One of the more common questions I am asked is when a young child should have their first dental visit. In fact, dental care actually begins with the mother’s healthy pregnancy. The primary (baby) teeth begin formation at 9-10 weeks into pregnancy, and as a result the mother’s nutritional intake, particularly vitamins and minerals, is very important for the early development of strong and healthy teeth.
Cleaning an infant’s mouth should begin even before the first teeth grow into the mouth. This can be easily done by wrapping a cold, damp washcloth over the index finger and wiping the gum surfaces. This is not only beneficial for cleaning the mouth of an infant, but it is also very soothing for infants who may be teething.
Once breast feeding has been established, a pacifier can be introduced. The prevalent opinion among dentists is that a pacifier is preferable to a thumb sucking habit, since the parent can control the pacifier use much easier than the thumb habit. Pacifiers should be replaced when they become cracked or sticky, and should be weaned at or around the age of three. If your child is given a bottle at bedtime, it should only be with water. Even milk has sugar, which leaves a sticky residue on the teeth.
Young children can be introduced to the use of a toothbrush as soon as teeth are visible in the mouth. A good children’s toothbrush should be soft with rounded bristles, and the brush should be changed every three to four months. We recommend that brushing be done by a parent up to the age of three, and together with a parent between the ages of three and six.
Toothpaste with fluoride can also be introduced at a young age, provided that the parent is dispensing a minimal amount (no larger than a grain of rice). The current thinking is that the benefits of fluoride for cavity prevention far outweighs the risks of excess fluoride consumption.
Children should also be introduced to flossing at a very young age, even as young as two or three years old. The earlier in a child’s life this daily habit is introduced, the more the likelihood that it will be a lifelong habit. Flossing sticks are particularly beneficial for this, as they are much easier for young patients to manipulate.
Although the first formal examination for young patients should be at three years, we recommend an early dental screening at 12 months, or six months after the first teeth have grown into the mouth. This is a very brief screening, and is used to check that the enamel covering on the teeth is healthy.
One of the items we emphasize in our young patients is proper nutrition. Children should be taught from a very young age about the difference between healthy and unhealthy food choices, and about the difference between sugar and sticky sugar. Snacks that contain sticky sugars can adhere to teeth for three to four hours after eating, making them very likely to cause cavities.
A final component to establishing lifelong dental health is a positive first visit to the dental office. Parents and dental office staff have a shared responsibility in making the child’s first visit both fun and positive. A happy first visit can pave the way for a lifetime of healthy smiles.
Dr. Allan Katchky is a dentist who practices in the East End.