It’s New to Us by Jean Stratton

OPEN, PLEASE: “I love kids. With kids’ dentistry, the principle is to prevent, so you don’t have to fix it later. For example, baby teeth have to be monitored. Damage to primary teeth can cause damage to developing permanent teeth. It’s important for 3- year-olds to come in for a check-up.” Richard Holstein D.M.D., FADH has practiced pediatric dentistry in Princeton for more than 30 years.

Dr. Richard Holstein of Princeton Pedodontics Is a Long-time Specialist in Pediatric Dentistry

The brutal fact is that many, if not most, people don’t like to go to the dentist. Some even need a tranquilizer before they set foot into a dentist’s office! It’s clearly not up there with a day at the beach, a good movie, a shopping spree, or ice cream. Quite the opposite.

Kids can be especially resistant to the idea of a dentist appointment. All this changes, however, if the dentist is Richard Holstein, D.M.D., FADH, whose Princeton Pedodontics office is located in Princeton Professional Park at 601 Ewing Street.

First, it is the office itself. It is very cool. A cheerful space, it is filled with an astonishing array of colorful fun things — from video games and TVS for watching cartoons and movies in the treatment rooms to a real Wurlitzer juke box (playing a variety of popular music) to authentic Indian headdresses to a “Treasure Chest” where everyone receives a special “reward” (definitely not lollypops!) after the check-up.

Dr. Holstein has definitely established a comfort zone, which is immediately apparent. “I’m just a big kid,” he says, with a smile. “I put things in the office that I like, and that the kids like too. They trust me, and I make it fun. We talk all the time, and before they know it, the procedure is over. We talk about everything. I know if there is a divorce in the family or if the kid’s not doing well in school. They even call me later when they’re in college. I’m doing more than dentistry.”

Pediatric Dentistry

Primarily, of course, Dr. Holstein is a serious and very professional dentist. A graduate of Tufts Dental School, he received post-doctoral certification in pediatric dentistry at the Children’s Hospital of Philadelphia (CHOP). He has served as Coordinator of Dental Education (director of the Post-Doctoral Residency Program) there, and is Senior Staff at CHOP and The University Medical Center at Princeton.

Dr. Holstein is an Assistant Clinical Professor of Pediatric Dentistry at the University of Pennsylvania, and has been Chairman of Pediatric Peer Review for the NJ Dental Association/NJ Academy of Pedriatric Dentistry for more than 28 years. He is a member of the American Academy of Pediatrics, American Academy of Pediatric Dentistry, American Dental Association, International Academy of Paediatric Dentistry, International Academy of Dentistry for the Handicapped, and The Philadelphia Pediatric Society. He is a Fellow of the Academy of Dentistry for Persons with Disabilities.

Dr. Holstein is concerned about every aspect of a child’s life as it is relevant to his or her dental health, including diet, exercise, and sports. The advent of childhood obesity and diabetes is reaching nearly epidemic levels, and much of it is being attributed to a diet heavy in sugar, which, not only is detrimental to one’s overall health, but is bad for teeth at any age.

“It is very important to educate the parents, the child, and the teachers about a healthy diet, and the danger of too much sugar,” says Dr. Holstein. “They need to interest the kids in more creative foods. Tooth decay is a disease mediated by two factors: bacteria and sugar. Everyone has bacteria in their mouths. Certain strains of these bacteria love to metabolize (eat) sugar, especially sucrose. They produce acid from the sugar; the acid dissolves the tooth structure, and cause cavities(tooth decay). It’s really that simple.

Bad To Eat

“Very shortly after you eat something with sugar, the decay process begins. This applies to parents as well as children. The extent of damage depends upon the type of sugar, the amount of time it remains upon the teeth, and the quantity of the decay-producing bacteria.”

Dr. Holstein is definite about what should be avoided in a healthy diet, and some of these items are prevalent in many children’s daily dietary intake. “Things that are bad to eat (we won’t call them ‘food’) are sweet and sticky. They become wedged between the teeth and in all of the grooves, feeding the bacteria that live there, until they are removed or decompose. Sweet cereals can often be found in children’s mouths days after they eat them, even when they brush. (Dentists sometimes use Jolly Ranchers to remove crowns from teeth — think about it).

“Sweet cereals, granola bars, Pop Tarts, and fruit roll-ups are at the very top of the list for causing tooth decay,” continues Dr. Holstein. “They offer little, if any, nutritional value, and are harmful to your children. They should be banned from schools — along with sodas and other sweet snacks. So many wonderful alternatives exist that are healthy. Your children will eat, and probably love them, if you raise them that way. This is where parenting comes in. Try to be sure your child eats no cereal with more than 13 percent sugar.”

Proper diet, along with fluoride in water and toothpaste, can help to reduce tooth decay, and of course, the other major factor is oral hygiene. Brushing at least three times a day, after every meal, and after snacks, if possible, goes a long way in reducing cavities. Flossing is very important, and parents can help the youngest children with this, and then monitor them as they get older.

First Visit

Brushing should be started as soon as the baby teeth come in, usually at six months. Even before that, Dr. Holstein says it is important to wipe the child’s mouth immediately after each feeding, A first visit to the pediatric dentist at age three is important, followed by a regular six-month check-up thereafter, he adds. At age four, a first X-ray to determine proper growth and development is appropriate. “It is very safe, and then at age six, when the six-year molars come in, we take another X-ray, looking for signs of tooth decay.

“I monitor the growth and development, and make sure the teeth are coming in properly,” he explains. “Children, by their very nature, are constantly changing. Their dentist must be an expert in growth and development, specific childhood pathology and dental restorative techniques, and child management in order to do his/her job properly. Experience is very important, and parents should choose the most experienced dentist for their kids.”

As children continue to grow, they can experience a variety of dental problems, including sports injuries, a broken or lost tooth. Dr. Holstein says it is very important to see the pediatric dentist as soon as possible after any of these incidents.

“If a kid loses a permanent tooth we can put in a temporary tooth. A permanent implant cannot be put in until growth has stopped, usually at 18.”

Dr. Holstein typically sees patients ages three to 18, including those with special needs, such as cerebral palsy, autism, and other conditions. He is specialized in dentistry for persons with disabilities.

In addition, however, he sees some adult patients whom he had treated as children. “Some are now in their ‘40s, and we also have a lot of second generation patients. Children of their moms and dads who were my patients years ago.”

This continuity sets his practice apart, and he clearly enjoys his patients. “In my practice, I am able to have a very special relationship with the kids. It is an honor and privilege for me.”

Princeton Pedodontics is open Monday through Thursday. Call for hours. (609) 921-1047.

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