When Should a Child See a Dentist for the First Time?

February 19, 2018 6:00 AM

Parents (and doctors, too) might differ on when dental care should begin. A Michigan Medicine pediatrician explains why screening early is best.

Parents may not know when their child should visit a dentist for the first time.

For many, it’s earlier than they might think.

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“A visit should take place by their first birthday, or six months after the first tooth becomes visible — whichever is earlier,” says Stephanie Goodson, M.D., a pediatrician at University of Michigan C.S. Mott Children’s Hospital. That recommendation, she notes, comes from the American Academy of Pediatrics and the American Dental Association.

This knowledge gap was reflected in a new C.S. Mott Children’s Hospital National Poll on Children’s Health that examined parents’ knowledge about dental care for very young children.

In a survey of 2,005 adults with children ages 5 and younger, more than half of respondents didn’t receive guidance from their child’s pediatrician or a dentist about when to start dental visits.

Among that majority, 1 in 6 parents believed children should delay visits until age 4 or older — a time when decay and other problems could already have developed.

But fewer than half (47 percent) of parents whose family doctors or dentists did offer advice believed that dental visits should start at age 12 months or younger.

“Dental disease is the most common childhood chronic disease,” says Goodson, who works with an initiative called SmileConnect to improve children’s oral health. “But it’s just not something people think about as being a medical issue.”

She spoke more about the value of young children seeing a dentist.

Dental care for young children: 6 things to know

Your pediatrician should address dental health: A child’s doctor should address the basic issues of oral hygiene. Many primary care physicians can apply a protective fluoride varnish to a child’s teeth around age 9 months. Pediatricians are also a great resource to ask for a referral to an infant-friendly dental practice, if needed.

But it’s no substitute for a dental exam: Although family doctors can offer a basic oral assessment, their ability is limited. “A dentist is trained to identify signs of early decay and provide preventive services to stop the dental disease from progressing,” Goodson says. “Believe it or not, due to a child’s diet, tartar can start developing at a very young age.”

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Early dental visits can prevent trouble: Risks for decay and discoloration begin with a child’s first baby tooth. It’s crucial for a dentist to keep a close watch, as infants with dental disease can’t receive typical in-office sedation for treatment. Notes Goodson: “Young children end up in the operating room under general anesthesia for a few cavities to be repaired.”

Exposure builds comfort: Very young children can sit on an adult’s lap during the exam — which shouldn’t be long or traumatic. “Dentists generally have lots of positive rewards, such as toys and stickers,” Goodson says. It also allows for a discussion about good oral health habits. Just as you see your pediatrician for well visits, children should also routinely see a dentist.

Home dental care is crucial: A child’s teeth should be brushed as soon as they emerge. “We recommend fluoridated toothpaste after 6 months of age,” Goodson says, noting that a rice-sized amount is plenty. “Once they can spit, use a pea-sized amount.” Children should not drink sugary beverages or fall asleep with a bottle, which can allow cavity-causing bacteria to thrive.

Don’t wait to get your child dental insurance: Parents should ensure their child is enrolled in a dental plan when his or her first tooth emerges. Some family insurance plans may have an enrollment period with a limited window, which could delay the start of care, Goodson notes. And it might take time to get an appointment with a preferred dentist.