Health August 2014

Dental Care for Toddlers

  • Initial visit recommended before a child’s first birthday
  • Prevention important to protect teeth until they are lost naturally
  • Lead by example to teach your child good dental care

I have had numerous mothers ask me about the best time for a child’s first dental visit. Paediatricians and general practitioners usually recommend that a visit be made before his or her first birthday, since it is at around six months of age that primary teeth typically begin growing in. I am usually guided by the following.

First visits are mainly about getting used to the dentist’s chair and, most important, about educating parents on how to care for their baby’s teeth.

If your child has transitioned from a bottle to a cup and does not snack or drink in the middle of the night, the child can wait one extra year, until age two, for their first visit. At this time the standard recommendation for a visit every six months kicks into gear.

Prevention is the name of the game. It is very important to keep primary (baby or milk) teeth in place until they are lost naturally.

The primary teeth are important for many reasons. They help children chew properly to maintain good nutrition, play a role in speech development, save space for permanent teeth, and promote a healthy smile that helps children feel good about the way they look.

Many first visits are nothing more than introductory icebreakers to acquaint your child with the dentist and the practice. Short, successive visits are meant to build the child’s trust in the dentist and the dental surgery, and can prove invaluable if your child needs to be treated later for any dental problem.

I always recommend having the appointments scheduled earlier in the day, when your child is alert and fresh. For children under 36 months, the parent may need to sit in the dental chair and hold the child during the examination. Or, parents may be asked to wait in the reception area so a relationship can be built between child and dentist.

The first visit usually involves a gentle, but thorough, examination of the teeth, jaw, bite, gums and oral tissues to monitor growth and development, and observe any problem areas.

If indicated, your dentist will administer a gentle clean, which involves polishing, or as I like to call it, “tickling the teeth”, and removing any plaque, tartar build-up or stains. Following this, a demonstration is given on proper home care to parents, as well as an assessment of the need for fluoride.

A number of common recommendations will usually be made at the initial visit.

1. Clean your infant’s gums with a clean, damp cloth after each feeding.
2. As soon as the first teeth come in, begin brushing them with a small, soft-bristled toothbrush and water.
3. To avoid baby-bottle tooth decay and teeth misalignment due to sucking, try to wean your child off the breast and bottle by one year of age, and monitor excessive sucking of dummies and thumbs. Do not give your child a bottle—of milk, juice or sweetened liquid—as a pacifier at naptime or bedtime. Prior to bedtime, drinking milk is fine.
4. Help your child brush at night, the most important time due to lower salivary flow and higher susceptibility to cavities. I recommend having the child brush first to build self-confidence, followed up by the parent, to ensure that all plaque is removed.
5. The best way to teach a child to brush is to lead by good example. Allowing your child to watch you, or an older sibling, brush is a technique that has worked for many of my patients.

In the end, it is the basics—brushing twice a day, flossing daily, and getting regular dental check-ups every six months—that have the most impact on a child’s smile. It is my experience that children with very proactive parents have the least incidence of decay, and as a result enjoy going to the dentist.

A visit to the dentist’s surgery should be a pleasant one and not one that is avoided at all costs.