Top Dentists 2011: Watch Your Mouth
That’s what dental professionals are trained to do. These specialists do it especially well.
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Periodontal disease is the most prevalent issue among adults. Among children, it’s tooth decay.
The formula is a simple one: A bacterial film on a kid’s teeth—what we know as plaque—hardens into acidic tartar that, when allowed to build, causes tooth decay.
And it’s five times more common than the next leading children’s health issue—asthma—says Dr. Rachel Maher, one of the state’s few certified pediatric dentists. One difference between the two problems is that tooth decay is preventable. “That’s the kicker,” she says.
Maher’s offices are a cheerful place. They are bursting with Disney decor. Vintage Jr. Pac-Man and Donkey Kong Jr. machines stand at the ready. There are issues of Family Fun, Parenting, Family Circle magazines for waiting parents. And there is lots of sunshine on a bright day.
The cheeriness belies the sometimes intense work that happens there. Of the 35 to 50 patients she sees each day, Maher does some routine consultations and cleaning, but she also sees the worst of cases, such as kids with cavities in all 20 teeth. “I’m often the last resort,” she says.
Children who need extensive work are often too rambunctious to sit still for long procedures, so Maher will treat them in the operating room, where they can be anesthetized for the duration of a procedure.
“Sometimes it’s the most efficient and comfortable way,” she says. “When treating a child, 100 percent of their attention is demanded. We need them to sit still and follow directions. That’s hard to do for a long time.”
The average age of those OR patients? An astonishingly young 3.25 years.
As a youth, Maher “never had a bad experience at the dentist.” Hers had a father and twin sons in the profession. Coming from a medical family herself, “I thought that was pretty neat. There were three generations.”
As a student at the University of Pennsylvania, Maher couldn’t imagine practicing pediatric dentistry. “I thought, Oh dear Lord, I’ll never be able to treat children.” Later encouraged by an associate, she explored it during a residency at Wilmington Hospital in 1999, where she also explored oral surgery. “I was pretty good at surgery,” she says, “but I’d never been there when something went really wrong.” So she followed the experience with a residency at Cincinnati Children’s Hospital. “I did 429 after-hours emergencies in a year,” she says, “I slept in the hospital.” She has practiced in Delaware for the past eight years and has served as chief of pediatric dentistry at Christiana Care for the past four.
The allure of dentistry is basic, she says. “There’s a medical aspect and a people aspect.
“In pediatric dentistry, we treat the child, but we also have to treat the parent,” Maher says. “For the parents, there has to be some education. And they often have some degree of guilt. For the child, there’s a behavioral piece.”
Education is key to preventing the degree of decay that lands patients in her OR. That means visiting schools and preschools to demonstrate effective brushing to students, teaching parents about the sugar that lurks in staples of kids’ diets and urging early examinations (they should begin at a year old), and encouraging pediatricians to take a quick look into their patients’ mouths during routine visits, then making referrals when necessary.
“We see a lot of babies,” she says, “so that’s important.”
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