Full Moon, Taxi Rides, Preventing Cavities – PediaCast 346
- Join Dr Mike in the PediaCast Studio for more news parents can use! This week we cover Zofran & birth defects, swaddling babies & sudden death (SIDS), the full moon’s effect on behavior, taxi and Uber safety, and pop stars & bad food. Dr Sam Weisz also stops by to talk about Sugar Bugs, dental care and cavity prevention.
- Zofran & Birth Defects
- Swaddling Babies & Sudden Death (SIDS)
- The Full Moon & Behavior
- Taxi & Uber Safety
- Pop Stars & Bad Food
- Sugar Bugs
- Dental Care
- Cavity Prevention
- Hyperemesis Education and Research Foundation
- Sugar Bugs (book – Amazon)
- Ask My Dentist TV
- Libertyville Dental
- Dr Sam: Facebook
- Dr Sam: Twitter (@askmydentist)
Announcer 1: This is PediaCast.
Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children’s, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello, everybody, and welcome once again to PediaCast. It’s a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children’s Hospital. We’re in Columbus, Ohio.
It is Episode 346 for June 22nd, 2016. We’re calling this one, “Full Moon, Taxi Rides and Preventing Cavities.” I want to welcome everyone to the program.
We have another jam-packed show for you this week, and I finally feel like we’re back in the production groove. Now, I know, last week was our first show back after the big move to our new studio, which by the way is incredible. I mean, literally, in the old space we were sandwich between a conference room and a cafeteria. And here we are now in a gorgeous state-of-the-art soundproof space. It’s scary how quite it is when nothing is going on in here.
We’re in beautiful glass tower in the heart of the Nationwide Children’s Hospital campus which happens to be the largest children’s hospital in the United States. So, it’s great to be here in the new and very much improved PediaCast studio.
And yes, we were here last week, but it does hadn’t quite settled. There were all those little tasks that go along still with moving and setting up a new space. But that checklist is finally clear and the minutiae of moving distractions is behind us. I feel like I can breathe again, if you know what I mean. I’m sure many of you do, maybe not in the sense of moving a sound studio maybe, but in terms of other life disruptions, which can be stressful regardless of the exact nature of the disruption.
But the move is behind us now. We’re settled. We’re back in the groove and lots of great topics for you this week. I hinted at some of them in the show title. Lots, really, lots of interesting news parents can use coming your way this time around.
Starting with pregnancy and morning sickness — there’s a pretty useful drug out there for nausea and vomiting — ondansetron known by the brand name, Zofran, which really helps with nausea and vomiting. It represented a great relief for many expectant mother who had severe forms of morning sickness. But then, something happened. A couple studies showed a possible association between Zofran and a couple of birth defects, namely heart abnormalities and cleft palate.
So many moms-to-be have steered clear of using it while pregnant and many OB-Gyn have stopped recommending its use. There have actually been quite a number of law suits regarding the association. But did we react too hastily? Was Zofran really to blame or was the underlying condition — vomiting, dehydration which led to poor nutrition — rather that the drug itself used to treat the condition, was that the real cause behind the birth defect?
So it’s the important question to answer because plenty of the expected moms are still suffer from the extreme morning sickness. They’d like some help which maybe Zofran could provide, but they also want reassurance that it’s safe. So researchers at UCLA have completed a very large study and looking a relationship that Zofran and birth defects. They have something to say about it, so we’ll explore that topic in detail.
And yes, I realize this is a pediatric podcast. But I think pregnancy and birth defects, they fit in. We can welcome expectant moms into the PediaCast fold. Can we all agree on that? I think so.
Then we’ll talk about swaddling babies with a blanket while they’re sleeping to keep them warm and cozy as they sleep. Is that a safe practice or could they increase the risk of SIDS? Well, the answer, as it turns out, depends on a number of other variables which are also important to consider at the same time. So we’ll run through the rules of safe sleep for babies again. We’ve done that before but it’s very important. And, we’ll let you know if swaddling is something you can or should fit into the equation.
And then, the full moon, does not really affect behavior? The nurses in many emergency departments across the country would say, “Absolutely, yes. No question.” And so would physicians in those same emergency departments and lots of law enforcement personnel agree with that? But does the full moon really affect behavior? Some researchers, actually, an international group of researchers across several continents set out to see if there were really was an association between full moon and sleep and also behavior. So we’ll explore what they found. You might be surprised.
After that, taxi rides and Uber and Lyft and other ride-sharing services, and also limousines, shuttles, town cars — do they provide and do parents request child safety seats when using these services? If not, why not? Are taxis exempt from the risk of accidents? No, they’re not. In fact, tens of thousands of taxi and other transportation services accidents occur every year in the United States. So, that makes this an important question to ask and topic to consider — how can we keep our kids safe when using taxi cabs and other transportation options?
And then, finally, in our news parents can use segment, a pop star recording artists in the music industry who endorse food and beverage products, can we trust them to promote healthy products? Probably, not right? But just how bad are their choices? Do any of them support healthy eating?
And if your children are being bombarded with bad choices from their favorite singers, how can parents effectively counter that pressure and encourage our children to eat well? We’ll consider the scope of the problem and explore ways of dealing with it at home.
Then, in our interview segment this week, we have a visitor from the Chicagoland region. Dr. Sam Weisz, he’s a family dentist with a host of educational opportunities for families to learn how to take care of children’s teeth and prevent cavities. So we’ll review proper dental care and consider such things as the first dental visit — can’t get my tongue working right — the first dental visit, when and then how often. When do you start brushing? When do you use toothbrush instead of just a wash cloth? What about toothpaste? What about toothpaste with fluoride? What about fluoride in the water, is it safe? How does that work to protect against cavities?
So, you know, just really an all-around treatment of dental care for kids. What are cavities and how do you prevent them? It turns out he also has a fabulous picture book for children which encourages proper dental hygiene. So we’ll talk about that as well at the end of today’s show.
Don’t forget we have plenty more opportunity for you to ask questions in the coming weeks. In fact, I have some great interviews coming soon that are based on some of your questions. For instance, on teenage cutting behavior and iron-deficiency anemia in young children, those will be coming your way soon. Maybe you have a question that you would like answered that would spark an entire interview segment. If you have the question, it’s likely that many parents out there also have the question. So, please ask.
It’s easy to get in touch with me. Just head over to PediaCast.org, click on Contact link and ask away. You can also dial the voiceline, 347-404-KIDS, 347-404-K-I-D-S.
Before we move on, I want to just take a moment to talk very briefly about the situation that happened in Orlando a couple of weeks ago or almost two weeks ago now, with the mass shooting. And if you have young kids in the car you may want to turn the volume down or skip a little ahead to get pass it if you’re not ready to talk about it with your kid. Which, you know it’s an important thing, if they have questions, to have age-appropriate answers for them.
I wanted to share with this audience a couple of thoughts from the American Academy of Pediatrics on this and just also observe silence in honor of the victims of the terrible tragedy.
So, Dr. Benard Dreyer is President of the American Academy of Pediatrics. And, he said “The United States bears witness to another senseless act of horrific gun violence. News reports of injuries and deaths from the mass shooting in Orlando, Florida are staggering. Mass shootings plague this country. The innocent are killed and lives altered irrevocably. Gun violence destroys people, families and communities. These tragedy was perpetrated on members of the lesbian, gay, bi-sexual and transgender community as they socialized in June, the month designated to combat stigma and to celebrate pride among LGBT people. As pediatricians, we grieve with them and their families. We offer ourselves as resources to help youth begin to heal and to advocate for policies that will end this violence.”
Dr. Karen Remley, Executive Director and CEO of the American Academy of Pediatrics says, “All families suffered as these cherished people died and were hurt in Orlando. As the LGBT community is wounded by gun violence, it is a reminder of us to love all children and young adults. We offer condolences to those killed, injured and grieving. But we also resolve to work harder to make all the children in the world feel valued. We can pick up the pieces and mend by overcoming the bitter intolerance that gives root to these terrible acts.”
So, let’s just take a moment and think about and remember those who were victims of this senseless tragedy.
All right, as we move on, I do want to remind you that the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals, so if you do have a concern about your child’s health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination.
Let’s take a quick break. I will be back with a lots of news parents can use and an interview with a dental expert. That’s coming up right after this.
Dr. Mike Patrick: Women suffering from extreme morning sickness often take the drug ondansetron, which is also known by the brand name Zofran, to combat debilitating nausea and vomiting. This work well for many women but recent concern arose because two studies have found the drug might increase the risk of birth defect and cleft palate in children exposed while in the womb.
Women concerned by these studies have new hope. Researchers in UCLA have found no evidence to link the anti-nausea drug to an increased risk of birth defects. In fact, women with extreme morning sickness who took Zofran reported fewer miscarriages and pregnancy terminations and higher live birth rates than women with extreme morning sickness who did not take the drug. This, according to an article recently published in the journal Reproductive Toxicology.
More than 190 lawsuits were filed in 2015 against the drug’s manufacturer alleging birth defects were caused by Zofran exposure.
Dr. Marlena Fejzo, lead author of the study and an associate researcher in the David Geffen School Medicine at UCLA, says the current study could help women make informed choices about whether to expose their fetuses to the medication. Dr. Fejzo, who suffered from extreme morning sickness herself during two pregnancies says, “This is the first study describing fetal outcome for more than 1,000 exposures to Zofran in the United States. I believe this data is critical to guide future decision making regarding prescribing what is one of the most effective and most commonly prescribed off-label treatment for nausea and vomiting.” She adds the over-all results do not support an increased risk of birth defects.
Extreme morning sickness, also known as hyperemesis gravidarum, is the condition that Duchess Kate Middleton experienced during both of her pregnancies. Its cause is unknown and the symptoms are intense. In fact, Dr. Fejzo says the continuous nausea and vomiting can be so violent that women can suffer from detached retinas, blown eardrums, cracked ribs and even a torn esophagus. The symptoms can last for several months, sometimes the entire pregnancy. Many women require IV fluids and feeding tubes and might be hospitalized multiple times due to the condition.
In this retrospective study, data on outcomes were collected on 1,070 pregnancies exposed to Zofran and compared to outcomes in two control groups. The first control group consisted of 771 pregnancies in women with a history of extreme morning sickness but no Zofran exposure and the second control group was made up of 1,555 pregnancies with no history of morning sickness and no history of Zofran exposure.
So what did they find? Well, heart defects were reported in five infants of mothers who had extreme morning sickness and Zofran-exposure compared to eight babies born with heart defects to mothers with no history of morning sickness and no Zofran exposures. So, again the kids with no Zofran exposures, no morning sickness, eight kids were born with heart defects, And in the kids where the mom had extreme morning sickness and she did takes Zofran, only five infants were born to those mothers with heart defects.
Cleft palate occurred in one Zofran-exposed infant compared with two cases of cleft palate in the no morning sickness and no Zofran control group.
Dr. Fejzo says, “What was really significant to me was that women with extreme morning sickness who took Zofran reported fewer miscarriages and terminations and experienced higher live birth rates. Taking this medication helped them get through their pregnancies and gave them their desired outcome, which was a live birth.”
This retrospective cohort study is part of a larger, ongoing investigation evaluating the genetics and epidemiology of hyperemesis gravidarum or extreme morning sickness. Eligible patients were primarily recruited through advertising on the Hyperemesis Education and Research Foundation Web site at HelpHer.org between 2007 and 2014.
Investigators say, “This study suggests that having a history of hyperemesis gravidarum may be associated with an increased risk of birth defects but exposure to Zofran does not appear to further increase the risk.”
Dr. Fejzo concludes by saying, “Women have to weigh the evidence of the efficacy of one of the most effective drugs for nausea and vomiting against the risk for birth defects. Women and their babies need nutrition during pregnancy, and if they have less nausea and vomiting that goal may be accomplished.”
So, pregnant women out there who have extreme morning sickness or maybe you know someone suffering from this, we’re certainly not saying go out and take some Zofran. After all, we don’t practice pediatric medicine by podcast, let alone offer obstetrical advise for specific patients. And, remember using Zofran for nausea and vomiting during pregnancy is considered off-label use.
What we are saying is this, talk to your doctor, the one taking care of your pregnancy as you walk down that risk-benefit pathway together and here’s an additional study you want to consider as you make that important decision.
The story mentioned the Hyperemesis Education and Research Foundation Web site, HelpHer.org. They have much more information on extreme morning sickness or hyperemesis gravidarum and they also have more information regarding this UCLA study. And I’ll include a link to that website, HelpHer.org, in the Show Notes for this episode, 346, over at PediaCast.org.
The risk of Sudden Infant Death Syndrome or SIDS appears to increase when infants are swaddled or sleeping on their stomachs and their sides. This, according to research at the University of Bristol and published in the journal, Pediatrics. Researchers looked at four studies which spanned two decades and covered three diverse geographical areas, including regions of England, Tasmania in Australia, and Chicago, Illinois.
Dr. Anna Pease, lead author of the report, says, “The focus of our review was not on studies about swaddling — which is a traditional practice of wrapping infants to promote calming and sleep — but on studies that looked at Sudden Infant Death Syndrome or SIDS. We tried to gather evidence of whether there was an association between swaddling and cases of sudden infant death.”
She goes on to say, “We only found four studies and they were quite different, none of them provided a precise definition for swaddling which made it difficult to pool results. We did find, however, that the risk of SIDS when placing infants on the side or belly for sleep increased when infants were swaddled.”
Despite the studies’ limitations, analysis indicates that current advice to avoid placing infants on their bellies or their side to sleep may especially apply to infants who are swaddled. In fact, the risk of sudden infant death associated with the side sleeping position almost doubled for swaddled infants.
The risk of SIDS was also higher for swaddled infants found sleeping on their bellies, including older infants who were placed on their backs but who had moved to the belly position while sleeping.
Dr. Pease says, “We found some evidence in this review that as babies get older, they may be more likely to move into unsafe positions while swaddled during sleep, suggesting an age is needed after which swaddling for sleep should be discouraged.” She adds that most babies start rolling over at around four to six months of age, and says, “On a practical level, what parents should take away from this is that if they choose to swaddle their babies for sleep, always place them on their back, and think about when to stop swaddling for sleep as infants get older and are more able to move.”
So, this is another study showing an increased risk of sudden infant death syndrome when babies sleep on their sides and bellies. And that increase risk is magnified when babies in this position are swaddled. So, definitely something to keep in mind. We’re not saying it’s safe as long as you don’t swaddle them to put them on their sides or their bellies. It’s still not safe at all. Always put them on their back. But if they are swaddled, it is even more dangerous for them to be on their side or their belly.
Now, we have cover the rules for safe baby sleep many times on this program. In fact, we’ve devoted entire episodes to safe baby sleep in the past. And I do want you to remember the basic rules that we’ve established — that babies should sleep alone, on their back, in a crib.
So those are the ABC’s of safe baby sleep. A for Alone , B on their Back and C in the Crib. Now, alone means no pillows or blankets or stuffed animals. And no swaddling, especially if your baby is able to roll because they might roll on to their bellies or their sides and get stuck there due to the swaddling.
Now once they’re rolling well, you don’t need to flip them over to their back again every time you find them on their side or belly. But that’s assuming that they are able to roll back to their back when they need or want to. So if swaddling prevents them from rolling back to their back, then that’s a problem.
So, appropriate warm sleeping clothes, yes. Although you do want to make sure that there is no flowing garments that they could get wrap into or strap or something of that nature. So appropriate warm sleeping clothes , that’s fine, but swaddling blanket not such a great idea especially as your baby begins to roll. And of course, always remember those ABC’s–Alone, on their Back, in the Crib. Pretty easy, right?
Always surrounded by an aura of mystery, the moon and its possible influence over human behavior has been the object of fascination and mythical speculation for centuries. And while nobody believes the full moon can really turn people into werewolves, many do accuse it of causing a bad night sleep and causing both physical and behavioral manifestations. After all, how many times have you heard or heard someone say, “There must be a full moon tonight.”
But is there any science behind these myths? An international group of researchers wanted to know. So they asked the question, “Can lunar phases really affect humans?” and they decided to study children to see if the full moon results in change sleeping patterns or any differences in daily activity or behaviors. Their findings, recently published in the journal Frontiers in Pediatrics will surprise some and disappoint others.
Dr. Jean-Philippe Chaput, from the Eastern Ontario Research Institute, says, “We considered that performing this research on children would be particularly more relevant because they are more amenable to behavioral changes compared to adults and their sleep needs are greater than adults,”
Investigators studied 5,812 children living on five continents. They came from a wide range of economic, social and cultural environments, and many variables were considered including age, sex, highest parental education, day of measurement, body mass index, sleep duration, level of physical activity and total sedentary time.
Data collection took place over 28 months and included the same number of lunar cycles for all participants. The cycles themselves were subdivided into three lunar phases: full moon, half-moon and new moon.
So what did they find? Well, nocturnal sleep duration — so how long the kids slept at night — during full moon and when compared to the new moon decreased by an average of… Are you ready for this? Five minutes. Yep, that’s it. Five fewer minutes of sleep during full moon, which is just a 1% variant. And many of you will be disappointed by the next finding — no other activities or behaviors were substantially modified.
Dr. Chaput says, “Our study provides compelling evidence that the moon does not appear to influence people’s behavior. The only significant finding was 1% less sleep during the full moon, and this is largely explained by our large sample size which maximizes statistical power.” He says the clinical implication of sleeping five fewer minutes each night during full moon does not, as he puts it, represent a considerable threat to health.
He adds, “Overall, I think we should not be worried about the full moon. Our behaviors are largely influenced by many other factors like genetics, education, income and psychosocial aspects rather than by gravitational forces.”
And while the study results are conclusive, you can bet controversy will surely remain and could result in further studies to determine if our biology is in some way synchronized with the lunar cycle, or if the full moon has a larger influence in adults, since we’re studying kids here, or those suffering mental disorders or specific physical ailments.
Dr. Chaput says folklore and even certain instances of occupational lore, such as emergency department workers and law enforcement personnel, suggest that mental health issues and behaviors of humans and animals are affected by lunar phases. Whether there is science behind this myth or not, he concedes that the moon mystery will continue to fascinate civilizations in the decades and centuries to come.
Dr. Mike Patrick: The vast majority of small children riding in taxis are not restrained in car safety seats. This, according to research presented at the annual meeting of the Pediatric Academic Societies which took place in Baltimore in early May, 2016. Researchers say there are tens of thousands of motor vehicle collisions involving taxis, limousines and other car services each year.
Automobile accidents are a leading cause of death among children in the United States, and all 50 US states require young children to be in car safety seats when travelling in a motor vehicle. However, in many places taxis are exempt from these safety regulations.
Stationed at 11 busy New York metropolitan area locations including airports, train stations, shopping malls and tourist locations, researchers looked for taxis loading or unloading passengers that included small children. These included infants, toddlers and children whose height did not exceed the height of the side view mirror.
Investigators observed the total of 69 taxis picking up or dropping off passengers that included 116 children. So what did they find? Well, 89% of small children were not properly restrained. 89% and of the 11% who were almost all of them were babies in infant carriers.
Researchers also called 97 taxi companies in the New York area, 39% reported car safety seat availability. Only 39%, and of these, 18% of the companies said the seats were limited in quantity or require a reservation, and 8% stated that there would be an extra fee to use one.
Reasons given for not providing child safety seats included health code restrictions and allergy and hygiene concerns.
Sarah Koffsky, a student at West Islip High School in Long Island served as principal investigator of the study through a summer internship with the Division of Developmental and Behavioral Pediatrics at the Cohen Children’s Medical Center.
And as an aside, wow, what a great opportunity for a high school student to serve as a principal investigator in a study with this kind of information and, hopefully, impact. That is really cool.
Sarah says, “Given that there were more than 40,000 motor vehicle collisions involving taxis, limousines, and car services in 2015 alone, exemptions to car seat laws put unrestrained children at risk. Although, it may be easier when travelling with young children to forego the inconvenience of a car safety seat, convenience should not factor into decisions regarding child safety.” That’s right, Sarah. Go get them.
The study authors again stressed that motor vehicle accidents are a leading cause of death among children in the United States, with statistics showing that 70% increased in the risk of death or serious injury for seven- to eight-year-olds who are not properly restrained. The American Academy of Pediatrics recommends that infants and toddlers be secured in rear-facing child safety seats and that children continue to be secured by car safety seats or belt-positioning booster seats until they reach the height of 4’9.”
Dr. Ruth Milanaik, who served as senior investigator of the project says, “Changes in law or policy to mandate use of car safety seats in taxis are necessary to ensure that all children travelling in motor vehicles are protected.” She adds, “Given that car safety seats have been shown to significantly decrease the risk of death or injury from motor vehicle collisions, there should be no exemptions in car seat safety laws for taxi services. When it comes to child safety, even one preventable injury calls for a change in policy.”
Study coordinator Tammy Pham says increased competition among types of transportation may present opportunities to increase passenger safety. She adds, “As the face of transportation changes, we hope that responsible companies will step up to provide safe travel options for families with small children.”
So, the investigators looked toward government and the transportation services themselves to affect the change. And those are good ways to go. I mean, you certainly would like there to be rules and place that these services must provide car safety seats. But until that happens, I think we should look to parents, too. Let’s not compromise our kids safety for the sake of convenience.
And I think Sarah would agree with me in saying that parents ought to stand up for the safety of their children. You often have a choice when it comes to transportation. Now sure it takes some planning ahead of time. But the safety of our children is really worth the extra time and effort it takes to ensure that they’re properly restrained and protected.
And it’s not just taxis, right? How about Uber, and Lyft and Sidecar and Curb and Halo and whatever other ride sharing services that will be launched in the years to come? Also shuttle services and town cars. Choose with safety in mind. Vote with your pocketbook. If they want your money to provide the service, they should be a safe service for your kids.
Now, laws and policies will certainly influence transportation services to make safe change. No doubt about that. But we parents play an important role, too. In fact, we’re the ones our kids are relying upon to keep them safe. So, let’s do our best to take that job seriously and do it right even in the taxi cab.
Recording artists are frequently the face of commercial products and children and adolescents are frequently their target audience. Unfortunately, the vast majority of these food and beverage products marketed by some of the most popular music stars are unhealthy. And this type of advertising is contributing to the alarming rise in childhood and teenage obesity. This, according to researchers at the New York University School of Medicine and recently published in the journal Pediatrics.
Researchers found that soda and other sugary drinks, along with fast foods and sweets are among the most common food and beverage products endorsed by famous music personalities. And what’s equally alarming, none of the music stars identified in the study endorse fruits, vegetable or whole grains. In fact, only one endorse a natural food investigators deemed healthy, and that was pistachios.
Dr. Marie Bragg, lead author and assistant professor in the Department of Population Health at NYU says, “We believe this to be the first study to use a rigorous nutritional analysis to evaluate healthfulness of food and drinks marketed by music stars. Investigators reviewed dozens of advertisements that were disseminated over a 14-year period.”
Dr. Bragg says, “Because of our nation’s childhood and teenage obesity public health crises, it is important to raise awareness about how companies are using celebrities popular with these audiences to market their unhealthy products. Researchers had already shown that food advertising leads to overeating, and the food industry spends $1.8 billion per year marketing to youth alone.”
To identify popular music stars, researchers used Billboard Magazine’s “Hot 100” song charts from 2013 and 2014. The researchers also verified recording artist popularity and marketing appeal with teenagers by reviewing Teen Choice Award winners and quantifying the number of YouTube video views associated with the celebrities’ food and non-alcoholic beverage brand endorsements.
Investigators then catalogued every endorsement between 2000 and 2014 using AdScope, an advertisement database that contains all forms of ads, including television, magazine, and radio. They also searched for official commercials or endorsements on YouTube and other media sources. Endorsements also included a celebrity’s participation in a concert sponsored by a specific product.
After sorting the endorsements into different marketing categories, the authors found that 65 of 163 identified pop stars were associated with 57 different food and beverage brands. Food and non-alcoholic beverages were the second-largest endorsement category, comprising 18% of all endorsements and ranking after consumer goods at 26% and ahead of retail products at 11%.
To assess nutritional value of the endorsed food products, the investigators analyzed nutritional information on food labels using the Nutrient Profile Model, which has been used in other food marketing research studies and provides a score that represents nutrient content. Twenty-one out of 26 food products, or 81% percent, were deemed “nutrient poor”.
Investigators determined a beverage’s healthfulness by looking at calories from added sugar. Of 69 beverages endorsed, 49 or 71% were sugar-sweetened. Full-calorie soft drinks were the most commonly endorsed in the category. In contrast, water-related endorsements appeared only three times.
Food and beverage companies spent $2 billion a year on youth-targeted ads, with American children seeing approximately 4,700 ads each year and teenagers viewing 5,900 ads per year. These numbers according to Institute of Medicine and their research. There were about 313 million views of the YouTube video versions of food and beverage endorsements associated with celebrities in this study’s sample, although unique views could not be counted.
Previous research has established that celebrity food endorsements promote higher product preference, and exposure to any kind of food advertising is linked to “excessive consumption”.
Dr. Bragg says, “These celebrity endorsement deals are often worth millions of dollars each, suggesting companies find them critical for promoting their products.”
Food and beverage marketing has been identified in a variety of epidemiological and psychological studies as a significant environmental contributor to our childhood obesity problem. And to give you an idea of the scope of this problem, in 2012, the US Centers for Disease Control and Prevention and the US Public Health Service reported that over one-third of all children and teenagers were overweight or obese.
Although, many food and beverage companies have taken a voluntary pledge not to target children under 12 years old with certain marketing, teenagers are not included in this pledge.
Dr. Bragg says, “Given the heavy targeting of teens and the amount of money they spend on foods and beverages, food marketing reduction pledges should expand to include teenagers. She adds, “This also would be consistent with the American Academy of Pediatrics recommendations, which encourages pediatricians to support local and national efforts to reduce food marketing while also counseling patients to limit screen time.”
The authors suggest that celebrities should use their influence to promote more healthful marketing and encourage the consumption of healthy foods.
Alysa N. Miller, study co-author and research coordinator in the NYU Department of Population Health, says, “The popularity of music celebrities among adolescents makes them uniquely poised to serve as positive role models. Celebrities should be aware that their endorsements could exacerbate our society’s struggle with obesity and they should endorse healthy products instead.”
So I don’t think that this research comes as a surprise to any of you, right? Although, it is helpful I think to be reminded that celebrities have their own best interest in mind, and not the best interest of our children and teenagers, particularly when it comes to thinking about their health. They promote what they promote because they’re paid big money to do it, and they’re paid big money to do it because their endorsements sells products, which then contributes to obesity.
So, as a parent, how do you combat that? Kids are going to see these ads to some degree regardless of our best efforts to keep them away. We can limit screen time. We can call on voluntary bans from the food and beverage companies in terms of advertising to our children and teenagers. But our kids are still going to see these ads to a degree.
We’ve been calling on lawmakers for years to put meaningful advertising bans into place to protect our children. But that hasn’t happened and will not likely occur in the years to come. So kids are going to see this stuff. There’s really just no easy way around that, which again begs the question, what is a parent to do?
It’s a good question. And I’m not sure that there’s an absolute right and wrong answer. For starters, I think you control what comes into your house with regard to food and beverage for as long as you can, and especially when kids are young and unable to shop for themselves and when eating habits are really starting to form. I think you model good nutrition with the eating choices that you make as a parent.
And I think this is really important — you spend time eating together at family meals and you talk about these things, you tell the truth. You tell the kids, and more than a few times, that celebrities are paid lots and lots of money to push unhealthy products because most celebrities care more about making the money than they care about what they’re pushing or your health. That’s the American way. It stinks to some degree, but it is what it is and kids should recognize that fact really from an early age.
Let them know it’s fine to like the celebrity. It’s fine to listen to their music but you got to realize that ultimately the celebrities push the products because the food and beverage companies want your money. And if they can afford to pay the celebrity that much money, how much are they making on these products? Lots.
I think kids get this, because they engage with market capitalism themselves. I mean, kids want stuff too and they do stuff to get stuff. It’s capitalism. It’s how our country works, and kids get this because it’s all around them. They engage the system when they do chores to get money, to buy stuff.
Of course, when we consider the big picture, there are lots and lots of benefits to our system, but there are drawbacks too. And discussing and communicating the benefits and drawbacks of how our economic system works with our children in a developmentally appropriate way, that can actually be fun. And it takes some of the wind out of the endorsement sales when you and your family simply talk about it, when your kids start to recognize it.
Make it a game. How many times can you find examples where something is being endorsed? Point it out. Shake your heads to the absurdity, “I wonder how much are they making to push that. That’s terrible for you.”
Your kids again can still follow the music, follow the star, but with a little more understanding of what’s happening under the surface. There’s no way that you can tell your kids this. There’s no way that thin singer is drinking all those sugar-sweetened beverages. It doesn’t add up.
And, as parents, when you get into your 30s, and then when you get into your 40s, you really really figure it out. That stuff really does put on weight and there’s no way that singer’s drinking. You can fill in the singer’s name and the beverage name. I won’t do it here, but you know and your kids know, or at least they should.
So family communication, really, I think is the key here and there are studies actually to suggest that that’s very true.
So, now, how do we get celebrities to start promoting healthy items? That I think is a more difficult answer. The healthy item have to start making a profit. They have to sell. The food companies have to make money off of the healthy items so that they can afford to have those items endorsed. And how do you start selling more healthy products? Families have to start buying them to get that economic wheel rolling.
Now, granted, I’m not an economist and I’m sure my treatment of the story bears witness to that fact. But I am an American and a parent and consumer. And we all have a sense of how this works and the kinds of food that we really should be buying and eating. We have to start doing it and modeling it and talking about it in our homes and with our families. That’s my two cents anyway. It’s not easy but it does begin with family conversation.
Dr. Mike Patrick: Dr. Samuel Weisz is a family dentist in Libertyville, Illinois which is part of the Chicagoland area. He’s passionate about educating young patients and families as they consider the importance of dental health and best practices for cavity prevention. And he does this not only in his office, one patient and family at a time in the exam room, but in the digital space as well, which of course is something we’re also passionate about here in PediaCast.
Dr. Sam maintains a blog and question-answer site at AskMyDentistTV. com. And he has an active Facebook page and Twitter handle which is @AskMyDentist, all one word. And to help educate the youngest of patients, he has co-authored a popular children’s book called Sugar Bugs. He’s here today to talk about Sugar Bugs, not just the book but the actual ones in the mouth that cause cavities as we consider ways to prevent dental decay in kids.
So let’s give a warm PediaCast welcome to Dr. Sam Weisz. Thanks for joining us today.
Dr. Sam Weisz: Thanks for having me, Dr. Mike.
Dr. Mike Patrick: Yeah, really appreciate it. And it’s great to have a dentist active on social media. Because I think it’s important for healthcare providers of all varieties really to get out there in the digital space with evidence-based content that helps families understand and sort of dispels fears and myths and junk science. So kudos to you.
Dr. Sam Weisz: Thank you, yeah. That’s always a passion of mine.
Dr. Mike Patrick: And I think you have the trifecta there. So, you have your blog where you can give longer information in more details. Then, you’re on Facebook and Twitter as well.
Dr. Sam Weisz: Yeah, I know. It’s been amazing to connect with people all over the country and in the world in Twitter and Facebook and be able to answer questions because access to care is sometimes hard, and I just want everyone accessible to a dentist.
Dr. Mike Patrick: If you’re just kind of out there on your own and it’s sort of hard to know which things to trust and what not to trust. I think when you have the healthcare provider like yourself that’s out there, folks want information from the professional. So, that’s fantastic.
And I don’t think we have discussed this before. Some of our listeners have heard little glimpses of it, but we’re actually ready to put it out there for real. We developed here at Nationwide Children’s a social media curriculum for healthcare professionals. It’s free. It’s basically a 12-podcast series. It’s about eight-and-a-half hours of content. So sort of like a day-long seminar, roundtable discussion type podcast where we cover the history of social media and health care, how you identify a target audience and craft a focus message, best practices for engaging on Facebook and Twitter, how to write effective blog post, podcast production, digital CME creation, even cover healthcare communication research.
So pretty comprehensive, and I think an important tool. There are a lot of places that charge hundreds of dollars for a course like this and we’re doing it free. Yeah, folks can find it at PediaCastCME.org/hcsm which stands for Healthcare Communications in Social Media. And it’s in iTunes, too. So just free podcast, 12 of them, to talk about what you and I are doing right now and just how to do it in the most effective way possible.
Dr. Sam Weisz: I think that’s going to be really helpful for people.
Dr. Mike Patrick: Yeah. So let’s talk about dental care. When do you think that kids should see a dentist for the first time?
Dr. Sam Weisz: So we want to see kids before their first birthday. Ideally, as the first tooth is erupting, usually that’s about six months, give or take for every individual.
It’s really super important to see them that early, even though it’s a quick examination because really what we’re doing is teaching the parents what we do to take care of their kids’ teeth. And if we can get them before those teeth come out, then we’re going to set them up for success and I hope we’re going to talk a lot about the setting up for success this whole interview.
Dr. Mike Patrick: Yeah, absolutely. So, really, as soon as the teeth are first erupting, that’s when you want to see them. And the other nice thing about that is then if they encounter a problem, they have someone to call, like someone they’ve already established a relationship with.
Dr. Sam Weisz: Exactly. I think really, probably, the most important thing about seeing them that early is setting up a dental home for the child, because they need to get comfortable in the space. And if they’re meeting someone at the first visit, when they’re three or three and a half, it’s a lot more uncomfortable than when they’ve already come in, they’ve already sat on the chair, they’ve already felt the instruments we’re using and know the voices.
Dr. Mike Patrick: Yeah. How often should kids come if there’s not a problem?
Dr. Sam Weisz: So we want to see everyone every six months, especially with kids because they’re developing so quickly, we can spot things early. We can see where the eruptions had grown and things of that nature.
Dr. Mike Patrick: So great advice there. What do you think the family should see? Should you seek out a pediatric specific dentist for kids or are family dentists well trained to take care of kids as well?
Dr. Sam Weisz: Yeah, well, as a family dentist myself, I’m probably a little bit biased. But I think it’s important to find a dentist that’s comfortable treating children. And, certainly, not all family dentist are… Where you live ends up being a major factor in how you choose a dentist. There’s a lot of patients in small towns and there’s just isn’t specialized care with pediatric dentists. So, that becomes much harder.
And, even in the urban settings where I see a lot of parents and children together at the same location, and that’s a huge draw for parents, just the convenience factor. There is a certainly high need for specialization in pediatric dentistry. It’s so valuable. They treat these complex cases and complex behaviors that require advanced training.
So, if we get going along and you’re following the tips and tricks that hopefully we’re going to be talking about then, I think you’ll be comfortable seeing a family dentist, a pediatric dentist, because your kid’s going to be set up for success. But if there is complications and problems and things like that, that’s why I think it’s important to find
Dr. Mike Patrick: Yeah, great. So let’s talk about how parents should start caring for an infant’s teeth. So once they first start to erupt, what sort of care should parents provide?
Dr. Sam Weisz: So, I mean, setting them up for success even goes beyond that first tooth. We want to really have them washing there and cleaning their gums with a wet wash or tooth tissue, something like that. There’s a product. There’s this little silicon Baby First toothbrushes and things that I love because they get the child brushing and moving around as soon as they can grip and chew. And it feels like they’re brushing their teeth so you’re kind of setting them up for that success of having things in their mouth, making it easier for when you’re starting to brush their teeth that they’re not fighting as much with you.
But usually, the lower front teeth come in about six months or so, and that’s when we start worrying about really getting a toothbrush out there.
Dr. Mike Patrick: Sure. And so, we really use a toothbrush right from the beginning.
Dr. Sam Weisz: Oh, yeah. And there’s little infant toothbrushes you’ll find in all the leisure spots that you shop. Actually the guideline now is to get a fluoride toothpaste at that six months visit. Now, the mistake people make is that they see the commercials with toothpaste and it looks this monster big swirl. And for infant, and even really for kids, you really just want a small smear like buttered toast on there. So, less is more for sure, especially so they can spit it out.
Dr. Mike Patrick: So, right from the get-go, you’re using a toothbrush, you’re using a toothpaste in fluoride with it but the key is you’re just using a tiny film of the toothpaste, not a big a large amount.
Dr. Sam Weisz: Yeah, I think that’s the best word to use, a film. It’s like literally you shouldn’t even really be able to barely see it out of there.
Dr. Mike Patrick: OK, now you talked about a fluoridated toothpaste. How is fluoride beneficial for dental health?
Dr. Sam Weisz: So, the way fluoride works is that it’s uptake in the body and it goes into the crystalline structure in the teeth. So it actually hardens the teeth in the right amount. So, the fluoride was actually discovered and showed up naturally in water, in the well water or wherever the water communities were. And they found that the communities that have the right amount of fluoride were getting a lot less tooth decay. So, they thought it for the rest of society.
Dr. Mike Patrick: Now, too much fluoride can also be a problem, right?
Dr. Sam Weisz: I mean, there’s that magic sweet spot. So if you get too much fluoride, you’re going to end up with something called fluorosis which is kind of like can be brown spot in the teeth, white spot in the teeth and in very severe cases of teething, it will actually end up weakening the teeth instead of helping them.
Dr. Mike Patrick: So there is a kind of sweet spot there, too, then where the right amount of fluoride. You don’t want too little but you don’t want too much, but as long as you’re hitting that sweet spot, then you would say that the benefit of fluoride outweighs the risk.
Dr. Sam Weisz: Oh, yeah. I mean, I have a two-and-a-half year old daughter and we’re a big advocate of using fluoride and drinking water with fluoride in it.
Dr. Mike Patrick: Yeah, absolutely. Now, I know, and we talked a little bit before we started recording that the city’s adding fluoride can be pretty hot political issues. So there’s some folks who have very strong feelings about that. Do you think cities should fluoridate the water? Not? Does it really matter as long as kids are getting fluoride in some way or another?
Dr. Sam Weisz: Talking about that, that’s more of a political topic. If you feel like your local municipalities should be telling you exactly what you have and consumed in your water, then you’re probably not going to be keen on getting anything in the water. But, if there’s one thing that I would put in the water for me personally, I think fluoride then is probably the most studied additive there is. I think some studies say it even reduce tooth decay by about 50% in the population. And that’s huge, especially we’re talking about rural settings wherein even the more uneducated population that are snacking on tons of sugar and eating all these carbohydrates that are frozen cavities, it’s helping to protect and prevent.
Dr. Mike Patrick: Now, let’s say a family’s water supply does not contain fluoride. So maybe they live in a city that doesn’t add fluoride to the water or they have well water that does not have fluoride in it. And I should mention, with well water , there are places that naturally have high fluoride so you might want to have your health department test your well water to see what the fluoride level is.
But let’s say they don’t have much fluoride in their well water, is just using a fluoridated toothpaste enough or do you think that kid should get like fluoride supplement?
Dr. Sam Weisz: Yeah, I think for those areas. And you’re right, sometimes the water supply in well water might higher than the normal, and they might be overconsuming fluoride. So you definitely want to make sure where you’re at and where you’re getting. For those that are getting the right amount as children, you wanted to actually uptake into the body and then it forms into the teeth, and that’s how you’re getting that strength. So it’s more than just having it on your toothpaste. You can take something, either get a bottle of water that has fluoride in it, or there’s fluoride supplements that you can take.
Dr. Mike Patrick: And parents would…
Dr. Sam Weisz: But again, you want to be careful and work with the dentist or your and pediatrician that knows the right amount because you don’t want to end up overconsuming.
Dr. Mike Patrick: Absolutely. And there are also fluoride varnishes that can be painted on the teeth. Is that helpful?
Dr. Sam Weisz: Yeah, I mean, that’s kind of the biggest fad right now as far as preventative dentistry is that they changed the fluoride. When I was a kid, we either swish around this foul-tasting fluoride stuff or you put in the tray and that’s the one thing I used to dread going to have it. And now, you paint the varnish on, and it actually sits on the teeth for a lot longer amount of time, and it had the benefit of, you can eat right away with it. So kids love that, because they’re not going home and waiting an hour or so to eat.
Dr. Mike Patrick: Yeah. Absolutely. So, lots of ways to get fluoride in. You want the right amount and parents should really talk to their dentist and/or their pediatrician in terms of figuring out what that right amount is and how to get it.
So let’s talk about cavities then. What exactly causes dental decay and cavities, also dental carries, all sort of same names for the same thing or different names for the same thing? What causes those?
Dr. Sam Weisz: Sure, so to get a little bit technical there, the bacteria called strep mutans, which is what I write in my Sugar Bugs, the mutans family. They’re the main cause of cavities. The sugar and the carbohydrates that we eat, and they go through a fermentation process by this bacteria on the teeth and that creates an acid. The acids from these bugs sit on the teeth. They are weakening the teeth, and specifically, they are weakening the calcium and the phosphate. So, the mutans had learned to survive in this acidic environment where other bacteria in our mouth can’t.
And I think that’s a really important thing because we’re made up of tons and tons and trillions of bacteria and it’s the one specifically that are causing this acid attack that are going to be the problem. So, my big goal is to not eliminate all bacteria because we can’t just do that. It’s to feed us the right food until it cling with the right products to get this acid-causing bacteria out of the mouth and stopping to eat these sugars so that we can knock off cavities.
Dr. Mike Patrick: And what’s the best way to do that? How can we prevent cavities from occurring?
Dr. Sam Weisz: So, it’s kind of the three-pronged approach I would say, which is the right food, eat healthy food, greens and things that are high in something called arginine. That is a really healthy way to keep the strep mutans away. And taking care of your teeth by brushing and flossing, and keeping those… Plaque is basically that thick film that these mutans live in and along with a lot of other bacteria, that we want to keep the plaque levels low.
So, brush twice a day, flossing once a day, removing heavy sugars and sweets and carbohydrates there on the mouth with drinking lots of water. Water kind of flushes the whole system down. And then, checkups with your dentist to make sure that things are going well, catching things super early because the earlier we can catch things, the easier the visits are and the less likely that it’s going to spread and wreak havoc in the mouth.
Dr. Mike Patrick: How long should each toothbrushing last?
Dr. Sam Weisz: Oh, I would say, you can sing happy birthday twice, and I think that’s two minutes. But the answer is two minutes. We need to brush two times a day for two minutes.
Dr. Mike Patrick: OK, so brush twice a day with a fluoridated toothpaste twice a day, two minutes at a minimum.
Dr. Sam Weisz: Exactly.
Dr. Mike Patrick: Well, and maybe you can kind of overbrush though, too, can’t you? You can overdo it?
Dr. Sam Weisz: Yes. That’s a good point, actually. And we talk about these acids. Our diet now is crazy high, and soda pops and things like that that are high in acid, and so, it’s actually important to know that, one, flush things out with water, and two, you don’t want to brush right after one of these acid attacks. You want to wait 30 minutes because they’re kind of weakening the enamel there, and then as you brush, you can be eroding your brushing away, weakening the enamel that you don’t want to do.
So you don’t definitely want to overbrush. And people that floss, or don’t floss, I should say, tend to the want to brush a little bit harder into the gums I find because they think that’s at least getting them clean in the gum which is not, and that causes a lot of recession and things like that, too. So, it’s technique and frequency.
Dr. Mike Patrick: And flossing is also very important. What about time of day? So it’s like first thing in the morning and before you go to bed, is that the best time to get a couple of brushings in? Or, do you have other suggestions?
Dr. Sam Weisz: I think ideally, you want to do it after your breakfast, because essentially which is great. We want to get all the bacteria out of our mouth and get things cleaned when we wake up. But then, we go and eat breakfast and now, with the cereals and things that are out there now, we have all the sugar back on our teeth. Then, we sit all day until the night with all these things on our teeth.
So if we can at least do it after meals, that’s going to be a better solution if we can get into the habit of that. Makes it a little tougher do.
Dr. Mike Patrick: So, brush twice a day, get the proper amount of fluoride, really watch what you’re eating in terms of more fruits and vegetables, less sugars. And of course, early detection and frequent dental visits every six months.
What about sealants? So once the baby teeth come out and you have the adult teeth, do you recommend sealants?
Dr. Sam Weisz: Yeah, the sugar bugs that we’re talking about, they hide a lot of times in the grooves of the teeth. So if you look at your teeth, the top part has this big groove, they’re built for us to chew in and gnash through our food, but that’s where they hide. And that’s kind of one of the weak points. So what we do is we put a seal over top of that, and they can’t hide into those grooves of those teeth and that’s significantly reduced the amount of cavities that kids are getting.
Dr. Mike Patrick: And then, one other important point we should make is no juice bottles or milk bottles in bed overnight. That’s a big big no, no, right?
Dr. Sam Weisz: Oh, yeah, I would say that’s probably number thing we start out with when we are seeing parents and kid, that the six month visit is to give them a guidelines. After you’ve cleaned their teeth or after you cleaned their gums, the only thing that they’re going to have is water. Those juices are really what’s causing the rampant cavities and decay that you’re seeing in kids.
Dr. Mike Patrick: Yeah, really important. And then, what are some symptoms of cavities that would kind of clue parents in that this is a problem and we need to get our kid… Even if they’re not ready for their six month visit yet, it’s time to get in to the dentist because of what’s going on.
Dr. Sam Weisz: If you’re noticing little brown spots, or just little small little specks of brown on the teeth, that’s usually the start of the cavity and should definitely be looked at. And usually, at six months, we’re not seeing those quite yet. Their teeth are just erupting but it’s soon thereafter if they are going to bed with a bottle of milk or juice or things like that. It happens very quickly.
Dr. Mike Patrick: Then, once they have those if it continues to progress, then you’re going to start to have some pain associated with the cavity?
Dr. Sam Weisz: Yes, so you’re going to start to see a bigger hole, and then, a larger hole manages into the nerve and that’s where there becomes that extreme pain that is so famous for coming in foreign abscesses and larger infections that can wreak havoc in those young kids’ body.
Dr. Mike Patrick: Yeah. But you’d rather catch it before it gets to that point.
Dr. Sam Weisz: Oh, yes, way before. And that’s why we want see them before, at six months to a year, because we’re going to catch things before they could even possibly be starting to that level.
Dr. Mike Patrick: And then, you can get bad breath and kind of a foul taste in the mouth too with decay, correct?
Dr. Sam Weisz: Oh, yeah, that’s a great point. And there’s a lot of bacteria that sit on the tongue too that do cost a lot of that and a lot of that do this thing hydrated as well. So I guess I can’t stress enough how much you should be drinking water over a lot of these other juices and sodas. I think soda might be the worst thing for your teeth.
Dr. Mike Patrick: Now, you have a picture book that’s out called Sugar Bugs. Tell us a little bit about that book.
Dr. Sam Weisz: So that was kind of my passion, is prevention, the stuff that we’re talking about today. They’re really for the dental community and for parents. There wasn’t a good book that spoke to the dentist in a way that is going to create a fun and exciting for them. There is always that undertone of scared and scary, and hurt and that kind of stuff.
And so I wanted to develop something where we could teach our little ones and our parents to use words like, “It’s going to be fun. It’s going to exciting.” And not, “Don’t worry. It’s not going to be scary,” because the minute that even though we’re telling them something good, which is “It’s not going to be scary,” that’s when the kid starts to clamp up and think, “Oh, my gosh! Where am I going? What am I doing?”
And so, this book kind of walks a young boy named Robby through the process. He just loves sugar so much. He eats donuts for breakfast, lollipops for lunch, ice cream for dinner. Probably my worst patient.
Dr. Mike Patrick: Yeah, right.
Dr. Sam Weisz: And then, over time, the mutans family find Robby and they moved in and they were the best of friends, until some things start to go rotten. The mutans turned up in his house and be bad guests, and they finally realized he was painfully chewing some of the food that he needs to come to see the dentist and he gets to learn about all the cool instruments that clean and fix his teeth. He learns to avoid the family like the mutans who are moving in by following those three rules we talked about, which is eating healthy foods and taking care of our teeth by brushing and flossing and getting good visits and checkups.
And then, at the end, he’s confronted with a choice in his fridge that very next day and we have to see what Robby does and if he starts back on the path of destruction or if he chooses the right path.
Dr. Mike Patrick: Yeah. It’s a great book, especially little kids who want you to read to them over and over again. It’s got great pictures. The illustrations are really just wonderful. The illustrator, was that a relation?
Dr. Sam Weisz: Yeah, that’s my wife. She’s an author and illustrator. And so, it helps when this idea was hatched in my head, and this is a story that I told the kids as I’m cleaning up their sugar bugs. So she was able to bring it to life.
Dr. Mike Patrick: Oh, and that’s fantastic, And your wife’s Erica Weisz, correct? So folks could look.
Dr. Sam Weisz: Yeah.
Dr. Mike Patrick: W-E-I-S-Z. And we’ll put a link in the Show Notes for this episode, 346, over at PediaCast.org. At least to the book on Amazon so that folks can find it pretty easily.
Dr. Sam Weisz: That’d be great. Thank you.
Dr. Mike Patrick: Yup. And we’ll also put links to your other sites, too — AskMyDentistTV.com — and then the practice that you work with, Libertyville Dental, and your Facebook page and your Twitter pages. We’ll put links to all those things so that folks can connect with you.
Dr. Sam Weisz: Sure. And I’m happy to answer questions, of course. That’s kind of what I do. So, please connect on Twitter or Facebook. Those are generally spots that you can find me.
Dr. Mike Patrick: Great. Well, Dr. Samuel Weisz. Really appreciate you stopping by and talking with us here on PediaCast.
Dr. Sam Weisz: Thanks for having me.
Dr. Mike Patrick: All right, we are back with just enough time to say thank you to all of you for taking time out of your day to make PediaCast a part of it. Really do appreciate that.
Also, thanks to our guest, Dr. Sam Weisz, from Ask My Dentist TV and author of Sugar Bugs.
That’s all the time we have today. PediaCast is a production of Nationwide Children’s.
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Announcer 2: This program is a production of Nationwide Children’s. Thanks for listening. We’ll see you next time on PediaCast.