Your Child's First Dental Visit

When to go

Mainstream guidance from dental bodies such as the American Dental Association and the American Academy of Pediatric Dentistry, and in the UK from the NHS, is to bring a child early:

• by the first birthday, or
• within about 6 months after the first tooth comes through, which is usually between 6 and 12 months

Baby teeth begin to appear at around 6 months, and by about 2.5 to 3 years a child has a full set of 20. Early decay can begin as soon as the first teeth appear, so waiting until a child complains of pain means the problem is already advanced.

Why baby teeth matter

Some parents feel that baby teeth do not need much attention because they fall out. They matter because they:

• let the child eat and speak comfortably
• hold space for the adult teeth that follow
• can develop painful infections that affect sleep, eating and school
• set up habits for brushing and food that continue into adulthood

Decay in baby teeth can spread quickly because their enamel is thinner. Some children need treatment under the age of 5, and prevention is far easier.

What happens at the first visit

The first visit is usually brief, around 15 to 30 minutes, and often feels more like a chat than treatment.

1. The dentist asks about feeding, brushing, thumb-sucking, any pacifier use, and your child's health.
2. Your child sits on your lap or in the chair. The dentist counts and looks at the teeth, gums and bite.
3. Teeth may be cleaned gently, and fluoride varnish may be applied.
4. You are shown how to clean the teeth at home, and how much toothpaste to use.
5. A plan for return visits is made, typically every 6 months, or more often if there are risks.

X-rays are not taken at every first visit. They are used only if the dentist cannot see something or suspects a problem.

How to prepare your child

• Keep it simple. Say, "The dentist will count your teeth." Avoid words like hurt, needle or drill.
• Avoid bribes or promises of a treat afterwards, which can suggest that something unpleasant is coming.
• Pick a time of day when your child is rested and fed.
• Read a picture book about a dental visit, or play dentist at home.
• Stay calm yourself. Children notice a parent's worry.
• Bring a list of questions, and details of any medicines or health conditions.

Caring for teeth at home

Before teeth appear, wipe the gums with a clean, damp cloth after feeds.

From the first tooth, brush twice a day with a soft, small-headed brush. Use a smear (rice-grain size) of fluoride toothpaste until age 3, and a pea-sized amount from 3 to 6 years. Children cannot brush well alone until around 7 or 8, so you should brush or help.

Feeding.

• Do not put a baby to bed with a bottle of milk, juice or sweetened liquid. Sugars pool around the teeth overnight and cause "bottle caries".
• Move to a cup from around 12 months.
• Keep sugary foods and drinks to mealtimes. Frequent snacking and sipping is a bigger problem than the amount of sugar at one time.
• Avoid adding honey or sugar to a pacifier.

Habits. Thumb-sucking and pacifier use are normal in infancy, but if they continue beyond age 3 to 4, they can affect the bite. Ask your dentist for gentle ways to help the child to stop.

What to expect as they grow

• Around age 6, the first adult molars come through behind the baby teeth, and the front teeth start to loosen.
• A dentist may suggest sealants on adult molars to protect them from decay.
• Around age 7 to 9, an orthodontic check helps spot jaw or bite problems early.
• Mouthguards are advised for contact sports.

Find out more about children's dentistry, and for daily routines see the Oral-care guide.

When not to wait

Do not wait for the first birthday if you see any of the following: white or brown spots on teeth, a swelling of the gum, a tooth that has been knocked, or a child who complains of pain. For a knock to a tooth, see dental emergency: what to do.