As a dentist, I am often asked by parents when their child’s first appointment should be. According to the American Academy of Pediatric Dentistry (AAPD), infants should be seen within 6 months of eruption of the first tooth and no later than 12 months of age.
To most people, this must seem very young, but there are compelling reasons for children to be seen early. Between 1988-1994 and 1999-2004, children in the 2-4 year old age group were the only people in the United States to exhibit an increase in tooth decay. A caregiver with untreated tooth decay doubles the odds of their child getting cavities and significantly increase the severity of those activities.
Tooth decay is a transmissible infectious disease caused by the bacteria mutans streptococci (MS) which infants contact through the caregiver’s saliva. Recent studies have shown that MS can grow in infants’ mouths before they even have teeth.
A recent study showed that caregivers routinely under estimate their children’s oral health needs and that for children younger than two (2) years, caregiver’s assessments correlated poorly with actual clinical treatment needs.
Only 1.5% of infants and 1 year old children had dental visits in 2000-2005, compared with almost 90% who visited a pediatrician. The value of an early preventative visit, which is covered by most dental insurance, is to provide an opportunity for the dentist/hygienist to educate caregivers about their child’s oral health, as well as to identify any decay or potential problems.
Parental dental education would include dietary suggestions, tips on brushing/toothpaste use, and taking care of untreated tooth decay in parents’ mouths. Parental toothbrushing should commence when the first teeth erupt.
New ADA fluoride toothpaste recommendations aim to maximize the decay prevention effects of fluoride toothpaste while minimizing the risk of swallowing too much of it. For children younger than 3, use a smear of toothpaste no larger than a grain of rice; for children 3-6 years of age, place no more than a pea sized amount of fluoride containing toothpaste on the brush.