As a pediatric dentist, one of the most common questions that parents ask me is “at what age should I bring my child to see the dentist?” The Canadian Dental Association and the American Academy of Pediatric Dentistry both recommend that a child’s first dental visit should be by age 1 or soon (approximately 6 months) after their first baby tooth erupts, whichever comes first. Because dental problems often start early, the sooner the child visits the dentist, the better. To protect against problems, such as Early Childhood Cavities, teething irritations, gum disease, and prolonged thumb- or pacifier-sucking habits, the dentist can provide or recommend preventive care.
If reading this information comes as a big surprise to you, you are not alone. Most parents who have come to see me for their child’s first dental exam are surprised to learn the same information.
The main concern I have discovered that parents have with bringing their infant or toddler to the see the dentist is the fear that they would not sit still in the chair. What they were not aware of is that as pediatric dentists we have absolutely no expectations for how a child is supposed to behave during their first dental visit. We actually do not expect for an infant or toddler to behave! Our specialty is focused on treating children of all ages in all spectrums of behavior with the goal of developing a happy, non-fearful dental patient in the end. Below you will see a technique known as the “knee to knee” exam which is commonly used for infants during their first visit.
This set-up allows for the child to be held safely by the parent as well as for the pediatric dentist to complete a thorough exam. Before starting, I always kindly remind the parent that the child will probably not like what is going to happen, likely cry and try to fight back but that the exam does not hurt the child and will be over fairly quickly.
After the examination, much of the first dental visit is spent talking with parents in order to teach them how best to care for their child’s teeth and how to prevent Early Childhood Cavities. Early Childhood Cavities, sometimes called Baby Bottle Tooth Decay, is a serious disease that can rapidly destroy your child’s teeth (as pictured).
So what are some of the causes Early Childhood Cavities?
- First and foremost is letting your child fall asleep with a bottle. When your baby is asleep, the liquids that contain sugar surround the teeth and can cause a rapid breakdown of tooth enamel. Even breast milk and formula can contain sugar.
- Prolonged nursing with mother or allowing your baby to fall asleep while nursing will also increase the risk.
- Allowing your infant to walk around with a bottle and drink sweet liquids continuously.
The first bit of advice I give parents is to try to get your child to sleep without using a bottle. Some tips that I recommend include:
- Letting your child take a “security” blanket, teddy bear, doll, or favorite toy to bed
- Hold or rock your child gently
- Give your child a back rub to help him or her to relax
- Read or tell your child a story
- Quietly sing or play calming music
Parents often comment, ‘well they are just baby teeth, won’t they fall out soon anyways?’ The first baby teeth will not shed until approximately age 6 and the last baby teeth are lost around age 12-13. So those little baby teeth still do get a lot of mileage put on them. Aside from that, some of the more serious effects of Early Childhood Cavities can include:
- Sensitivity and pain
- Premature loss of teeth
- Ear and speech problems
- Crooked and/or damaged permanent teeth
- Poor self-image
- Loss of appetite and failure to gain weight
And so the question now is how can I prevent Early Childhood Cavities? Some tips to consider are:
- Getting into the habit of putting your baby to bed without a bottle
- Never put the baby to bed with a bottle filled with formula, milk, juice, sugar water, or soda pop. If your baby must have a bottle to go to sleep, fill it with water
- Do not let your infant walk around with a bottle
- Start teaching your infant to use a cup between 6-12 months. Trade your baby’s bottle for a training cup by age one
- As soon as your child has teeth, you need to start brushing them. A soft toothbrush with a small head or finger toothbrush (see below) will usually do the trick
- Taking care of your own teeth-cavity causing bacteria is often transferred from parent to child
- Check with your pediatrician or dentist to make sure your child is getting the right amount of fluoride each day
Ultimately as pediatric dentists, we are here to promote the prevention of cavities and the development of good dental care at home. In creating a relationship with your child’s dentist in their infant years you can better ensure that your child will grow up with healthy teeth and happy smiles.
Keith Da Silva DDS, FRCD (C)
Specialist in Pediatric Dentistry
Humbertown Pediatric Dentistry
202-270 The Kingsway, Toronto, ON, M9A 3T7
Dr. Keith Da Silva is a Fellow in Pediatric Dentistry with the Royal College of Dentists of Canada and is a Diplomat of the American Board of Pediatric Dentistry. Dr. Da Silva’s clinical interests include the primary prevention of dental disease and working with children with special health care needs. Moreover, he is dedicated to working with families to make dental visits as enjoyable as they can be. He was born and raised in the GTA and is proud to serve the community.