Welcome to our  Listing of Frequently Asked Questions!

Your child must have most of these characteristics:

• approximately 18 months-2 years of age although this age can vary

• the child should be walking and able to pull his/her pants up and down by him/herself

• the child must have some bladder control--you may find s/he is waking up from naps with a dry diaper and/or becomes aware that s/he is ready to urinate or have a bowel movement

• the child is able to communicate that s/he is going to urinate or have a bowel movement

• your child must be interested in using the toilet and show s/he is curious and ready to learn to use the toilet

If your child seems to be interested and ready to start using the toilet you might go to the library and find a couple of children's books about using the toilet. One we use at the Health Dept. is "Going to the Potty" by Fred Rogers.

Remember to keep the atmosphere positive as your child learns to use the toilet. Praise him/her for trying to use the toilet. Instead of saying "do you need to use the potty" (the child will usually say "no") say something like this: "I'd like you to try using the toilet" and set the child on the potty chair or toilet. Stay calm and stay positive.  

For more Family Health Education related FAQs, click here.

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Dental Services

Frequently Asked Questions About The Fluoride Mouth rinse Program

• Why is mouth rinsing with fluoride important?
  Today, fluoride is the most effective weapon to combat tooth decay.

• How often is it done?
  Children rinse for 1 minute, once a week during the school year.

• Can my child still have topical fluoride treatments at the dentist?
  Yes. The mouth rinsing program complements your dentist's plan to make your child's teeth less susceptible to tooth decay.

• Can my child still take supplemental fluoride tablets prescribed by our dentist?
  Yes. Your child will benefit from both programs. The fluoride mouth rinse protects the teeth already erupted into the mouth. Fluoride tablets work to give protective fluoride into the enamel of teeth still developing in the jaw bone.

• What is my child accidentally swallows the mouth rinse?
  If a child accidentally swallows the 5 ML or 10ML he or she is given during the rinsing exercise, there is NO DANGER (the child may experience mild stomach upset). The solution is harmless. Small children will practice first with water.

• Could dairy products cause a problem?
  It is best to wait 15 minutes before and 30 minutes after eating dairy products to rinse with fluoride so that the fluoride ions will unite with the calcium in the teeth, rather than uniting with the calcium in the milk, cheese, or yogurt.

• Could my well water contain fluoride?
  While that is always possible, the wells in our area do not usually contain fluoride.

• What is the cost of the program?
  The program is free.

What is "Baby Bottle Tooth Decay" / "Bottle Rot" / "Early Childhood Caries"

Baby bottle tooth decay / bottle rot / early childhood caries (ECC) is a dental condition that if left untreated, can destroy an infant's / toddler's baby (primary) teeth. ECC is caused by frequent and prolonged exposure of sugary liquids to a child's teeth. Some of these liquids are milk, juice, soda pop, or formula. Bacteria (found in plaque) in a child's mouth "eats" the sugars found in sweetened liquids, and converts the sugars to acid. This acid can destroy tooth enamel. Every time a child drinks a sweetened liquid, a 20 minute "acid bath" attacks the child's teeth. When a child is sleeping at nap or bedtime with a bottle filled with milk, juice, soda pop, or formula, the child can not properly swallow, and the liquids pool around the teeth. Tooth decay can occur in no time! This same condition can also result from prolonged demand breast feeding. Children with ECC are in pain and usually do not eat properly. If you put a child to bed with a bottle, make sure it is filled with only water. Never dip a pacifier in honey or sugar. A child should be off of the bottle by his or her first birthday. ECC is totally preventable! Parents should brush their infant's teeth as soon as the first tooth erupts into the mouth. (Parents can use a wet washcloth or gauze instead of a toothbrush on an infant also!) Ask your dentist or pediatrician about fluoride supplements. Primary teeth are very important - children need healthy teeth to eat with, to speak clearly, and to look good to themselves - the primary teeth also reserve the space for the permanent teeth, and those teeth have to last a lifetime! Our teeth also support and give our face shape.

** Severe cases of ECC require hospitalization - these children need their dental work done under general anesthesia in an operating room - an average ECC surgery is about 4 hours long! (The hospital bill alone averages a cost of $5,000 - $8,000!!) In Marquette County, our clinics have seen well over 500 children between the ages of 1 and 6 with mild, moderate, or severe ECC. In 2005, 69 hospital patients were treated.

What is Xylitol?

• Xylitol is an all natural sweetener found in many fruits, vegetables, and birch bark. It is also produced by the human body during normal metabolism.

• Xylitol tastes and looks like sugar.

• Xylitol is found in products such as gum, mints, toothpaste, rinses, and granules for cooking and baking. You can purchase Xylitol (such as Ice Breakers (cubes) gum, Spry dental products, mints, gum, candy, and Epic mints and gum) over-the-counter or online at the Marquette County Co-op, retail stores, pharmacies, and gas stations. Websites include: www.xlear.com or www.epicdental.com

How does Xylitol benefit my child's teeth?

• Xylitol decreases dental decay by neutralizing the acid formed by bacteria in the mouth that causes tooth decay.

• Studies have shown a 70% reduction in tooth decay by people who regularly use Xylitol products.

• Studies have also shown a 70% reduction in tooth decay in children's teeth whose mother's use Xylitol products. Expectant mothers and other caregivers should use Xylitol products during the first few years of a child's life! Xylitol keeps the bacteria count (in the mouth) down, decreasing the chance of bacteria transmission.

• Xylitol also promotes re-mineralization of early decay.

Is Xylitol safe?

• Xylitol has been used as a diabetic sweetener since the 1960's.

• The Food and Drug Administration approved its safety in 1963.

• The World Health Organization and the Food and Drug Administration's "Joint Expert Committee on Food Additives" confirmed the safety of Xylitol in 1983.
  Babies and small children can safely use Xylitol.

• Xylitol has no known toxic levels.

Are there any other benefits of consuming Xylitol?

• Children who regularly use Xylitol products have a 40% reduction in middle ear infections.

• Xylitol has 40% fewer calories and 75% less carbohydrates than sugar.

• Adults can benefit from regular Xylitol use also!

Where can I find more information about Xylitol?

• www.xylitolinfo.com (Danisco Corporation)

• www.cda.org/library/articles/xylitol.htm (California Dental Association)

• www.Laleva.cc\food\xylitol.html (article by Sverill Sellman)

• http://en.wikipedia.org/wiki/Xylitol

What is Fluoride Varnish?

Fluoride Varnish is a protective coating that is painted on teeth to help prevent new cavities and to help stop cavities that have already started.
The paint on Fluoride Varnish is sticky, so it attaches to the teeth easily and makes the outer layer (enamel) of the teeth harder,  helping to prevent cavities.

Why is Fluoride Varnish recommended for Children's teeth?

Tooth decay is one of the most common preventable diseases seen in children.  Children as young as 12-18 months can get cavities.  Cavities in children's teeth can cause pain and prevent children from eating, speaking, sleeping and learning.

Who will provide this Service?

A trained health professional will apply the Fluoride Varnish to your child's teeth.

How long does Fluoride Varnish last?

The Fluoride Varnish sticks to the teeth until brushed away the next day, however, the benefits of the Fluoride will last for several months.  Fluoride Varnish should be reapplied every 3-4 months for the best results.

What is the cost of the Fluoride Varnish Program?

This program is free.

How is Fluoride Varnish applied to the teeth?

The Fluoride Varnish is painted on the teeth with a small disposable brush.  It is quick, painless, easy and does not have a bad taste.

Does my Child still need to go to the Dentist?

Yes, your child should still see a dentist regularly.  This is not a substitute for daily brushing and flossing or regular dental checkups.

What should I do after the Fluoride Varnish is applied to my Child's teeth?

Do not brush your child's teeth until the next day. 
Do not eat hard or chewy foods or chew gum on the treatment day.  This might chip the Fluoride Varnish off.
The Fluoride Varnish is yellow, therefore, teeth will appear yellow for 24 hours.  This yellow color will go away when the teeth are brushed the next day.
Children taking fluoride supplements (drops or tablets) should discontinue the use of the supplements for 3 days after following the treatment.

Does my Child need Fluoride?

Children who are at risk for dental decay or do not live in communities with fluoridated water benefit from the application of Fluoride (Varnish) to their teeth to help stop or prevent decay.

Is Fluoride Varnish safe?

Yes, Fluoride Varnish can be used on babies from the time they have their first teeth.  Only a small amount of fluoride varnish is used.

At what age should Fluoride Varnish be applied?

Fluoride Varnish is recommended for children of all ages, including infants.  Fluoride Varnish is an effective replacement for weekly school fluoride mouthrinse programs.

If my Child has crowns, fillings, sealants, or braces, is it still okay to receive a Fluoride Varnish treatment?

Yes, your child can benefit from Fluoride Varnish treatments with or without previous dental work.

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Environmental Health

When is a Temporary Food License Required?

Answer: Any event which provides food to the general public (whether it be "for sale" or "free") is required to have a Temporary Food License. This includes both non-profit and for-profit organizations promoting a sales event or membership drive. A temporary food service establishment is one which provides food to the public at a fixed location for a temporary period of time (not to exceed two weeks). Each license application must be completed and submitted to the Division of Environmental Health at least two weeks prior to the event. All applications must be accompanied by the appropriate fee, as follows:

All temporary food licenses cost $50.00 plus applicable State surcharges. Any license application received less than 30 days prior to the event will be charged an additional $25.00 penalty.

Contact the Health Department for more specific exemptions or licensing requirements.

How do I get my Well Water Tested?

Answer: Specific water sample bottles are required by the State of Michigan Laboratory and are available at the Health Department in the Division of Environmental Health for citizens wishing to test their well water. The most common water tests are:

Bacteriological - to determine if there is any coliform bacteria in the water; and
Partial Chemical Analysis - to determine the level of Chloride, Fluoride, Hardness as CaCO₃, Iron, Nitrate, Nitrites, Sodium and Sulfate.

Samples being sent to the State Laboratory in Houghton must be accompanied by the appropriate lab fees payable to the "State of Michigan" which are as follows:

Bacteriological $12.00
Partial Chemical $14.00

Water samples are time dependent and must be mailed the same day they are collected (Monday, Tuesday, or Wednesday) to the Houghton Laboratory. Do not collect and mail water samples near any federal holiday when the U.S. Postal Service is not working.

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Personal Health

MDCH PROGRAMS

Maternal Infant Health Program (MIHP): "Who is eligible for this program?"

Answer: for the MIHP program: pregnant women who are eligible for Medicaid (since this is a Medicaid covered program), who have some condition or situation that puts the pregnancy (or parenting) "at risk" for complications or difficulties. Examples of these include: a pregnant teen with little support; a pregnant woman with a history of depression; a pregnant woman who smokes cigarettes or continues to use alcohol.

An infant (from birth to age one year) who is Medicaid eligible and who has a condition or situation that increases the "risk" of death or illness during the first year of life. Examples include: a teen parent with poor support; parents who smoke cigarettes and/or use other drugs; a parent with depression or mental illness.

"How are referrals made?"

Answer: anyone who is interested can self-refer although a medical provider signature is required to bill Medicaid for the services. The main referral sources are through the medical providers offices and through the WIC Program. Inquiries may be made at 475-5765.

"What happens when you get a referral to one of these program?"

Answer: the family receives home visits (and office visits if desired) by members of a team, including an RN, a Dietician and a Social Worker who get to know the families' needs and concerns. The Team members provide information and support and coordinate referrals to a variety of other programs and services in the community.

"What is the Children's Special health Care Services Program and how does someone quality for it?"

Answer: CSHCS is a State of Michigan-funded program to assist families of eligible children (through age 21 and some adults) with the cost of medical care for certain conditions. These conditions are chronic in nature and require regular medical care. Examples of these conditions include: childhood diabetes mellitus; cerebral palsy; most any birth defect (if it needs medical attention); chronic ear infections that involve some hearing loss. For those with hemophilia or cystic fibrosis, there is no age limit.

"How does someone get enrolled in CSHCS?"

Answer: The medical provider for the child sends a report about the condition to the central office in Lansing. Each local health department in Michigan has staff who can assist parents and providers with the eligibility and enrollment process. Barb Eheman and Lori Marta are the staff at the MCHD who can answer questions and assist families. Call 475-5765 for more information.

IMMUNIZATION QUESTIONS

"Is there a recommended period of time a person should wait in the clinic or pharmacy following an immunization?"

The rationale for a "waiting period" after vaccination is, presumably, that if an allergic reaction to the vaccine were to occur, the person would still be in the facility. With appropriate screening, the likelihood of a serious allergic reaction is extremely low. Accordingly, the Advisory Committee on Immunization Practices (ACIP) has never recommended a specific waiting period after vaccination. Potentially life-threatening allergic reactions occur in a matter of minutes. Even without a waiting period, it is likely that the person would still be in the facility should a life-threatening reaction occur.

"With what frequency should splenectomized patients receive Hib, pneumococcal, and meningococcal vaccines?"

Persons with functional or anatomic asplenia should receive two doses of pneumococcal polysaccharide vaccine separated by 3-5 years, depending on age. They should also receive at least one dose of meningococcal polysaccharide vaccine. The need for additional doses is uncertain. Adults--even those without spleens--are at very low risk of invasive Hib disease. ACIP recommends that a single pediatric dose of Hib conjugate vaccine "be considered" for asplenic persons.

"What is the dosing schedule for giving Td vaccine to an unvaccinated person?"  

The primary vaccination schedule for adult tetanus diphtheria toxoid (Td) is a 3-dose series; the first two doses are separated by a month, and the third dose is given 6-12 months after the second dose. Booster doses should be given every 10 years thereafter. This schedule applies to any unvaccinated person 7 years of age or older.

"IF a teenager contracts Pertussis, does this mean s/he was not properly immunized?"

Not necessarily. Vaccine-induced immunity to Pertussis is believed to persist for about 10 years following the last dose. So even if a child receives all 5 doses of Pertussis vaccine on schedule, he or she may still be susceptible as a teenager. The need for "booster" doses of Pertussis vaccine for adolescents or adults is currently being studied.

"If a health care worker develops a rash and low-grade fever after MMR vaccine, is s/he infectious?"

Approximately 5-15% of susceptible persons who receive MMR vaccine will develop a low-grade fever and/or mild rash 7-12 days after vaccination. However, the person is not infectious, and no special precautions (e.g., exclusion from work) need to be taken.

"My patient has had two documented doses of MMR. Her rubella titer as nonreactive at a prenatal visit. What should I do?"

It is possible that she failed to respond to both doses. It is also possible that she did respond but has a low level of antibody. Failure to respond to two properly timed doses of MMR vaccine would be expected to occur in one or two persons per thousand vaccinees, at most. A small number of people appear to develop a relatively small amount of antibody following vaccination with rubella and other vaccines. This level of antibody may not be detectable on relatively insensitive commercial screening tests. Controlled trials with sensitive tests indicate a response rate of >99% following two doses of rubella-containing vaccine. I would suggest you make a note of her documented vaccination and stop testing. Another approach would be to administer one additional dose of MMR. However, there are no data on the administration of additional doses of rubella-containing vaccine in this situation.

"How likely is it for a person to develop arthritis from rubella vaccine?"

Arthralgia (joint pain) and transient arthritis (joint redness or swelling) following rubella vaccination occur only in persons who were susceptible to rubella at the time of vaccination. Joint symptoms are uncommon in children and in adult males. About 25% of post-pubertal women report joint pain after receiving rubella vaccine, and about 10% report arthritis-like signs and symptoms. When joint symptoms occur, they generally begin 1-3 weeks after vaccination, persist for 1 day to 3 weeks, and rarely recur. Chronic joint symptoms attributable to rubella vaccine are very rare, if they occur at all.

"Can I give a PPD (tuberculin skin test) on the same day as a dose of MMR vaccine?"

A PPD can be applied before or on the same day that MMR vaccine is given. However, if MMR vaccine is given on the previous day or earlier, the PPD should be delayed for at least one month. Live measles vaccine given prior to the application of a PPD can reduce the reactivity of the skin test because of mild suppression of the immune system.

“Who should receive the new human papilloma virus vaccine (HPV) and how many doses are recommended?”

First of all, this is a vaccine for girls.  HPV is recommended for 11-12 year olds, however can be started as early as 9 years of age.  Catch-up vaccination is recommended for females 13-26.  It is given in a 3 dose schedule.  The second dose is given 2 months after the first and the third dose is given 6 months after the first dose.  It can be given when any other age appropriate vaccines are given.

 “Why has my child developed chicken pox even though he/she has had the Varicella immunization?”

While it was thought that one dose of varicella vaccine would be sufficient to protect against chicken pox, we are seeing break through cases indicating that the immunity level is not optimal.  The break through disease that is being seen is a mild case of chicken pox.  As a result, at this time it is recommended that your child receive a second dose of Varicella vaccine to boost the immunity and offer better protection against chicken pox. 

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Revised: February 12, 2007 .