When should I schedule my child's first trip to the dentist?
Should my 3-year-old be flossing? How do I know if my child needs
braces? Many parents have a difficult time judging how much dental
care their children need. They know they want to prevent cavities,
but they don't always know the best way to do so.
When to Start Caring for a Child's Teeth
Proper dental care begins even before a baby's first tooth
appears. Remember that just because you can't see the teeth
doesn't mean they aren't there. Teeth actually begin to
form in the second trimester of pregnancy. At birth your baby has
20 primary teeth, some of which are fully developed in the jaw.
Running a damp washcloth over your baby's gums following
feedings can prevent buildup of damaging bacteria. Once your child
has a few teeth showing, you can brush them with a soft child's
toothbrush or rub them with gauze at the end of the day.
Even babies can have problems with dental decay when parents do
not practice good feeding habits at home. Putting your baby to
sleep with a bottle in his or her mouth may be convenient in the
short term - but it can harm the baby's teeth. When the sugars
from juice or milk remain on a baby's teeth for hours, they may
eat away at the enamel, creating a condition known as bottle mouth.
Pocked, pitted, or discolored front teeth are signs of bottle
mouth. Severe cases result in cavities and the need to pull all the
front teeth until the permanent ones grow in.
Parents and child care providers should also help young children
develop set times for drinking during the day as well because
sucking on a bottle throughout the day can be equally damaging to
You may want to take your child to a dentist who specializes in
treating kids. Pediatric dentists are trained to handle the wide
range of issues associated with kids' dental health. They also
know when to refer you to a different type of specialist such as an
orthodontist to correct an overbite or an oral surgeon for jaw
A pediatric dentist's primary goals are prevention, heading
off potential oral health problems before they occur, and
maintenance, ensuring through routine checkups and proper daily
care that teeth and gums stay healthy.
The American Dental Association (ADA) recommends that a
child's first visit to the dentist take place by the first
birthday. At this visit, the dentist will explain proper brushing
and flossing techniques (you need to floss once your baby has two
teeth that touch) and conduct a modified exam while your baby sits
on your lap.
Such visits can help in the early detection of potential
problems, and help kids become accustomed to visiting the dentist
so they'll have less fear about going as they
When all of your child's primary teeth have come in (usually
around age 21/2) your dentist may start applying topical fluoride.
Fluoride hardens the tooth enamel, helping to ward off the most
common childhood oral disease, dental caries, or cavities. Cavities
are caused by bacteria and food that are left on the teeth after
eating. When these are not brushed away, acid collects on a tooth,
softening its enamel until a hole - or cavity - forms. Regular use
of fluoride toughens the enamel, making it more difficult for acid
Although many municipalities require tap water to be
fluoridated, other communities have no such regulations. If the
water supply is not fluoridated, or if your family uses purified
water, ask your dentist for fluoride supplements. Even though most
toothpastes contain fluoride, toothpaste alone will not fully
protect a child's mouth. Be careful, however, since too much
fluoride can cause tooth discoloration. Check with your dentist
Discoloration can also occur as a result of prolonged use of
antibiotics, as some children's medications contain a large
amount of sugar. Parents should encourage children to brush after
they take their medicine, particularly if the prescription will be
Brushing at least twice a day and routine flossing will help
maintain a healthy mouth. Kids as young as age 2 or 3 can begin to
use toothpaste when brushing, as long as they are supervised. Kids
should not ingest large amounts of toothpaste - a pea-sized amount
for toddlers is just right. Parents should always make sure the
child spits the toothpaste out instead of swallowing.
As your child's permanent teeth grow in, the dentist can
help seal out decay by applying a thin wash of resin to the back
teeth, where most chewing occurs. Known as a sealant, this
protective coating keeps bacteria from settling in the
hard-to-reach crevices of the molars.
Although dental research has resulted in increasingly
sophisticated preventative techniques, including fillings and
sealants that seep fluoride, a dentist's care is only part of
the equation. Follow-up at home plays an equally important role.
For example, sealants on the teeth do not mean that a
child can eat sweets uncontrollably or slack off on the daily
brushing and flossing - parents must work with kids to teach good
oral health habits.
If Your Child Has a Problem
If you are prone to tooth decay or gum disease, your child may
be at higher risk as well. Therefore, sometimes even the most
diligent brushing and flossing will not prevent a cavity. Be sure
to call your dentist if your child complains of tooth pain. The
pain could be a sign of a cavity that needs to be treated.
New materials have given the pediatric dentist more filling and
repair options than ever before. Silver remains the substance of
choice for the majority of fillings in permanent teeth. Other
materials, such as composite resins, also are gaining popularity.
Composite resins bond to the teeth so the filling won't pop
out, and they can be used to rebuild teeth damaged through injury
or conditions such as cleft palate.
Tooth-colored resins are also more attractive. But in cases of
fracture, extensive decay, or malformation of baby teeth, dentists
often opt for stainless steel crowns. Crowns maintain the tooth
while preventing the decay from spreading.
As kids grow older, their bite and the straightness of their
teeth can become an issue. Orthodontic treatment begins earlier now
than it once did, but what once was a symbol of preteen anguish - a
mouth filled with metal wires and braces - is a relic of the past.
Kids as young as age 7 now sport corrective appliances. Efficient,
plastic-based materials have replaced old-fashioned metal
Dentists now understand that manipulation of teeth at a younger
age can be easier and more effective in the long run. Younger
children's teeth can be positioned with relatively minor
orthodontia, thus preventing major orthodontia later on.
In some rare instances, usually when a more complicated dental
procedure is to be performed, a dentist will recommend general
Parents should make sure that the professional who administers
the medicine is a trained anesthesiologist or oral surgeon before
agreeing to the procedure. Don't be afraid to question the
dentist. Giving your child an early start on checkups and good
dental hygiene is an effective way to help prevent this kind of
extensive dental work. Encouraging your child to use a mouth guard
during sports can also prevent serious dental injuries.
As your child grows, plan on routine dental checkups anywhere
from once every 3 months to once a year, depending on the
dentist's recommendations. Limiting intake of sugary foods and
regular brushing and flossing all contribute to your child's
dental health. Your partnership with the dentist will help ensure
teeth healthy and a beautiful smile.
Lisa A. Goss, RDH, BS, and Garrett B. Lyons Sr., DDS
Date reviewed: April 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.