17.3: Physical Health

Learning Objectives

1. Identify common vision and hearing concerns during middle childhood.
2. Describe the process of dental development and summarize best practices for promoting oral health in school-age children.
3. Differentiate between Type 1 and Type 2 diabetes in children.
4. Explain the physiological mechanisms of asthma and recognize strategies for managing asthma in childhood.

Vision and Hearing

The most common vision problem in middle childhood is nearsightedness, also known as myopia. Twenty-five percent of children will be diagnosed by the end of middle childhood. Being nearsighted can be corrected by wearing glasses with corrective lenses.

Figure \(\PageIndex{1}\): Eye exams are recommended annually for school-age children. Image is in the public domain.

Children may experience multiple ear infections in early childhood, but this is less common within the 6- to 12-year age range. Numerous ear infections during middle childhood may lead to headaches and migraines, which may result in hearing loss.³²

Dental Health

Children in middle childhood will start or continue to lose teeth. They experience the loss of deciduous, or “baby,” teeth and the arrival of permanent teeth, which typically begins at age six or seven. It is essential for children to visit a dentist twice a year to ensure their teeth remain healthy and to provide continuous monitoring as they lose teeth and new ones emerge. Many children have some form of malocclusion (when the upper teeth aren’t correctly positioned slightly over the lower teeth, including underbites and overbites) or malposition of their teeth, which can affect their ability to chew, floss, and brush properly. Dentists may recommend that it’s time to see an orthodontist to maintain proper dental health. Dental health is exceedingly important as children grow more independent, making their own food choices, and as they start to take over flossing and brushing. Parents can ease this transition by promoting healthy eating and proper dental hygiene.³⁴

The foods and nutrients that children consume are also important for dental health. Offer healthy foods and snacks to children, and when they do eat sugary or sticky foods, encourage them to brush their teeth afterward.

Figure \(\PageIndex{2}\): A boy brushing his teeth. Image by Latrobebohs is licensed under CC BY-SA 3.0.

Children should floss daily and brush their teeth at least twice daily: in the morning, at bedtime, and preferably after meals. Younger children need help brushing their teeth properly. Try brushing their teeth first and letting them finish. You might try using a timer or a favorite song to help your child learn to brush for 2 minutes. Parents or caregivers are encouraged to supervise brushing until your child is 7 or 8 years old to avoid tooth decay.

The best defense against tooth decay is a combination of flossing, brushing, and adding fluoride, a mineral commonly found in most tap water. If your water doesn’t have fluoride, ask a dentist about fluoride drops, gel, or varnish. Also, ask your child’s dentist about sealants—a simple, pain-free way to prevent tooth decay. These thin plastic coatings are painted on the chewing surfaces of permanent back teeth. They quickly harden to form a protective shield against germs and food. If a small cavity is accidentally covered by a sealant, the decay won’t spread because germs trapped inside are sealed off from their food supply.

Diabetes in Childhood

Until recently, diabetes in children and adolescents was thought of almost exclusively as type 1, but that thinking has evolved. Type 1 diabetes is the most common form of diabetes in children and is the result of a lack of production of insulin due to an overactive immune system. Type 2 diabetes is the most common form of diabetes in the U.S. It used to be referred to as adult-onset diabetes, as it was not common during childhood. But with increasing rates of overweight and obesity in children and adolescents, more diagnoses are happening before adulthood. It is also important to note that Type 2 disproportionately affects minority youth. ³⁵

Figure \(\PageIndex{3}\): The finger-prick test. Image by the U.S. Army is in the public domain.

Asthma

Childhood asthma that is unmanaged may make it difficult for children to develop to their fullest potential. Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

To understand asthma, it is helpful to know how the airways function. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation causes the airways to become swollen and very sensitive. The airways tend to react strongly to certain inhaled substances. When the airways react, the surrounding muscles tighten. This narrows the airways, resulting in less air flowing into the lungs. The swelling can also worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed.

Figure \(\PageIndex{4}\): Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. Image by the National Heart, Lung, and Blood Institute is in the public domain.

Sometimes, asthma symptoms are mild and resolve on their own or with minimal treatment using asthma medication. At other times, symptoms continue to worsen. When symptoms get more intense and/or more symptoms occur, you're having an asthma attack. Asthma attacks are also called flare-ups or exacerbations (eg-zas-er-BA-shuns).

Figure \(\PageIndex{5}\): The different things that can trigger asthma. Original image by 7mike5000 is licensed under CC BY-SA 3.0. Image modified by adding content from a video by the CDC, which is in the public domain.

Treating symptoms as soon as you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal. Asthma has no cure. Even when you feel fine, you still have the disease, and it can flare up at any time.

However, with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma. If you have asthma, you can take an active role in managing the disease. For successful, thorough, and ongoing treatment, build strong partnerships with your doctor and other health care providers.³⁹

References, Contributors and Attributions

32. Rathus, Spencer A. (2011). Childhood & adolescence voyages in development. Belmont, CA: Wadsworth Cengage Learning.

34. Chew on This - Healthy Teeth for Baby and Beyond by the National Institutes of Health is in the public domain (modified by Dawn Rymond)

Childhood by University of Hawai’i at Mānoa Food Science and Human Nutrition Program is licensed under CC BY-NC-SA 4.0 (modified by Dawn Rymond)

35. Diabetes by the National Institute of Diabetes and Digestive and Kidney Diseases is in the public domain

Preventing Type 2 Diabetes - Steps Toward a Healthier Life by the National Institutes of Health is in the public domain

39. Asthma by the National Heart, Lung, and Blood Institute is in the public domain