The American Academy of Pediatric Dentistry (AAPD) recommends taking your child to a dentist soon after the first tooth comes in, usually between 6 and 12 months of age.
The American Academy of Pediatrics (AAP) recommends that children have a caries risk assessment and clinical evaluation at every well-child visit starting at 6 months, that parents find a dental home for children with particular dental risks by the time they are 1 year old, and that all children visit a dentist before the age of 3. Despite these recommendations, 1 out of every 5 U.S. children between the ages of 1 and 18 go without dental care each year, including an estimated 17 million low-income children.
“Parents think, ‘I know my child, and they won’t sit still,’” says Gigi Meinecke, a Maryland dentist and member of the Academy of General Dentistry. At her practice, the first visit merely introduces a child to the world of dentistry. The children sit on their parents’ laps, some use the chair as a carnival ride. They learn good cleaning habits, all without an actual cleaning. “The bottom line is, we want your child to feel comfortable,” she says.
The main impediment to children getting dental care is parents' perception of the cost. Parents should understand prevention is often much more cost-effective than dealing with problems when they become critical. A small cavity left untreated may not only create a lot of pain for a child, but can ultimately result in a relatively expensive tooth extraction.
Healthy teeth important for overall health
Tooth decay (caries) has serious consequences when it comes to your child’s health and affects 40–50 percent of children before age 5. More than half of the four million children born each year will have cavities by the time they reach the second grade.
Early dentist visits are key to preventing early childhood caries, a condition in which children 5 years of age or younger have one or more decayed, missing, or filled tooth surfaces, often referred to as “baby bottle tooth decay” or “nursing caries.” The earlier the dental visit, the better the chance of preventing dental problems.
The most common causes of tooth decay are bacteria and unrestricted use of sugar-sweetened drinks (juice, soda, milk). The AAPD discourages bedtime bottle use, with the exception of bottles containing water. Parents are encouraged to abandon the bottle altogether in favor of a cup by the first birthday.
When it comes to juice, only offer it in a cup with meals or snacks. In fact, if your baby is young enough to drink from a bottle, the AAP recommends that you avoid offering juice altogether.
As with bottle-feeding, the AAPD also discourages unrestricted, nighttime breastfeeding once your child’s first tooth comes in. “At-will breastfeeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced.”
But not all experts agree that unrestricted, nighttime breastfeeding causes tooth decay. (Will night nursing rot your baby’s teeth? Read this.)
When questioned, Meinecke says she doubts the AAPD is trying to suggest parents restrict breastfeeding, especially at such a young age—after all, she breastfed her child into toddlerhood. She says the real concern is nursing one’s child to sleep, and that it’s important to clean a baby’s teeth after breastfeeding.
According to the AAP, human milk itself does not promote tooth decay—research shows unrestricted breastfeeding is not associated with caries. In fact, breastfed children in the study had lower rates of caries than non-breastfed children, supporting the theory that human milk provides some type of protection against the bacteria that cause tooth decay. Even so, the AAP echoes statements by the AAPD that breastfed babies who fall asleep while nursing with unswallowed milk in their mouth are at greater risk for tooth decay.
If your baby continues to breastfeed through the night (as many babies do) and you are concerned about caries, Meinecke suggests a simple solution: keep a wet washcloth nearby at night, and simply rub it over your child’s teeth after nursing. She said the same approach would work for formula-fed children.
Tips for caring for your child’s teeth at home
In addition to visiting a pediatric dentist, be sure to introduce good hygiene at home. Here are some tips for keeping your children’s teeth clean, starting in infancy:
- Clean the gums. Even before your child’s teeth appear, you can clean your child’s gums with a wet cloth. A gentle wipe after breastfeeding is all it takes.
- Brush twice a day. Once your child’s teeth do appear, brush them twice a day with a fluoridated toothpaste and a soft-bristled brush. Use just a smear of toothpaste for children under age 3 (about the size of a grain of rice) and a pea-sized amount for children 3–6 years old. Your child will need your help with brushing. Encourage your child to develop his “rinse and spit” skills early.
- Introduce floss. Yes, even toddlers can floss! Of course, a small child will need your help, but flossing once a day (which helps remove plaque) can usually begin around 24 months, or when two teeth are touching each other—but check with your dentist first; not all 2-year-olds need to floss.
- Eat healthy. A balanced diet is essential for healthy teeth and gums. A high-carb diet of sugars and starches increases the risk for tooth decay. The AAP recommends completely avoiding all carbonated drinks for the child’s first 30 months and limiting juice to one cup a day, only at mealtimes.