- First Visit by First Birthday
- Preventing Cavities
- Post Operative Care
- Frequently Asked Questions
- Dental Emergency
- Sedation
- Resources
First Visit by First Birthday
Both the American Academy of Pediatric Dentistry and the American Academy of Pediatrics agree that a child’s first dental visit should be when the first tooth erupts, usually around 6 months of age or no later than 12 months of age.
An early interaction between dentist and child establishes a dental home for the child, fostering a positive relationship between the dentist and child. Appointments are focused on prevention and parental education, working with parents to raise a healthy child with a great smile.
More than 25 percent of children in the United States have cavities by age 4, and cavities can occur sometimes as early as age 1. Early interactions with the dentist can help parents learn how to decrease their child’s risk of developing cavities.
What to expect at first visit
Early dental visits are similar to well baby check ups they have with their physician.
The typical exam includes:
- Review of the child’s gestational and medical history
- Respond to your questions and concerns
- Knee-to-knee exam
- How to care for your child’s mouth including a light cleaning to demonstrate oral hygiene techniques
- The relationship between diet and oral health
- Appropriate use of fluoride
- Oral habit counseling including finger and thumb sucking
- Oral and facial trauma prevention
- Teething and developmental milestones
- Anticipatory guidance specific to your child
- Cavity risk factor assessment
- Fluoride varnish application
Be prepared for your child to fuss during the exam and toothbrushing, although some parents are surprised how well their child responds to the visit.
What to tell your child about their first visit
Tell your child that they are going to the tooth doctor, who helps children keep their teeth healthy.
Tell them that during the visit, the dentist will "brush", "count", and maybe "take pictures" of their teeth.
Please don’t use the words "shot", "hurt", "needle", "pull", and "drill.” If your child needs dental treatment, our office staff are very good about explaining dental treatment to children. We use specialized language that helps describe our procedures in a more kid-friendly manner.
Because most children’s fears are related to the unknown, we use a lot of “Tell-Show-Do” to allow your child to learn about the procedure using age appropriate language as well as see and touch the tools before starting any procedure.
We work hard to reinforce positive behaviors and create an overall fun first experience.
Visit your local library or bookstore for books about dental visits. These books can help prepare your child by familiarizing them with dental procedures, terms, routines, and expectations. Below are a few suggestions.
The Berenstain Bears Visit the Dentist
by Stan and Jan Berenstain ISBN: 0394848365 Publisher: Random House, Oct. 1981 $3.99 32 pages Paperback
Book Description:
This timeless classic is still the most popular book about a child's visit to the dentist. It is a cute book that will help prepare your children for a non-threatening visit to the dentist.
Click here for more information about this book.
Click here to buy this book from Amazon
Brush Your Teeth Please
by Leslie McGuire, Jean Pidgeon, and Dina Anastasio ISBN: 0895774747 Publisher: Readers' Digest, May 1993 12 pages Hardcover pop-up book.
Book Description:
What child can resist imitating a chimp brushing its teeth back and forth? Or a shark that flosses every day? Youngsters will have lots of fun learning about proper dental hygiene in this delightful pop-up book. This book is for toddlers.
Show Me Your Smile: A Visit to the Dentist (Dora the Explorer)
by Christine Ricci (Author) and Robert Roper (Illustrator) ISBN: 0689871694 Publisher: Simon Spotlight/Nickelodeon, January 2005) $3.99 24 pages Paperback
Book Description:
Children love Dora and Dora's visit to the dentist will help dispel anxieties they may have about their visit. Dora and her Mom go to the dentist where Dora gets her teeth cleaned and learn about what a dental office does.
What to Expect When You Go to the Dentist (What to Expect Kids)
by Heidi Murkoff, Laura Rader (Illustrator) ISBN: 0694013285 Publisher: HarperFestival, Mar. 2002
Book Description:
Growing Up Just Got Easier... With the help of Angus, the lovable Answer Dog, best-selling author Heidi Murkoff extends a hand to children and parents as they tackle life's first experiences together. When you were growing up, chances are visiting the dentist wasn't your favorite thing to do. Luckily for your child there have been many changes around the dentist's office since your first visit -- changes that have made "opening up wide" a lot less scary and a lot more fun.
Preventing Cavities
Preventing Dental Decay in Children
The following are ways in which parents can help fight this preventable disease in their children:
Dental visit within the first year of life: Your child’s first dental visits should with the appearance of their first tooth or no later than one year.
Preventing cavities from nursing or using a bottle: We see children as early as one with cavities due to improper bottle or nursing habits. To best way to prevent baby bottle cavities (now referred to as severe early childhood decay) is to avoid at-will breast-feeding after the eruption of the first primary (baby) teeth and other sources of nutrition are being introduced. Children should never fall asleep with a bottle containing anything other than water. Drinking other beverages than milk from a bottle should be avoided as they can damage teeth and lead to cavities.
Fluoride use: Young children require fluoride to help developing teeth grow strong. Fluoride also helps prevent tooth decay in older children when used on a regular basis. Fluoride is particularly important around the time teeth erupt into the mouth. This is because it takes approximately two years for the enamel to reach full hardness and until then teeth are more susceptible to cavities.
Sealants: Sealants work by filling in the deep pits and grooves on the chewing surfaces of the teeth. Sealants allow the tongue, saliva, and toothbrush to clean off the biting surface for effectively. The application is fast and comfortable and can effectively protect teeth for many years
Model good dental habits: By taking care of your own teeth you teach your child the importance of good dental health. Studies have also shown that babies and small children can “catch” cavity-causing bacteria from their parents. By decreasing your bacterial count, you can decrease the likelihood of transmitting them to your child.
Healthy eating habits: Parents should ensure their children are eating a balanced diet and limit frequency of snacking on sugary foods, which can increase a child’s risk of developing cavities. In addition, avoiding soda, energy drinks and juices with high sugar content can lead to better dental health and prevent cavities. Healthy snacks that are good for your teeth include yogurt, string cheese, firm/crunchy fruits, and nuts.
Sugary Beverages Drinks filled with sugar or carbonated soft drinks often contain phosphoric acid that can cause enamel staining and cavities.
Sticky Foods When eating sticky food, food gets stuck in the deep pits and grooves of their teeth and under braces. This can result in tooth decay or cavities if left. Foods to avoid include fruit snacks, gummi vitamins, caramel, Starbursts, taffy, Tootsie Rolls, Skittles, and other sticky treats.
Sugary Foods Sweet foods such as candy, cookies, cakes and pies can be difficult for anyone to avoid. When you eat sugary foods or drinks, normal oral bacteria feed on the sugar and create acids as a by-product. These acids then wear down your enamel, weakening it and making it more susceptible to tooth decay and gingivitis. Snacking on sweets throughout the day or during an extended period of time is especially harmful, since damaging acids form in the mouth every time you eat a sugary snack and continue to affect the teeth for at least 20 minutes afterwards. Pleases eat these foods in moderation and consider brushing and flossing soon after consumption to combat the effects of these foods.
Date to start cleaning a baby’s teeth: It is never too soon to start! Beginning at birth, you should clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, you can start brushing two times daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. It is important to remember that children do not have the ability to brush their teeth effectively, so for children under the age of 2, use a "smear" of toothpaste to brush a child’s teeth. For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child’s tooth-brushing.
picture courtesy of AAPD.org
Post Operative Care
Postoperative Care
Care After Local Anesthetic
Local anesthesia has be a new and fun feeling to your child. They may want to bite, chew, scratch or suck on the area that was anesthetized. Following a procedure requiring local anesthesia, please keep the following in mind:
- Keep a close eye on your child for an hour and a half to two hours after treatment.
- Children need to be reminded to avoid chewing, scratching, or sucking on the area that are a sleep because it can cause swelling and pain.
- Limit your child’s intake of liquids and foods until the numbness has subsided.
Post-Extraction Care
- Ensure that your child does not bite, suck, or chew on their lips, tongue, cheeks, etc while they are numb
- To ease your child’s pain following the extraction, use Motrin or Tylenol as directed.
- Your child will bleed following an extraction so they will need to bite on gauze for 15 to 30 minutes following extraction. Applying pressure to the area helps the bleeding stop.
- Avoid using a straw and spitting for two days following the surgery.
- Soft, cold foods are recommended following surgery and local anesthesia has subsided.
- Pudding, jello, yogurt, mashed potatoes, pasta, etc
- Avoid hot food or those that are crunchy.
- Avoid having your child placing his or her fingers or tongue in the empty socket.
- Brushing should be done that night with care to avoid the area that night only. A clean mouth will heal faster.
Care for Space Maintainers
- Your child must stay away from sticky, chewy, hard, or crunchy foods,
- Gum, caramels, gumi vitamins, Milk Duds, licorice, gummy bears, Skittles, Starbursts, jelly beans, beef jerky, ice, hard candies, jaw breakers will all weaken or break the wires.
- Tell your child to avoid sticking their fingers or objects in their mouth that would pulling on or poke the wire.
- If your child's space maintainer comes loose or breaks, call our office as soon as possible to recement the appliance or decide whether the appliance needs to be remade.
Frequently Asked Questions
What age should my child go to the dentist?
In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears or no later than his/her first birthday.
What is the difference between a pediatric dentist and a family dentist?
Pediatric dentists are the dental equivalent to pediatricians. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.
How often does my child need to see the pediatric dentist?
A check-up every six months is recommended in order prevent cavities and other dental problems. However, some children require more frequent visits and cleanings based on their individual risk factors for cavities.
When should I start brushing my baby’s teeth and what should I use to clean them?
The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. When the first tooth erupts, use a toothbrush that has a soft-bristled toothbrush with a small head, preferably one designed specifically for their age.
Toothpaste: when should we begin using it and how much should we use?
As soon as the teeth begin to erupt, you should begin brushing twice daily using fluoridated toothpaste. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, a "pea-size" amount of toothpaste when assisting your child’s toothbrushing. Remember children should spit out and not swallow excess toothpaste after brushing. Children do not effectively brush their teeth alone until at least the age of 8 so you need to assist your child and monitor toothpaste usage.
picture courtesy of AAPD.org
Are baby teeth really that important to my child?
Baby teeth are extremely important to children. Baby teeth allow children to speak clearly, chew naturally, and aid in the growth and development of the permanent teeth and jaws.
When should I stop giving my child a bottle?
Both the American Association of Pediatrics (AAP) and AAPD recommend the bottle usage should be stopped by 12 months of age. Transition at this time with a sippy cup should be quick and limited so the child uses a regular cup primarily. Remember putting your child to bed with anything other than water puts them at high risk for cavities.
Sippy cups are ok right?
Children should not be walking around with anything in a sippy cup other than water. During meals, children should use regular cups. At meals is where they should be consuming white milk (not chocolate or strawberry) or their one serving a day of juice (4 to 6 oz).
Is 100% fruit juice healthy?
Juice has a lot of sugar in them, even natural sugar, that can cause cavities. Even watered down juice can cause cavities. The AAP recommends no more than 4 to 6 oz of juice a day because at this point they do not receive any additional nutrient value and it is considered equivalent to sugar water.
Are thumbsucking and pacifier habits harmful for a child's teeth?
Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers past the age of three, a mouth appliance may be recommended by your pediatric dentist.
What age should my child stop thumb sucking or a pacifier?
The AAPD recommends quitting habits by 36 months of age or 3 years to prevent effects on the jaw and teeth alignment. If habits persist, then your child may need early orthodontic treatment. Helpful books to use stop habits include:
Harold's Hideaway Thumb by Harriet Sonnenschein
Helping the Thumb Sucking Child by Rosemary Van Norman
How safe are dental X-rays?
There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons, high-speed film, and digital x-rays are used to ensure safety and minimize the amount of radiation.
What are sealants?
Dental sealants are a plastic fillings that bonds to the deep grooves in your tooth's chewing surface. When sealing a tooth, the grooves of your teeth are filled and the tooth surface becomes smoother and flatter so food and plaque are less likely to accumulate.
Dental sealants are applied as a preventative measure during the years of most likely tooth decay. It is more common to seal "permanent" teeth rather than "baby" teeth, but placement depends on an individual’s cavity risk.
Tooth sealants for children generally last from 3 to 5 years when a sticky diet is avoided and grinding is kept to a minimal. A dental sealant only provides protection when it is fully intact so dentists will check them at your visits.
What should I do if my child falls and knocks out a permanent tooth?
After insuring that your child is ok, attempt to find the tooth. Hold it by the crown, not by the root and try to put it back into the socket. If the tooth is dirty, then you may rinse it in water prior to reimplantation. If reimplantation is not possible, then put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.
Does bottle water contain fluoride?
Some bottle water does have fluoride but the amount varies between brands and even within bottles. The best way to ensure adequate fluoride intake is to contact your local water supply and ask if it is optimal.
Dental Emergency
Bitten Lip or Tongue
If your child has bitten his lip or tongue severely enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling and help stop the bleeding. . If there is bleeding, apply firm but gentle pressure with a gauze pad or clean cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take your child to the nearest hospital emergency room.
Broken, Chipped, or Fractured Tooth
If your child has chipped or broken a piece off of his tooth, have him rinse his mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off and place in a cup of milk. Call us immediately.
Knocked Out Tooth
If your child's tooth has been knocked out of his mouth, find the tooth and rinse it with water (no soap), taking care to only touch the crown of the tooth (the part you can see when it's in place). If it is a permanent tooth, and if you can, place the tooth back in its socket and hold it in place with a clean towel or cloth. If you can't return the tooth to its socket, place it in a clean container with milk. In either case, call us immediately. If you act quickly it's possible to save a permanent tooth. If a baby tooth has been knocked out, do NOT put the tooth back in place. You can rinse out the child's mouth and check for any other tooth damage. Pressure with gauze or a washcloth will help stop bleeding. We do not put baby teeth back in their sockets after being knocked out because it is very unlikely the teeth will heal properly. Call our office to schedule an appointment to make sure no other teeth have been damaged and that proper healing is occurring.
Loose Tooth
If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled.
Toothache
If your child complains of a toothache, rinse his mouth with warm water and inspect his teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children's pain relievers may be taken orally. Schedule an appointment immediately.
Broken Jaw
If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call our emergency number and/or head to the hospital immediately. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life-threatening.
Avoiding Injury
You can help your child avoid dental emergencies. Childproof your house to avoid falls. Always use car seats for young children and require seat belts and booster seat for older children. And if your child plays contact sports, have him or her wear a mouthguard. Ask us about creating a custom-fitted mouthguard for your child.
Sedation
Nitrous Oxide (Minimal Sedation)
Nitrous Oxide or more commonly called “laughing gas” is a combination of Nitrous Oxide and Oxygen used to help the body relax. Even though it is called laughing gas most people don’t become giggly. Most people do feel more calm and relaxed after administration begins.
Nitrous Oxide is a colorless and faintly sweet smelling gas. It is the most popular form of anxiolysis (anxiety relief) used in pediatric dentistry today because of its quick onset and recovery while being effective in alleviating anxiety and fear. The onset and recovery each takes approximately 2 to 3 minutes. The majority of children benefit from the use of nitrous oxide during their dental treatment as it makes for an overall calmer and more pleasant experience. Most children will report feeling warm, heavy, and more relaxed. Patients while on nitrous oxide will respond to verbal commands and be able to carry on a conversation. Nitrous oxide does not put your child to sleep or alleviate the need for local anesthetic (numbing) however, it can prolong short attention spans and can take the edge off of what sometimes can be perceived as an unpleasant situation. Another benefit of nitrous oxide is it helps suppress strong gag reflexes because it is a mild analgesic.
Your child can benefit from nitrous oxide if he or she experiences one of more of the following:
- Anxiety about of dental care
- Has a lot of work to complete yet is fairly cooperative
- Previous bad dental experiences
- Fear of shots
- Difficulty getting numb
- Sensitive teeth
- Strong gag reflex
General Anesthesia (Deep Sedation)
General anesthesia is a form of deep sedation where your child no longer is conscious and can no longer feel pain. Longer, more complicated treatment may require general anesthesia. General anesthesia is usually a gas that is breathed in by the child, and is administered by an anesthesiologist. Because the child is placed in a deep sedative state, the child must be continuously monitored. When a child is deeply sedated, breathing slows down. As breathing slows, the risks of airway complications rise. For this reason, the anesthesiologist controls the breathing of the child. This control minimizes airway complications and allows for surgeries to be done predictably and as safe as possible. Tonsillectomies, ear tubes, and other surgeries are all done under general anesthesia.
The child that needs dental treatment, but cannot tolerate it in the dental office most likely requires general anesthesia to complete the treatment. A child may need general anesthesia for dental work if they are young, have a lot of teeth that need to be fixed, uncooperative, have special needs or complex medical condition(s).
What is most important:
- Your child is properly prepared for in general anesthesia
- The anesthesiologist is trained in pediatrics and treats them each day
- Your pediatric dentist is well-versed treating children under general anesthesia, is efficient, and very meticulous.
What are the benefits?
Treating children in a painless, non-traumatic setting has many long-term benefits:
- Treatment is painless.
- Treatment is safe. Restraint of children for dental work can be unsafe for the child and dentist.
- Your child receives all dental work at one time, eliminating the trauma of multiple dental visits and decreasing the amount of time out of the parent’s schedule.
- Your child is allowed to stay positive about the dentist, which has been shown to pr