As visitors poured in from around the world, Cook Children’s Health Care System provided top-notch medical care not just for residents, but for traveling fans with children who may have needed unexpected care. Cook Children’s treated more than 200 visiting families in its Urgent Care centers over the course of the event.

Between the heat and the fandom, the summer games would bring the health system launched the "World Cup Wednesday" public health series. For nine weeks leading up to the tournament, this series provided families with essential resources on injury prevention, heat and water safety tips, and more.

While soccer matches in North Texas have come to an end, the impact of keeping global and local visitors safe will live long after the fans have gone home.

Collin County Health Care Services has issued a health alert due to an increase in chickenpox (varicella) across the county. Chickenpox is an infection caused by varicella-zoster virus, leading to a fever and an itchy rash with spots all over the body.

Because it is highly contagious, chickenpox is a reportable condition in Texas and must be disclosed to the local health department. According to health officials, schools and childcare settings are high-risk environments for outbreaks. Prompt identification and exclusion of cases are critical to limiting transmission.

While chickenpox used to be a common illness in the United States, it has become much rarer due to the chickenpox vaccine which helps prevent the infection.

Cook Children’s Health Care System doctors know parents and caregivers may have questions about this, Laura Romano, D.O., a hospitalist at Cook Children’s and mom herself, addresses some concerns.

• I got chickenpox as a kid. Should I be concerned if my little one gets it?
  • One infection with chicken pox should give you lifelong immunity.
• How effective is the varicella vaccine?
  • Two doses give up to 98% protection and have decreased hospitalizations and death by over 97% since 1995!
• What if my little one only had one dose. What does that mean for them?
  • If your child has already had one dose of the chicken pox vaccine, they will most likely not need another one if they get an actual infection. Please talk with your pediatrician about this.
• What happens if someone is immunocompromised and is around someone who has varicella?
  • The most common complication is a skin infection caused by scratching at the lesions, which may require antibiotics to help treat. Other more serious complications include pneumonia, ataxia (difficulty walking), dehydration, or encephalitis (swelling of the brain). People who also have chicken pox are at risk for shingles later in life. Vaccination against chicken pox helps prevent against all these complications including the furture risk of shingles.
• What complications can arise from chickenpox?
  • The most common chickenpox complications are bacterial infections of the skin and soft tissues in children and pneumonia in adults.
• How do you treat chickenpox?
  • While there is not a single treatment for chicken pox, doctors focus on symptom relief. Doctors recommend Tylenol for fever, calamine lotion or oatmeal baths for itchiness. Lesions should go away in the 10-14 days. 

Symptoms of Chickenpox:

A mild fever may occur 1 to 2 days before rash onset, particularly in adults. In children, the rash is often the first sign of disease.

Seek immediate medical attention when your child:

• has trouble breathing
• has a severe headache
• is very drowsy or has trouble waking up
• has trouble looking at bright lights
• has trouble walking
• seems confused
• seems very ill
• has a stiff neck
• has a fever that lasts for more than 4 days
• has a bad cough
• has an area of rash that leaks pus (thick, yellowish fluid) or becomes red, warm, swollen, or sore
• is vomiting

Going to the dentist and taking your kids to the dentist may bring up a lot of emotions and most likely some anxiety for many of us. One of my own traumatic memories as a child was at a dentist appointment. I was scheduled to have several teeth pulled for orthodontic purposes, and in short, I refused to let the dentist touch me. My mom called my dad from the dentist office to convince me to do it, and then they both decided after complete refusal that it would be better if I went to a pediatric dentist where there may be more options for me as a kid. This was in the 1990s, and thankfully things have changed for the better over the last thirty years. However, the fears that we experienced ourselves as a child can very much affect how we approach the dentist with our own children. I often tell people that my dental experiences may be the very reason I became a child life specialist.

While there may be fears and hesitancy, oral health among children is incredibly important. The CDC reports, “On average, 34 million school hours are lost each year because of unplanned (emergency) dental care, and over $45 billion in US productivity is lost each year due to untreated dental disease.” They also report that “By age 8, over half of children (52%) have had a cavity in their primary (baby) teeth.” In our area, Cook Children’s Community Health Needs Assessment found:

• 1 in 4 children in our 8-county service area does NOT have excellent or very good dental health.
• 1 in 7 children (ages 1-17) in our 8-county service area did not receive all needed dental care.

This month is National Children’s Dental Health Month, and we want to help you know how to prepare and support your children as they visit the dentist. We know that this area can be challenging for kids and parents to navigate, and we want to give you tools so that you and your child can feel more comfortable in the dentist chair. Lack of dental care can lead to even more traumatic medical and dental experiences for children. Our hope is that these tools can empower you and your child to not fear their next dental visit. In speaking with Betsy Hillyard, CCLS, oral health program coordinator at Cook Children’s Center for Community Health, she shared some top things to remember in preparing for the dentist. As a certified child life specialist (CCLS), Betsy not only helps and prepares children, she also educates parents, community partners, and dental professionals on working with children through dental experiences.

1. Know what to expect! If it is your child’s first-ever dental visit, make sure that you know what your children will be doing once they are there. The American Academy of Pediatric Dentistry recommends for children to see a dentist by their first birthday or once their first tooth has emerged. Often between the ages of 6 months to 3 years, children visit the dentist only for a lap visit for the dentist to count teeth, address any early concerns that may come up and educate families on proper oral health. Parents are often invited to be a part of these visits. As it becomes time for your child to begin getting their teeth cleaned, it is important for them to know whether you will be with them or not, what processes their dentist has (x-rays, cleaning, fluoride, etc.), and what they can do while they are in the dentist chair (watch a movie, listen to music, etc.). Betsy encourages to even ask your dentist if you could go and take a tour of the office before the visit. The more information you know about your child’s visit will help you be able to prepare your child more effectively for the most positive experience.

2. Prepare your child. It is so important for your children and you to know what to expect before going to the dentist so that you can use that information to help prepare your child for their specific appointment. There are lots of tools available to help you prepare them and provide you with child appropriate language. You can read books about the dentist, play dentist with some stuffed animals or dolls, practice opening big and wide, and watch some videos to help them have an idea of what to expect. Betsy created a video to help kids know what to expect when headed to the dentist. Seeing the tools that will be used and the process is very helpful to your child. Betsy recommends having your child draw a picture of what they expect about their visit before they go and then having them draw another picture about their experience after their appointment.

1.  A note about children with sensory needs: If your child struggles with certain noises or other sensations, it is important to work with your dental office to discuss possible comfort items and adaptations that are available to help your child. Having a conversation or appointment before to discuss this can be very helpful. Often weighted or warm blankets, earphones and sunglasses can be provided to help your child. Also, if your child has a certain comfort item, plan to bring that along like you would for a doctor’s appointment.

3. Keep it positive. It can be difficult for some adults to be positive about their own dental appointments and experiences. However, children pick up on our fears and worries and will often adopt your feelings before ever having their own experience. So, when preparing your child for the dentist, be careful and intentional with your words. When discussing the dentist and dental hygienist with your children, be careful not to use the dentist as a threat or a bad thing that they will experience. Make sure that you remind your children that dental appointments are necessary and helpful to our health and dentists help keep our mouths and teeth healthy. If you have your own fears of the dentist, make sure that you do not project those fears on your children. While validating their nerves and addressing their fears is encouraged, it is important not to make going to the dentist seem like a negative place or punishment. Use encouraging language with your children when discussing their appointments and be sure to praise your children when they do a good job at their appointments. 

When you know what to expect, take the time to prepare your children for their visit, and keep it positive, the dentist can be a great experience for your kids. Preventative dental care and oral health is so important to our children’s overall health and development. The more that we can do to prevent unplanned and emergent dental care, the more we support our children’s healthcare experiences and emotional safety. Thankfully my kids are having a much more developmentally appropriate and positive experience at their dental appointments than I did as a kid. We want to continue to support our children in making good choices for their health including their oral health.