The first dental visit for a child is a breakthrough in a child's life, it uncloaks not only the overall oral health but also the child’s behaviour pattern and psychological well-being. Don’t wait for the dental issue to kick in, plan the first dental visit. If the child is in pain, it’s difficult for the dentist to gain the child’s trust during initial visits, so the first dental visit helps the child to be familiarized with the dentist and dental setup. Here comes the question, when should we first take our child to the dentist or a pedodontist?
Dr. Harsha S K a consultant paediatric dentist in Malappuram, Kerala, shares her opinion on a child's first dental visit “The first dental visit is extremely important in a child's life since it lays the foundation for their lifelong oral health journey. To allay worries, develop trust, and establish a reliable dental care regimen, it's critical to approach this appointment with positivity and support. Parents can make the experience smoother by educating the child honestly and positively, respecting their worries, and preparing them for easy procedures. It is crucial to welcome the child's expressed fears, refrain from using negative language or making unrealistic promises, and offer educational resources like Peppa Pig's first dental experience. This early start guarantees early detection and avoids future dental problems, putting the child on the road to lifetime oral health".
What to expect from child’s first dental visit:
First dental appointment with a pedodontist will give information regarding the following:
1. Pattern, timing, and problems associated with Teething
2. Early childhood /Nursing bottle caries
3. Feeding practices
4. Parental counseling
5. Oral hygiene maintenance
Apart from just detecting early lesions affecting teeth, the pedodontist also evaluates any craniofacial development disorders and provides nutritional counseling. Parents need to be educated about the following issues:
1) Teething: It’s not always a pleasant event, teething can cause discomfort, pain, and irritability to the child. A first dental visit after the eruption of the first primary teeth would help manage these problems.
2) Early childhood caries (ECC): Also called “baby bottle caries”/ Nursing bottle caries” is a frequent dental problem in children, early dental visits can educate the parents regarding the signs of developing decay and will help in avoiding decay in the future.
Early childhood caries (ECC) or Nursing bottle most commonly affects infants and preschool children worldwide.
The American Academy of Paediatric Dentistry (AAPD)
Major risk factors for ECC:
Dietary - sugary diet (sweetened food and beverages)
Feeding practices: Kids fed overnight while sleeping with sweetened milk containing several cariogenic sugars are at greater risk.
This leads to reduced sugar clearance and the oral microbes will produce lactic acid at a faster and higher rate, finally leading to decay.
Recommendation to reduce the risk of developing ECC:
Careful and proper tooth brushing should be performed twice a day.
Pedodontists recommend the use of “pea-size” fluoride toothpaste for children, (less than 500 ppm fluoride content)
Educating the parents on their child’s feeding practices.
3) Oral hygiene instructions:
Oral hygiene should be given importance from birth, the first dental visit will guide the parent in cleaning the gum pads and freshly erupted teeth. Brushing using a soft and age-appropriate-sized toothbrush will help in reducing bacterial colonization.
Check out the Video by Dr. Tanya Batra (@drtanyabatra) on delayed Tooth Eruptions on MedBound. https://l.medbound.com/M2WYybGFGyueMtXcA
4) Diet counselling
At the first dental visit and every other appointment, the pedodontist should discuss the role of sugar intake and the snacking frequency.
Parents should be made aware of the detrimental effects of overnight bottle feeding
AAPD suggests that children should be weaned from breast or bottle milk by the age of 1 year.
Managing the Child during first dental visit: First dental visit particularly for an anxious child, just making the child sit in the dental chair and examine is a milestone. Making them understand what is being done through simple explanations, stories, and videos, or even making them observe their fellow child undergoing treatment can help them in building trust in the dentist, Giving them a dental mirror to hold, slight distraction through toys while examining them are some of the useful strategies.
A recent study by Hamideh Alai-Towfigh et al 2022, revealed that "Despite 12 months of age, being the CDA's official position, the majority of Canadian dentists did not recommend it".Another retrospective study by Meer R. et al, India,2008 concluded that "Most of the children report for the first dental visit only after 6 years with chief complaints like pain and decay".
Despite the improved healthcare system and availability of specialists, the first dental visit for a child is being neglected. Parents should be educated about the importance of a child’s first dental visit, through educational videos, acts, and pamphlets in maternity and children's hospitals. General pediatricians and gynecologists should motivate the parents to visit pedodontists for the child’s good oral health, during the child's vaccination visits and awareness programs in babycare centers.
Follow the Author on MedBound: Dr. Meghana Pasala (@Meghanaortho)
