February is National Children’s Dental Health Month, which aims to encourage healthcare providers and educators to promote the benefits of good oral health to children and their families. A child’s first dental visit can have a profound impact on their perception of oral health professionals and their personal oral hygiene efforts for years to come. With that in mind, we’ll examine the importance of a child’s first dental visit, prevention and education, and overcoming fears.
The importance of a child’s first dental visit
A child can experience their first caries as early as 3 years old. Because tooth decay has become a common issue among pediatric patients, both the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) recommend that a child’s first dental visit coincide with the arrival of the first tooth and/or the 1-year age mark.
The goal for dentists is to prevent decay in pediatric patients before it ever has the chance to begin, and to create an environment in which the first-time patient feels safe in their care. Most of this effort comes down to prevention and early detection, as well as creative collaboration between dentists and a child’s family to help alleviate anxiety.
Not only does preventive care help save a child from the painful effects of tooth decay, it also helps create a more positive experience related to oral healthcare overall. In fact, a child who doesn’t associate the dental experience with pain is more likely to have a positive opinion about going to the dentist when they’re older. And being able to screen a child as early as 1 year not only allows for preventive therapies and early treatment to begin sooner, it also benefits the child and their family by helping to establish optimal feeding and oral hygiene habits from the very beginning.
In 2002, the AAPD adopted its Policy on the Dental Home, suggesting that children who have a dentist early on are far more likely to receive appropriate and routine preventive care and, as a result, reduced risk for dental disease as they mature.
To put it into perspective, consider a child who is experiencing tooth decay as early as 3 years old. That child will likely have to undergo restorative treatment that can be anxiety-triggering. And yet, it’s one of the most common problems in pediatric dentistry today, with early childhood caries (ECC) being 5 times more common in children than asthma. In fact, more than 30% of children who don’t routinely see a dentist when their first teeth start to come in or by the time they are one year old tend to exhibit caries within the next two years.
ECC can be seen as soon as teeth start to erupt, resulting when sugars are broken down by oral bacteria to produce an acid that demineralizes the tooth structure, resulting in cavitation. Sugary drinks are the main cause for the caries, and the impact on children is significant, not only in terms of oral health, but also many other quality-of-life issues.
In fact, children’s dental health problems account for 52 hours of lost school on average and up to 30% more in healthcare costs for families. Decay, which causes pain, also can impact sleep, speaking patterns, and nutritional intake, all of which can lead to negative outcomes.
Prevention and education in pediatric dentistry
The good news is that early dental care can help children and their families get the information they need to ensure good oral health, all while helping to establish a positive experience about visiting the dentist.
It’s important to emphasize early in a child’s development that there are preventable behaviors that cause chronic tooth decay. And these tend to be influenced by everything from social and behavioral patterns, to what a child eats and drinks, and how regularly they brush and floss – all of which can cost families more than those who practice preventive care early.
Here are some facts:
- Annual treatment costs for children who have their first dental exam by age 1 are significantly less than for children who see the dentist for the first time after the age of 3.
- Children who see a dentist by the time they are 1 year old are more likely to see a dentist on an ongoing basis.
- Children who are in the care of a dentist early on are less likely to require restorative or emergency visits that can be traumatizing.
- Children who are seen after the age of 2 or 3 have an increased risk for preventive, restorative, and emergency visits over time.
Teachable moments in early childhood dentistry
Early exams of children can have a lasting impact on their oral health, which is why ensuring that all bases are covered is important from the start. A proper oral examination of pediatric patients rests on three key pillars: risk assessment, oral examination and anticipatory guidance.
What this means is that assessing for risk factors can be created by conducting medical, social and dental histories, all three of which can help build the preventive strategies needed for each patient and their family. For example, feeding habits can affect risk for caries, particularly when it comes to carbohydrate-rich diets. Understanding how and what a child eats (and when) can help determine the risks for developing tooth decay. Other factors to consider include the eating and drinking habits of the family, as well as the family dental health history.
A robust oral examination provides the opportunity to check the oral cavity for any signs of early decay, as well as to track the development of teeth. An exam also should coincide with a demonstration about how to clean a baby’s teeth using gauze, a toothbrush or a washcloth. Fluoride varnish also is regularly used to prevent caries from developing at this stage.
It’s important that caregivers know that they should start brushing teeth or a tooth as soon as the first tooth erupts, ideally with a soft-bristled brush and the age-appropriate amount of fluoride toothpaste. Many cities also add fluoride to the water system, making it easy to deliver fluoride with routine water consumption.
Overcoming the fears of a child’s first dental visit
When it comes to making a child feel comfortable in the dental chair, there are a few ways to overcome fears and set the stage for a kid-friendly experience. According to Parents magazine, a child might visit the dentist at least 10 times before they reach kindergarten, making these checkups not only essential but also a consistent part of their young lives.
Thankfully, there are some creative ways that both dentists and families can make the experience better for kids:
- Start early: The earlier the child is introduced to the dentist, the better prognosis for a healthy mouth. Starting early also means the child is introduced to the experience, giving them a chance to adjust to the new place, sounds, and experiences.
- Keep it simple: Don’t overload the child with too much information. It’s also important to stay positive and to avoid sharing “dental horror stories,” or mentioning treatments that may never happen (like getting a tooth pulled). Parents and dentists ultimately want to build trust from the start.
- Choose words wisely: Rather than referencing things like “pain” and “shots,” try taking a more fun approach, like telling kids that dentists check their smiles to see their healthy teeth.
- Pretend first: Some dentists recommend families play dentist before the real visit, only rather than the child being the patient, they are the dentist. Give them a toothbrush to help them count teeth. Another idea is allowing them to practice on a stuffed animal. The goal is to make them more familiar with the process in a fun way.
- Make the practice kid-friendly: A lot of pediatric practices go out of their way to make the office space fun, colorful, and friendly to children, using everything from books and video games to puzzles and toys. This is a great way to welcome a child who hopefully will look forward to the subsequent visits.
- Avoid sugary treats: Ditch the lollipop and encourage praise and a healthy snack, small toy, or stickers after a visit to the dentist. Giving kids candy after having their teeth cleaned sends the wrong message about oral health.
Creating a positive experience for a child’s first dental visit is important in setting the foundation for a lifetime of good oral health. By focusing on prevention and education, and ensuring a child feels comfortable in the dental chair, children can overcome their fears and enjoy their trip to the dentist.
Menchaca RL. The Effect of Early Dental Care of Pediatric Patient Behavior [master’s thesis]. Columbus, OH: The Ohio State University. 2016.
Merdad L, El-Housseiny AA. Do children’s previous dental experience and fear affect their perceived oral health-related quality of life (OHRQoL)? BMC Oral Health. January 16, 2017.
Roth Port D. 8 tips to help kids overcome fear of dentists. Parents. February 5, 2012.
Triplett OL, Dormois L. A child’s first dental visit. Decisions in Dentistry. February 13, 2019.
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A version of this article originally appeared in the February edition of OnTarget. Read the latest edition and view current promotions at pattersondental.com/dental/ontarget.