Probably the most frequent question that I have answered in the past thirty or so years practicing pediatric dentistry is “when should my child first come to the dentist?” Interestingly, the answer has changed over the years.

When I first started my practice my goal was to fix teeth, so my answer was “around the age three or so.” That is about the age where children have all their primary teeth present and their occlusion – or the contact between their upper and lower teeth – established. They have the social skills required to talk and interact well with others, and have began to lose at least some of their separation anxiety. As long as there is no immediate threat (like a toothache) they can usually do well for the dentist.

After my first ten years of practice, I realized that when younger children came in it was usually because they had a toothache and needed help quickly. We changed what we told the parents to “age two” so we could catch decay earlier and hopefully minimize the number and severity of cavities. The children were generally less cooperative and almost always cried; however, we were always able to accomplish our exam without actually hurting them and felt the crying was worth the exam.

After a few years of these age two exams and having examined hundreds of children with sixteen baby teeth each decayed to the gum line, it became painfully obvious that for these children, it was too late. I remembered that an older pediatric dentist from Iowa named Art Noack had for years been teaching that children should be seen even earlier: between 6 months and one year. My thought at the time I first heard this concept was that he was an academic dentist, not a practicing dentist. I could not have been more wrong.

The primary goal in seeing children between the time that the first baby tooth comes in and the first birthday is to make a cavities risk assessment. This process includes educating the parents on the causes of tooth decay and how cavities can be prevented, and discussing the family history with cavities and how it is actually a contagious bacterial infection.

In addition, we teach diet and hygiene measures that should be adopted to control bacterial growth. Finally, the goal is to establish a relationship with the dentist so that regular checkups and preventative care can be maintained.

Visit our First Visit page for more information on your child’s first visit to the dentist or contact our office to make an appointment. We look forward to seeing you – by first tooth or first birthday!”

by Dr. Charles Keithline