Preparing for Your Child's First Visit
According to AAPD (American Academy of Pediatric Dentistry) guidelines, infants should initially visit the pediatric dentist around the time of their first birthday. First visits can be stressful for parents, especially for parents who have dental phobias themselves.
It is imperative for parents to continually communicate positive messages about dental visits (especially the first one), and to help the child feel as happy as possible about visiting the dentist.
How can I prepare for my child’s first dental visit?
Pediatric dentists are required to undergo extensive training in child psychology. Their dental offices are generally colorful, child-friendly, and boast a selection of games, toys, and educational tools. Pediatric dentists (and all dental staff) aim to make the child feel as welcome as possible during all visits.
There are several things parents can do to make the first visit enjoyable. Some helpful tips are listed below:
Here is a list of parent and dentist-approved books:
What will happen during the first visit?
There are several goals for the first dental visit. First, the pediatric dentist and the child need to get properly acquainted. Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history. Third, the dentist needs to evaluate the health of the existing teeth and gums. Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen.
The following sequence of events is typical of an initial “well baby checkup”:
If you have questions or concerns about your child’s first dental visit, please contact our office.
Sedation Dentistry for Children
In contrast to general anesthesia (which renders the child unconscious), dental sedation is only intended to reduce the child’s anxiety and discomfort during dental visits. In some cases, the child may become drowsy or less active while sedated, but this will quickly desist after the procedure is completed.
When is sedation used?
Sedation is used in several circumstances. Firstly, very young children are often unable to keep still long enough for the pediatric dentist to perform high-precision procedures safely. Sedation makes the visit less stressful for both children and adults and vastly reduces the risk of injury. Secondly, some children struggle to manage anxiety during dental appointments. Sedation helps them to relax, cope, and feel happier about treatment. Thirdly, sedation is particularly useful for children with special needs. It prevents spontaneous movement, and guides cooperative behavior.
What are the most common types of sedation?
Most pediatric dentists have several sedation options available, and each one comes with its own particular benefits. The dentist will assess the medical history of the child, the expected duration of the procedure, and the child’s comfort level before recommending a method of sedation.
Conscious sedation allows children to continually communicate, follow instructions, and cooperate during the entire procedure. The major methods of conscious sedation are described below:
Nitrous oxide - The pediatric dentist may recommend nitrous oxide (more commonly known as “laughing gas”) for children who exhibit particular signs of nervousness or anxiety. Nitrous oxide is delivered via a mask, which is placed over the child’s nose. Nitrous oxide is always combined with oxygen – meaning that the child can comfortably breathe in through the nose and out through the mouth.
Laughing gas relaxes children extremely quickly, and can produce happy, euphoric behavior. It is also quick acting, painless to deliver, and wears off within a matter of minutes. Before removing the mask completely, the pediatric dentist delivers regular oxygen for several minutes, to ensure the nitrous oxide is eliminated from the child’s body. On rare occasions, nitrous oxide may cause nausea. For this reason, most pediatric dentists suggest minimal food intake prior to the appointment.
Oral sedation - Children who are uncooperative, particularly anxious, or unable to control their muscles for prolonged periods, may be offered an oral sedative. Oral sedatives come in many different forms (usually tablets, pills, and liquids), and may make the child feel drowsy. If oral sedatives are to be used, the pediatric dentist may require parents to prepare the child before the appointment. Some common preparatory measures may include: limiting food and fluid intake prior to the appointment, having the child wear comfortable clothing to the appointment, and preparing to stay with the child for several hours after the appointment. Oral sedatives rarely produce serious side effects; nausea is among the most common.
Other forms of conscious sedation - Other less common ways to administer sedatives include intravenous (IV sedation), the use of suppositories, and even the use of a nasal spray. In most cases, the method of delivery may change, but the chemical nature of the sedative remains the same.
What about general anesthetic?
General anesthetic (which puts the child in a deep sleep), is rarely used in dental work unless:
General anesthetic requires more intensive preparation before the treatment and a longer period of recovery after the treatment. Conscious sedation is usually favored wherever possible.
When Will My Baby Start Getting Teeth?
The initial growth period for primary (baby) teeth begins in the second trimester of pregnancy (around 16-20 weeks). During this time, it is especially important for expectant mothers to eat a healthy, nutritious diet, since nutrients are needed for bone and soft tissue development.
Though there are some individual differences in the timing of tooth eruption, primary teeth usually begin to emerge when the infant is between six and eight months old. Altogether, a set of twenty primary teeth will emerge by the age of three.
The American Academy of Pediatric Dentistry (AAPD) recommends a first “well-baby” dental visit around the age of twelve months (or six months after the first tooth emerges). This visit acquaints the infant with the dental office, allows the pediatric dentist to monitor development, and provides a great opportunity for parents to ask questions.
Which teeth emerge first?
In general, teeth emerge in pairs, starting at the front of the infant’s mouth. Between the ages of six and ten months, the two lower central incisors break through. Remember that cavities may develop between two adjacent teeth, so flossing should begin at this point.
Next (and sometimes simultaneously), the two upper central incisors emerge – usually between the ages of eight and twelve months. Teething can be quite an uncomfortable process for the infant. Clean teething rings and cold damp cloths can help ease the irritation and discomfort.
Between the ages of nine and sixteen months the upper lateral incisors emerge – one on either side of the central incisors. Around the same time, the lower lateral incisors emerge, meaning that the infant has four adjacent teeth on the lower and upper arches. Pediatric dentists suggest that sippy cup usage should end when the toddler reaches the age of fourteen months. This minimizes the risk of “baby bottle tooth decay.”
Eight more teeth break through between the ages of thirteen and twenty three months. On each arch, a cuspid or canine tooth will appear immediately adjacent to each lateral incisor. Immediately behind (looking towards the back of the child’s mouth), first molars will emerge on either side of the canine teeth on both jaws.
Finally, a second set of molars emerges on each arch – usually beginning on the lower arch. Most children have a complete set of twenty primary teeth before the age of thirty-three months. The pediatric dentist generally applies dental sealant to the molars, to lock out food particles, bacteria, and enamel-attacking acids.
How can I reduce the risk of early caries (cavities)?
Primary teeth preserve space for permanent teeth and guide their later alignment. In addition, primary teeth help with speech production, prevent the tongue from posturing abnormally, and play an important role in the chewing of food. For these reasons, it is critically important to learn how to care for the child’s emerging teeth.
Here are some helpful tips:
If you have questions or concerns about the emergence of your child’s teeth, please contact your pediatric dentist.
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