Just as children regularly see their pediatricians for preventative care, it is recommended that your child see a pediatric dentist by his or her first birthday. Establishing a pediatric dentist as your child’s primary care dentist early on allows you to instill preventative dental health habits that will keep your child free from oral disease. Your dentist will also be able to establish a friendly relationship with your child. Your child’s dental appointment is tailored to his age and stage of development, cavity risk and ability to cooperate.

A comprehensive dental exam, cleaning, and a preventative fluoride treatment will be performed, and dental images will be taken when appropriate. Your family’s current dietary habits and oral hygiene routine will be reviewed, and your dental professional provide suggestions that will reduce your child’s cavity risk.

Regular preventative dental appointments also allow families to take a proactive approach to their children’s dental health, and provide an opportunity for the pediatric dentist to address parents’ questions. The dentist also has an opportunity to prepare parents for changes and potential conditions that their child may experience at their particular stage of development. Plus, starting these habits early will help them continue into adulthood, and help maintain your child’s oral health throughout their life.

Here are the most common topics of concern for children from birth to age 18.

Newborn, Toddlers and Teething

Oral health care begins even before your baby’s teeth come in. Gently massaging your baby’s gums with a soft cloth after feedings helps them get used to having their mouth (and later their teeth) cleaned.

As soon as your baby’s teeth begin to erupt, use a small, soft toothbrush and a rice grain-sized smear of fluoride toothpaste.

If your child receives a bottle at bedtime, it should contain water only. Children who are put to sleep with juice, formula or milk are very likely to develop tooth decay.

Teething usually starts around 6 months old, and most children have all 20 of their baby teeth by age 3. Your child may drool and be fussy as teeth are pushing through the gums. Teething rings or a cold, clean washcloth may be used to alleviate pain. Tylenol, ibuprofen, or any other over-the-counter analgesics approved by their pediatrician may be used. However, topical anesthetics such as Baby Orajel are not recommended due to the potential for accidental anesthetic overdose.

Note that a low-grade fever and diarrhea may be associated with teething. However, any child with fevers at or over 101 degrees, and those who show changes in drinking, eating and voiding should be evaluated by a pediatrician.

Oral habits such as pacifier-use or thumb-sucking should be discontinued by age 3, as it can affect tooth alignment and the growth of the jaws.

Permanent Tooth Eruption

Permanent teeth begin to appear around age 6, with the lower central incisors and the permanent first molars erupting around the same time.

Incisors have ridges on the edges. They erupt slightly behind the existing row of teeth, and are often slightly rotated. As the front teeth erupt, the tongue pressure will move them forward so that they align with the other teeth.

Permanent teeth are slightly darker in color than the primary teeth; the color difference is normal. Their appearance will look more natural after all of the baby teeth are lost and all the permanent teeth have erupted.

Dental Sealants

Dental sealants, a special coating placed in the grooves of the teeth, are often recommended for teeth as a way to reduce cavity risk on the chewing surfaces of the teeth. Sealants are particularly beneficial for permanent molars, and for other teeth determined by your dentist to be at high risk for cavities.

Orthodontics

At your child’s continuing care appointments, your pediatric dentist will assess how the permanent teeth are coming in, and how the teeth are fitting together.

Orthodontic screening appointments are recommended around age 7, but may be required earlier for children with issues such as obvious underbites, prominent overbites, etc.

Although orthodontic treatment usually starts later, the screening allows the orthodontist to anticipate potential problems, and to proactively plan for the best time to begin treatment.

Tweens and Adolescents

Regular dental appointments are especially important at this age. Many children are receiving orthodontic care; this makes oral hygiene more challenging, and thus places them at an increased risk for cavities and hygiene-related periodontal problems. Also, changes in diet often occur, since they are less dependent on parents to provide all their meals and snacks.

Panoramic X-rays are used to assess the presence and development of wisdom teeth. Referral to an oral surgeon for wisdom tooth removal around the ages of 16-21 is common, due to the lack of room in the mouth and problems associated with wisdom tooth eruption and care.

Oral Health Tips for All Ages

  • Use toothpaste containing fluoride as follows:
    • Age 0-2 years: rice grain-sized amount
    • Age 2-5 years: pea-sized amount
  • Snacking should be limited to designated mealtimes and snack times, as frequent snacking on sugary and carbohydrate-containing snacks greatly increases the risk for tooth decay.
  • Make tap water your drink of choice in between meals, as it naturally cleanses the teeth. Avoid sipping on sugary (carbohydrate-containing) drinks, especially milk and juice, in between mealtimes. Frequent exposure to these sugary liquids greatly increases your child’s risk for cavities.
  • Parents should brush their child’s teeth up until age 8, as children 8 and younger lack the fine motor skills needed to perform brushing correctly.
  • Floss in between any teeth that are touching, as brushing alone cannot remove plaque located between the teeth.
  • See your pediatric dentist every 6 months, or more frequently at their recommendation, to ensure their oral care is efficient, and that there are no problem areas.