Your Child's First Dental Visit: When to Go and What to Expect

Parents ask me this more often than almost anything else: when should my child first see a dentist? The answer tends to surprise people, because it is earlier than most expect.

The recommendation from both the American Dental Association and the American Academy of Pediatric Dentistry is a first visit by the first birthday, or within six months of the first tooth coming in, whichever happens first.

That is not because a one-year-old usually needs anything done. It is so we can catch early decay, check how the teeth and jaw are developing, and talk through the habits that matter most over the next few years. It also means your child has been in a dental office while nothing was wrong, which makes a real difference on the day something is.

What actually happens at a first visit

For a toddler it is short, often fifteen or twenty minutes, and usually done knee-to-knee: your child sits facing you and lies back with their head in my lap, so they are looking at you the whole time. Nothing about it hurts.

• We count the teeth and look at the teeth, gums, tongue and bite.

• If it is appropriate, we gently clean and polish, and we may apply fluoride varnish.

• I show you how to brush your child's particular mouth, which beats general advice.

• We talk about bottles and sippy cups, pacifiers and thumb sucking, and what they eat and drink.

• X-rays are taken only when there is a reason, based on your child's risk and what we can see, not automatically at this age.

There is no drilling and no needle at a routine first checkup unless your child has come in with an emergency.

How to prepare your child without making it scarier

• Keep it brief and matter-of-fact. A long build-up signals that something frightening is coming.

• Skip the reassurances that plant the idea. Children hear the words in "it won't hurt" and "you're not getting a shot," not the "not."

• "The dentist is going to count your teeth" works well, because it is true.

• Morning appointments usually go better for small children than late afternoon ones.

• Bring a comfort object if your child has one.

• If you are anxious about dentists yourself and another adult can bring them, consider it. Children read us accurately.

Baby teeth matter more than people assume

Holding space for the permanent teeth is one of their jobs, not the only one. Baby teeth are how a child chews properly and forms many speech sounds. And decay in a baby tooth behaves like decay anywhere else: it can reach the nerve, cause real pain, and lead to infection. The enamel on a primary tooth is thinner, so it can progress faster than parents expect.

The pattern I see most often is a child put down to sleep with a bottle or sippy cup of milk or juice. The liquid sits around the front teeth for hours with little saliva to wash it away. Water at bedtime, everything else with meals, prevents a lot of trouble.

The home routine that does the most work

• Before any teeth arrive, wipe the gums with a clean damp cloth.

• Once the first tooth appears, brush twice a day with fluoride toothpaste. A smear the size of a grain of rice until age three, and a pea-sized amount from three to six.

• Supervise brushing and teach spitting rather than rinsing, so the fluoride stays on the teeth longer.

• Start flossing once any two teeth touch, because a toothbrush cannot reach between them.

• Plan on brushing for your child, or going over it afterward, until around age six to eight. Younger children do not yet have the fine motor control, however willing they are.

• Watch how often sugar appears more than how much. A cup of juice nursed over an afternoon is harder on teeth than the same juice finished with lunch.

Worth asking about at your visit

• Sealants, the thin coatings placed on the chewing surfaces of permanent molars, where a large share of childhood cavities begin.

• Fluoride, including whether your tap water is fluoridated and whether varnish makes sense for your child.

• Thumb sucking and pacifier use, common in toddlers and usually nothing to act on, but worth discussing if they continue once permanent teeth arrive.

• A mouthguard once your child starts contact sports.

• What to do in an emergency. Worth knowing in advance: a knocked-out baby tooth should not be pushed back into the socket, the opposite of the advice for an adult tooth. Call us the same day either way.

When not to wait for the next checkup

Call sooner if you notice swelling of the face or gums, a tooth that has hurt for more than a day, a new white or brown spot on a front tooth, a tooth knocked loose or out, or a child who has quietly started chewing on only one side.

And if your child is already three, or five, or older and has never been seen, that is nothing to apologize for. We start where you are and keep the first visit easy.

This is general information rather than a diagnosis. Every child's mouth is different, and what is right for yours depends on an examination. If you have questions about your child's teeth, or it is time for that first visit, we are glad to see you.

Hashimi Dental, 3701 Market St. Suite E, Riverside, CA 92501