam’s and I do have that something that is that’s have to do with that spacing of the teeth if you’re smaller is typically more space between them ended the tongue is larger it’s actually more protective because your tongue typically is moist and the sudden slide back has a lot of protective qualities and it so usually kids with down syndrome have less Dick Hey but maybe have more gun disease issues %HESITATION depending how much it would compensate how easily it is for them to close our mouths on to keep their guns you know left over the gardens %HESITATION so it’s it is usually and then they create a lot more charter typically does the with saliva is so usually have less cavities like that’s usually think of a good teacher Betsy depending on how many how much to K. there is so you are it is a true and common statement for kids with down syndrome have last A. K. OB and that’s why I know that you made a comment about having more issues with Soviet either from the Cape point of view are also crowded and things like that because Liam’s map is more forgiving in that sense which is definitely suffer lighting and a blessing it should be a relief to parents because I tell you well we brought Liam to you after having severe with you for a couple years and seen what what just having cavities and just you know just some things we I was rolling my eyes going now what we’re going to have what Liam but it’s been it’s been great yeah it’s it’s it’s really yeah the biggest thing is really that you have to skip the face in the dirt in the ditch the discrepancy between the size discrepancy between the size of the upper and lower jaw which is something you typically deal with out when they’re done growing and depending on the severity you may or may not need arts and out sick or jaw surgery do you align to make sure that chewing is it out as easy as possible but that varies just like you know the different severity of different shape the face at all you kind of process that individual basis but there are plenty of clinics and doctors throughout the country that are well versed in making sure that your child can masticating %HESITATION queue you know them the best possible but law that is down when they’re there to complete done growing that’s when those things are taken care of but finding a dentist that can help you until you get to that point is key in making sure that you have routine visits having that be once a month to make sure your child is comfortable to tolerate things in a dental you know setting to all the way that you know every six months if they’re kind of used to it or roll with that and their dental needs are not extreme any where on that spectrum it is important to stay on top of their dental care because like anything else the more you kind of avoid it because you might have angst than your own issues about dentistry itself that worse is going to be sold you know it’s like you just kinda have to say we just got it pushed through this because at the end it will be definitely definitely more beneficial for your child they have routine care I know sometimes it’s overwhelming said problem or do you have to do but it is really important to make things easy to catch things when they’re small and you know easier to handle than when they get larger and bigger problems so what can we do at home to prepare a child for dental care and visiting the dentist I think that it %HESITATION do you seen that tooth brush A. I. even a washcloth getting inside the child’s mouth at six months between six and eight months I think it’s critical even if there’s absolutely no truth I think that I tell parents when their you know how the child and changing table and just before they go to bed to take a washcloth or little single brash and it could be I’ve seen nothing on it or it could be we have some water or can have a natural fluoride free toothpaste I’m any of those whatever you think your child you know the most cooperative or you can try them all and see what works and once it might work one week and two weeks later does it need to go to the next thing but I think just making them aware and just talking and saying you know mom and dad are you know grammar whoever’s playing and the bad if you like you know look we’re gonna buy parties now with just talking to the child in making them aware that even if there’s nothing in there right now that this is something that we have to clean just like we have to clean your bottom and you know the rest your body so that is something that I really think it’s critical for all children that are around that like kind of six to eight months or it later it just whatever they kind of seem like the stuff that we can put on our plate now when you kind of get out out a little bit of a fog %HESITATION I think it’s critical to do that then you can also incorporate into your you know reading any kind of books about going to the dentist I’m just so they just kind of aware that is there something that you go to take care of %HESITATION then just modeling I think it’s really important for for your kids to have them you know in the bathroom when you when you’re brushing your teeth and just talking about it with them all of that the earlier the better %HESITATION I think to do so when they do go to the dentist for the first visit it they might not register remember it but don’t have that in their sub conscious and know that this and that we have to be doing and the first visit is what I recommend because it’s really for the parents to have a double homes they know and that’s really parent education appointment more than the trial then we will look in their mouth seeing if there is an issue that a year I think between you know your fourteen months or so definitely the latest by eighteen months you should got their first visit we should at least maybe a Sabah someplace to go around the year and bringing to the dentist and the songs are things that you do at home with your child helps if you let the dentists know that I can bend here she can incorporate that into the visit as well make it a easier transition for that child for that first visit a lot of people you know their kids have siblings as well so are there methods that won the sibling may have as much %HESITATION anxiety about going to the dentist or I know that when in our case Sophia had definitely more anxious about the dentist and Liam ever did he just I think you just kind of rolled with the punches anything that you could speak on with the siblings how to incorporate them sometimes it works both ways I have parents I always ask them especially for the second one do you think that your older sibling would be helpful to model you know I mean every dynamic is different right and if the older ones were fearful of the little ones go first and model for their older siblings you know what it’s like to go into that that said the dental chair it’s so variable I think the best thing to do is to communicate with your medical provider and just to figure out the best plan to see if the children should be together the separate bring on different days which one should go first I think that if they’re younger trialled likes to emulate the older one and the older one is fearful it might be better to remove the older child from the situation if if it’s the opposite is helpful to have them com I think that’s my concern is for you know parents who may be there they’re a typical child has a lot of angst and fear I know one thing we always talk to Sophia about is you know Liam looks up to you and he’s going to mimic you so how do we take their fears out of the whole equation to because you know severe ultimately grew out of mostly granted those fears but our for our fair with that likes you know Liam would see %HESITATION I should be afraid of this and then it would be a much harder behavior I know he’d go out of it but it would it would be so much work to get him to grow out of that initial for here yes I I hear what you’re thinking that makes logical sense I may tell you from my twenty plus years of experience treating kids so much of it is an eight some people are just like our fearful for absolutely no reason nothing ever happened to them you know in this you know to bend the of knowledge I I think there is just someone asked and when someone asked me this before and I mentioned that my son Jack was scared of dogs I nothing happened to him he like came out petrified of dogs and people ask you know why why and I’m like well I don’t know why are you why are you drawn to them I mean I think that there’s something in our DNA are you know we get spiritual hypothetical about this but I think you kind of come in a lot of times with with these fears are not so the good news is that although so many people have anxiety about it it’s important for me to really judge how where the parent is because a lot of times a lot of the energy comes to the parents and the parents have angst I’m I need to make sure that they feel comfortable before I even step at near the child’s mouth I think I like it’s important as a a a a provider to really make sure you connect on a personal level first before you go and invite yourself into that very private space of their mouth he then I’ll know like you know I I have to work some ways with kids that are more in just like you know Sophia %HESITATION or my son Jack or sometimes I have to it’s fine we can like honestly I kind of get that I feel the kids will jump on a chair and even they might eat the pediatrician the five with me or sometimes are fine with the church and then you know don’t want anyone in their personal space in their mouth so it’s I think a lot of it is finding the right match with the dentist you can kind of look beyond what they bite their preconceived I’ll make sure I don’t have any preconceived ideas about how any child going to react with down syndrome are not in really be kind of aware of what I have to deal with right now in the room at the small men’s and then be able to adjust accordingly and how they’re going to provide their care I think that’s really important and and hopefully there’s a lot of pediatric dentist or family dentist opinion you know where you are the country that’s not always a pediatric specialist you know available it’s important for parents to find that right fit so then their child the matter is that if they are typical or not to thrive and get the most out of their dollar experience because that’s the reason why became PM that does that I’m really molding how their kids are going to care for their bodies are these I hope that I can influence out of our multi room influencing how they’re going to perceive you know dental care and it’s such a critical importance to your overall health especially long term I think about you get older heart disease and and diabetes and so many other things are connected to do relate how healthy your mouth is so if a child can feel comfortable and maybe say to me you know I got you know doc Laski I don’t like what you do but you know I know I feel safer deal that’s okay because at least I know that they know that as when they’re adults in there in the world they can hopefully find somebody they feel comfortable with and will go for there are there are you know by annual dental cleaning so they can keep their body as you know healthy as possible this is why we love you thank you okay I hope everybody actually can say they love their their dentist because of your your top notch if I had had you as my or someone like you as my pediatric dentist I I would have not had a gap in my adult life with fearing and they’re not going to the dentist right that’s the whole thing is like avoiding I mean I know is that something you never have to see it doesn’t hurt the market go but that would hurt just like oh you know I wish I could see neo you know X. months ago it’s it’s it’s counter to do what we want could you it’s like it’s not bothering you but it’s really prevention you know out of revenge as were the kind of care and it’s true it’s so true with the mouse it definitely and that’s why that’s my biggest thing is if if I need you know the right dental home for anyone throughout the country I think as a guest and yet to find someone to love they do I think it’s a it’s imperative but thank you for your time of course thank you appreciate it we don’t get this much time to talk normally in the dentist’s chair and you’re so informative and I’ve always loved how your mind works and just get the information but with a great personality with it and we appreciate it thank you.

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