Hand, foot and mouth disease on the rise

Q: Our local paper published an alert that hand, foot and mouth disease is on the rise, and I don’t even know what that is. My kids are off to school and preschool in a few weeks. Is there anything I should do to make sure they don’t get it? — Laura K., Nashville, Tenn.

A: Hand, foot and mouth disease is a mild virus that mostly infects children from infancy to about 5 years of age. Sometimes, kids as old as 10 contract it, and adults have been known to get it too! We’re aware of the recent report from the Children’s Hospital at Vanderbilt in Nashville that there’s been a steep rise in the number of cases of this enterovirus, most commonly caused by a coxsackievirus. Although it is rarely a serious infection, you want to spare your children, if at all possible.

In child day care centers and schools, it spreads through person-to-person contact. The first sign often is a spotty rash on the hands and feet, and sores may appear in the mouth. Tough cases can result in blistering on the upper arms and legs, and ulcers in the mouth. The blisters contain the virus. Until they dry, they’re highly contagious. As with any virus, it can leave kids feeling wiped out.

The virus and symptoms will resolve on their own, but if you have young ones, now would be a good time to teach or reinforce personal hygiene, especially frequent hand-washing. Also, make sure the folks in charge of the preschool and the teachers are aware of the heightened need for good hygiene, so everybody stays healthy and happy.

If your child does catch it, keep him or her away from other kids for a few days — up to a week, if symptoms last that long. As for treatment, ask your doc about using child-safe pain and fever relievers and mouth sprays.

Q: I looked at the ingredients in my toothpaste, and it contains triclosan. I know it’s a hormone disruptor, and I want to go with an herbal toothpaste, but do they work? And does my family need fluoride in the toothpaste to protect our teeth? — Jessica B., Tucson, Arizona

A: Yes to your first question, and no to your second. The most important thing you and your family need to do is brush regularly: once in the morning, once before bedtime (when you floss, too) and, if you can do it, after every meal. Do that and see a dental pro every six months; that’ll maintain healthy teeth and gums.

As for herbal toothpastes, a recent randomized control study of people who had slight to moderate chronic periodontitis found that herbal toothpaste worked just as well as the control toothpastes that contained both triclosan and fluoride, and improved their periodontal conditions.

And as for fluoride, you can have too much or too little. The right balance of fluoride in water (and if you choose to have it in your toothpaste) is important for good tooth health. But you do get it in your water supply. The Centers for Disease Control and Prevention recommends water fluoridation, and the addition of fluoride to the water supply is something public water utilities have been doing since 1945. Recommended levels are between 0.7-1.2 milligrams per liter. The CDC also recommends that parents monitor the use of fluoride toothpaste in children up to age 8, if you have a fluoride concentration in your water supply above 2 mg/L. You can check out the CDC database for water fluoridation levels in your water. For children 8 and younger, when permanent teeth are forming, too much fluoride can result in fluorosis, which can cause yellowing and pitting of the tooth enamel. That’s why it’s important to teach proper brushing, which means spitting out (not swallowing) toothpaste after every brushing.

So, you can go for the herbals, and to slow inflammation and aging, brush, floss and see a dental pro regularly.