Monday, February 9, 2015

So when do I first take my child to the dentist?

Have you parents seen this article circling the web?

I received a question in response from a friend asking about the appropriate time for a child's first dental appointment. (The article is an easy and informative read by the way!) Unfortunately, her dentist had a different recommendation than what was stated in the article and she felt confused. Here is the recommendation from the article:
The first trip should either be when the first tooth erupts or by your baby’s first birthday. Dental visits every six months from the get-go will also help your child feel comfortable—and even excited—to go every time.
This isn't the first time I've faced this question and I understand as a parent it puts you in a pickle. On one hand, the American Academy of Pediatric Dentistry is giving one recommendation (the one quoated above) and your dentist is giving you another.

My personal opinion is consistent with the American Academy of Pediatric Dentistry stance. I have seen children, even infants and toddlers, with serious dental decay resulting in the need for baby root canals (pulpotomies), crowns/caps, fillings, or even extractions of most or all of the teeth and done in an operating room setting under general anesthesia. Imagine going until age 6-7 before having any teeth because they had to be removed! (-- on top of the lasting orthodontic and growth problems associated with these missing teeth.)

An earlier appointment can catch these problems early on before becoming serious.

But, many dentists do not follow this timeline. Perhaps they are unaware of the recommendation. Many dentists are not interested or comfortable seeing children, especially very young children. Maybe they just don't agree.

What is the dentally conscious mommy (or daddy) to do?

Consider a pediatric dentist.

A pediatric dentist can be a great option, especially for those seeing a dentist with less interest in children's dentistry. Pediatric dentists spend an extra 2-3 years of training focusing on issues specific to children in dentistry. Less time is probably spent on learning new procedures or dental techniques and more is spent on the nuances of behavior management, special needs children (and adults), education, etc. I think most dentists would agree their job is one of the hardest in dentistry-- using sharp tools and instruments on squirmy, often unhappy and even uncooperative kiddos all day long-- all while trying to provide as comfortable and happy an experience as possible (I can't tell you how many adults tell me the "I was traumatized as a kid" stories). Because they see kids all day everyday they really are the experts on all of the issues from teething to pacifiers and also on education to help you set your child up for positive dental experiences in the future. They often provide a fun environment and low stress environment and can continue to see your child until they reach adulthood.

There can be an advantage to a specialist's care and early infant dental care may be a prime example.

Talk to your general dentist.

I understand there are instances where a pediatric dentist is not available -- maybe there isn't one in your town, maybe they don't take your insurance, or maybe they simply aren't taking any more patients. Don't despair! Many dentists are great family dentists! They are comfortable and talented in seeing both adults and children. I would place most of my dental school classmates into this category. I think if you have a good relationship with your dentist you should feel comfortable continuing the care of all your family members with them.

Many general dentists follow these early guidelines but if your dentist does not, I think it is reasonable to ask why the policy differs from the recommendations of the academy. She likely has a good reason behind her decision to delay care -- perhaps after knowing your own personal dental practices are good she has minimal concerns; maybe she has seen the dental hygiene of your older children and knows you are doing a good job and your questions have been answered in the past.

Take personal responsibility for your child's oral health.

If your dentist has recommend delaying care until an older age, it is even more important to follow the tips in the article above (or check out my previous post on this -- link below) as these will help prevent any big issues. Something as simple as being aware of any major issues (for example, holes or black or brown spots in teeth) while brushing your child's teeth and discussing them with your dentist can make a big difference. Don't be afraid to ask questions or for advice if you have challenges (such as how to brush the teeth of uncooperative toddlers), whether by phone or at your own appointment.

And in answer to a few common questions:

So, what happens at an infant dental appointment? It doesn't seem like they could do much!

You are right, there may not be much "dentistry" occurring in the appointment of a six month old. Maybe they only have two teeth!  BUT... it doesn't mean that a lot isn't accomplished during these appointments.

The dentist will take a look at your child's teeth and oral soft tissues (gums, cheeks, etc), to check for any big abnormalities or concerns. This may be a simple visual exam without any tools. They will clean the teeth (maybe just with a toothbrush) and they will likely apply some fluoride to help protect the teeth.

Most of the appointment will probably be spent on education. This is a good opportunity to bring up any specific concerns or questions you have. They can give you demonstrations and tips on topics such as how to clean your kids teeth (even when they scream or move), ideas on snacks healthy for their teeth, questions about thumb sucking and pacifiers, and most importantly perhaps, they should provide positive dental experiences to avoid those horror stories we hear later in life.

Ok, you have me convinced but what if they cry?

Your child will cry, but don't worry, we expect that (don't they cry for most strangers at that age?) and that actually helps us see (open mouths!). Luckily, the crying usually wont last long. Most children perk right up as soon as they are back in Mom's arms.

I think the bottom line is that you should advocate for your child to have the best dental experience possible. Early childhood is an ideal time to teach your child consistent dental care and to find the experience comfortable, easy, and even fun! If you aren't sure how your dentist feels about treating kids, ask! You should get a good feeling from their response if they like or are comfortable seeing children and at what ages. Have a discussion with your dentist to see if he feels he can provide this kind of care and if not, he may have some referrals for a good pediatric dentist in your community.

* * *

*Have you seen my 2013 post on how to avoid inadvertently passing on your own dental phobias to your child and other tips to help your child have a positive experience at the dentist (yep, I said it way before Fox News!)?

Check it out!


Shannon Barrett said...

I think you should take your kids to a dentist depending on how their teeth are now, regardless of age. These recommendations are well-intentioned, but you should go based on what is best for you little ones. Take care!

Shannon Barrett @ Best Care Dental Center

Erin said...

Hi Shannon,

Thanks for your input. I was hoping to make broad recommendations but each parent of course needs to do what they feel is best for their child. I know that many not in the dental field aren't sure what this is so I hope some of my recommendations will be helpful. But, certainly, if there are any dental concerns there should be no delay in seeking care from a dentist.


Rachel Culmer said...

Hannah loves going to the dentist! She gets so excited about it.

James Harvon said...

I am going to keep this in mind as my kids of coming of age to visit the dentist. My wife has an appointment soon and it would be a great chance to bring the kids. Being comfortable with the area should help eliminate any fear the kids have of the dentist.

Cesar Briggs said...

Those are really helpful recommendations. Parents know best when it comes to their children's needs. Anyway, I think bringing your child to the dentist early on is a good practice because dentists are professionals, and they are the ones who know the knicks and knacks of a sound oral health. Anyway, thanks for sharing that! All the best!

Cesar Briggs @ Solara Dental Care

Eunice Greer said...

I totally agree! It's really important to bring your kids to the dentists regularly, so that they will get used to practice as early as possible. Also, it will also help create a positive image of dentists for them, so that they wouldn't be afraid of them. In any way, thanks for sharing that, Erin! All the best to your lovely family!

Eunice Greer @ Downtown Dentals