First Dental Visit - Caring for their first teeth is critical

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By Dr. David Leader

This is the first of a series of monthly columns on dental health. As such, I thought it best to begin in the beginning.

Your child's first dental appointment should be before his or her first birthday. There is a great deal of confusion about when children should first see a dentist. In the past 10 years, there has been a change in how dentists think about treating children . Many dentists and physicians have been slow to adapt to this new way of thinking. Here is your opportunity to climb on board; I think that you will like it.

Historically, dentists were taught to treat children when they could sit still and behave. Physicians were fully responsible for their patients' early dental examinations and to educate parents in proper care of their children's teeth . Children were referred to dentists by their pediatricians or family practitioners at three to five years old for their first dental appointment.

By this age, children were thought to be able to control themselves and allow dentists and hygienists to treat them. The problem with this way of thinking is that very young children often develop decay . In over 14 years of volunteering for Head Start preschool I have seen several three- to five-year-old children who had serious, even painful, infections and tooth decay that their parents did not know about . It is possible that early visits to a dentist could have prevented much of this disease and trauma.

Baby teeth are very important to children's mental and physical health. Healthy teeth help a child speak properly, eat a healthy diet, and allow the adult teeth to come in straight. Children can expect to use some of their baby teeth until they are up to 13 years old . Some adults never loose all of their baby teeth.

Today, dentists want to see very young children and their parents. Dentists no longer expect every child to be quiet and still. Your children will be catered to. Everything will be explained in such a way that they will understand . Sure, your child may cry. Many adults would like to cry during a dental appointment, but maturity prevents such acting out. A benefit of this behavior is that when a child is crying, his or her mouth is usually open making the dentist's job that much easier.

Parents can be very helpful before and during the dental appointment. Do not prepare your child for their first dental visit. It is not helpful to tell a young child that going to the dentist does not hurt.

• First, because children do not have a way of knowing that going to a dentist may be uncomfortable or scary unless they are told.
• Second, because children and adults have different ways of thinking about what hurts. If you allow your child to interact with the dentist unprepared, that child may surprise you. Many children come into my office unprepared, go through the entire appointment without comment, and leave the office not even realizing that they have impressed their parents and the dental office staff.
• Third, some procedures are uncomfortable. Let the dentist tell your child what to expect. Dentists do it all the time and we all have our own techniques for putting our young patients at ease.

Young children have a very short attention span, so children's appointments are intentionally quick. The dentist will check your child's teeth for proper development and home care, and for signs of disease and poor nutrition . They will talk with you about fluoride use and nutrition and will show you how to brush your young child's teeth.

Children are not able to clean their own teeth well until they are 6 to 8 years old. They need for mom or dad to help them out. If you expect young children to do a thorough job, you will be disappointed . Most dentists will recommend the application of pit and fissure sealants to protect at least the 6 and 12 year molars.

Many children are growing up without tooth decay. It is not just due to luck. Start your children early. Always use fluoride products correctly. Brush your children's teeth for them regularly. Limit your children's consumption of soda and sweets, and take your children to the dentist before they are 1 year old.

For a list of oral hygiene products for your child, please visit Kids Dental Care 

Dr. David Leader is the Chairman of the Health Advisory Committee of the Lynnfield Schools, a member of the Professional Advisory Committee of Tri-CAP Head Start, and is a member of the Mass Dental Society Council on Dental Care and Benefits Programs.