The Tinkerer

PlayWell Pediatric Blog

When should my child first see a dentist?

March 8, 2022

I have a lot of families who bring their kids in for a first visit at 3… or 5… or not until something is wrong. Often time this stems from old recommendations still held onto by older general dentists, who often don't prefer to see kids under a certain age, anyways. Many families think the first dental visit should occur between 3 and 5 years of age. Truth be told, I see a lot of kids come in for a first visit in that age range, and it's true that many of them are fine and have no cavities, no bad habits, are eating well and not snacking leisurely, and don't still have pacifiers or thumb sucking habits, etc. Everything is well and good! But there are many kids, too, who come in for a first visit during those ages who do have things going on - things which would have been better prevented rather than trying to fix afterwards (you get a lot less fight saying "no" to thumb sucking in a 2-year-old than to a 5-year-old). Habits are forming and 5-year-olds can be stubborn and developing their own sense of independence. Better to have good habits already than to try to change everything on the back end.

But the end result of the most common problem we deal with in dentistry is cavities - it's 5x more common than the 2nd most common chronic disease of childhood in America - asthma. When a 4-year-old comes in for a first dental visit and has cavities, especially if there are 8 cavities, it is usually beyond the scope of what a child can tolerate to have two to four 1- hour long dental visits to "numb, drill, and fill" all those teeth. Kids age 3-5 represent the largest subset of kids who I treat with sedation dentistry - having an anesthesiologist start an IV and have the child go to sleep so I can do all the restorations at once.

The American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) recommend children start seeing the dentist as soon as they have teeth, or no later than 1 year of age. Like visits to the pediatrician, these visits are 80% talking and 20% examining the child. I want to talk to parents about how to prevent problems from happening! We talk about when on-demand feeding can become problematic, when non-nutritive habits become problematic, when to start brushing teeth, what toothpaste to use and how much, how to brush teeth (for you and for your child), for how long kids need help with this, when to start flossing, how diet and frequency of eating/drinking factor into cavity causation, gum disease and care, injury prevention, etc. These are things we like to talk about as they become age-appropriate, and ideally just a smidge BEFORE they become relevant so you're armed with the information in advance!

Some 1- and 2-year olds are a little less than thrilled about having their teeth examined - I like to say it's a lot like your child's first haircut. Sometimes there's a little stress from the unfamiliar situation, but with a time or two (and with a lot of LEGO® to play with), we learn that the dentist can be a pretty fun place to go to, and that's fully half of the battle! We want kids to have healthy smiles but we also want kids to enjoy going to the dentist for a lifetime. At PlayWell Pediatric Dentistry we never lose sight of the latter while seeking the former. "Building up young smiles" is our motto and that means keeping your child as our focus, not just your child's teeth.

A kid playing with his toys

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