Observant toddler Elena sits on her mother’s lap as she scans the dental exam room. She looks at the camera, she looks at the dental tools, and she looks at Pamela Alston, DDS, director of dental health services at the Alameda Health System (AHS) Eastmont Wellness Center.

Alston, who has been a general dentist with AHS for 35 years, prepares to examine Elena for her first dental appointment. Alston inspects the toothpaste and toothbrush Michelle has been using on Elena to make sure they are age appropriate. She then provides her with additional oral care education before doing the examination. Once finished Alston says, “Good job Mom!” Elena didn’t have any cavities or signs of tooth decay.

Next, Alston brings in Nicholas Ching, DDS, AHS staff and pediatric dental specialist to see Elena. Alston and Ching are unique in the sense that they both are at ease treating children. Unfortunately, a lot of dentists are uncomfortable having younger patients because there isn’t a lot of behavior management training offered in dental school and if they do see a younger patient, they are typically easier to handle.

Ching talks to Michelle about how much candy Elena should have on Halloween.

Happy Halloween?

Almost 4% of candy consumed in the U.S. happens on Halloween. Dental Hygiene Awareness Month is also in October. Coincidence or message?

“I used to not participate in Halloween but I was seen as the mean house. So then I did what a lot of other dentists try to do, I turned on the light and left a basket of toothbrushes on my porch and I was still seen as the mean lady,” laughed Alston. “Finally I gave out treats with a message, you can have this if you promise your parents you’ll brush your teeth tonight after you eat all your candy.”

Eat, Drink and Be Scary

What’s Halloween without a good horror story? And who better to tell that story than a dentist?

“The scariest thing I’ve seen…there’s like a hole in the middle of the tooth and it’s filled with sticky candy,” said Alston. “And I ask the child, do your teeth hurt? ‘Yes.’ So here they are, their teeth hurt and are full of candy and they don’t understand the relationship between eating the candy and having the pain. That’s scary to me.”

Alston’s example is pretty scary, but Ching couldn’t let her get the prize for fright. “I think the scariest thing I’ve seen is a child coming to me with a large swelling,” said Ching as he holds his jaw. “That usually indicates it’s been a long-standing infection. I just feel bad for the child because they’re not happy, they’re in pain and often I have to send them to the hospital to take care of the swelling and then we can take care of the teeth cleaning.”

Both dentists say that a common misconception is that only sweets are bad for your teeth. Anything that is considered a fermentable carbohydrate (includes fruits vegetables, starches, dairy and others) can promote cavity formation, even organic food can contribute to cavities. Additionally, “grazing” on food or snacks over an extended period of time is worse than just eating it all at once. They would prefer for someone to eat that piece of cake in one sitting instead of nibbling on it for a few hours because the nibbling increases the teeth’s exposure to the fermentable carbohydrate that contributes to cavity-causing bacteria.

Their recommendation is after eating sweets on Halloween or in general, wait twenty minutes, so saliva has time to break down the starches and sugar in the mouth and then brush your teeth.

In regards to sweet treats, Alston thinks it is ok on occasion but recommends that parents don’t reward their children with food because that can lead to a long-term association of unhealthy food and good behavior.

All Smiles

If it seems like Alston and Ching have a great dentistry “chemistry” it’s because they have known each other for a long time and they both became dentists for the same reason, to help people.

“Do you know the saying give a man a fish and you feed him for a day, teach a man to fish and you feed him for life? You can apply this to oral education,” said Ching. “If you can empower the parent and the patient, hopefully both, on how to take care of their teeth, that’s better I think than any patch-up work or filling their teeth. That (education) would have the longest lasting effects.”

Alston and Ching are both Bay Area natives and alums of the University of California, San Francisco, School of Dentistry. While they weren’t there at the same time, Ching was one of Alston’s externs at the Eastmont Wellness Center. He studied his specialty in pediatric dentistry at the Harvard School of Dental Medicine. Upon completion, he returned to the Bay Area and to working with Alston again at AHS.