Your Child's First Dental Visit: When to Go and How to Prepare

Many parents are surprised to learn that dental organisations recommend a child's first dental visit much earlier than they expected. Both the American Academy of Pediatric Dentistry and the American Dental Association suggest a first visit when the first tooth appears, or at the latest by the first birthday. That might sound early for a baby with two teeth, but these visits are short, gentle and mostly about setting up good habits.

Why so early?

Tooth decay in young children is common, and it can start as soon as teeth appear. Baby teeth have thinner enamel than adult teeth, so decay can progress quickly. Early visits help in several ways:

• The dentist can spot early signs of decay, such as chalky white lines near the gums, when they may still be reversible.
• You get practical, age-specific advice about brushing, fluoride, bottles, sippy cups, snacks and thumb-sucking.
• Your child gets used to the sights and sounds of a dental office before any treatment is needed.
• You establish a "dental home" to call if there is an injury or a toothache.

Baby teeth matter even though they fall out. They help children chew and speak, and they hold space for the adult teeth developing underneath. Some back baby teeth stay in place until around age 10 to 12.

What happens at the first visit

For babies and young toddlers, the first visit is often a "knee-to-knee" exam. You sit facing the dentist with your knees touching, and your child lies back with their head in the dentist's lap and their body on yours. This position lets the dentist see inside the mouth while your child can see and touch you. Crying is normal and actually gives the dentist a good view.

The dentist typically:

1. Asks about your child's health, feeding, bottle or breastfeeding habits, and any family history of dental problems.
2. Looks at the teeth, gums, tongue and bite, and checks for early decay.
3. Wipes or brushes the teeth and may apply fluoride varnish, a quick paint-on coating.
4. Shows you how to brush your child's teeth and answers questions about teething, pacifiers and thumb-sucking.
5. Suggests when to come back, based on your child's risk.

X-rays are not usually needed at a first visit for a baby. The whole appointment is often quite short.

Preparing a toddler or preschooler

If you feel anxious about dental visits, that is completely understandable. Try not to share those feelings in front of your child. Let the dental team lead, and ask them beforehand how they like parents to help. Some offices prefer parents stay close; others find older children do better alone in the chair after the first visit.

Pediatric dentist or family dentist?

A pediatric dentist has completed additional training after dental school focused on infants, children, teenagers and children with special health care needs. Their offices tend to be designed for kids, with smaller equipment and staff used to working with little ones. A general or family dentist can also care for children, and many do so very well, especially once children are a bit older.

Consider a pediatric dentist if your child is very young, very anxious, has special health care needs, or has already had significant decay. A family dentist can be convenient if you want the whole household in one place. Either way, ask the office what ages they see and how they handle young or nervous children.

Common questions parents bring

Teething. Teething can cause drooling, chewing and fussiness. A clean, chilled (not frozen) teething ring or gently rubbing the gums with a clean finger may help. The FDA advises against teething gels containing benzocaine for children under two, and against teething necklaces because of choking and strangulation risk. High fever or diarrhoea are not typical teething symptoms and should be checked by your child's doctor.

Bottles at bedtime. Letting a baby fall asleep with a bottle of milk, formula or juice leaves sugars pooling around the teeth for hours, which raises the risk of decay. If your child needs a bottle to settle, water is the safest option for the teeth.

Fluoride toothpaste. Current US guidance recommends a smear of fluoride toothpaste, about the size of a grain of rice, from the first tooth until age three, and a pea-sized amount from three to six, with an adult doing or supervising the brushing.

Pacifiers and thumb-sucking. These are normal soothing habits in babies. Most children stop on their own; the dentist can monitor the bite and advise if a habit continues as adult teeth approach.

After the first visit

Keep the routine going with regular checkups at the interval your dentist suggests, often every six months. Praise your child after the visit and talk about it positively. If something did not go well, ask the office for suggestions; a short "happy visit" to ride the chair and meet the team can help nervous children reset.