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Published March 24, 2013, 11:35 PM

Small bites: Why your toddler should see a dentist early

FARGO – A child’s first trip to the dentist may be before she even has her first tooth, if parents follow recommendations from major health organizations.

By: Sherri Richards, INFORUM

FARGO – A child’s first trip to the dentist may be before she even has her first tooth, if parents follow recommendations from major health organizations.

The American Dental Association and American Academy of Pediatric Dentistry both say children should visit a dentist by their first birthday, or when the child’s first tooth appears. Literature by the American Academy of Pediatrics cites this advice.

It’s a guideline the Early Childhood Dental Network of West Central Minnesota has been working to get out to parents across the region.

“We really try to stress what the ADA recommends because they’re obviously the experts. They know what’s best, they have the research to show good practices,” says Jane Patrick, ECDN coordinator.

A visit that early helps parents and children find a dentist they are comfortable with, can identify oral health issues before they become a problem, and will promote a lifetime of good oral hygiene, the ECDN says.

But as the ECDN promotes the message, Patrick says they hear often from parents whose dentists won’t schedule appointments with young patients until age 3.

It’s a practice Dr. David Hetland, a dentist with Designer Smiles in Fargo, understands. He says his youngest patients are typically around 2 or 2½. Any younger than that, and “personally in my office I would find it difficult to get anything done. It might just be that quick look and that ride in the chair,” he says.

“We kind of tell (parents) earlier is better than later. We’ll tell people for certain by the time they have all their baby teeth,” Hetland says.

Dr. Brent Holman, a pediatric dentist in Fargo, says his office is asked by parents multiple times when a child’s first visit should be scheduled.

“The reason you get different answers is not so much because of what’s considered the acceptable standard, it’s just what dental offices are comfortable with,” he says.

Some may view kids as more challenging to handle, he says.

Holman encourages visits by age 1, mainly so he can talk to the parents.

While he spends a couple minutes assessing the child’s risk of tooth decay, most of the visit is spent educating the parents on proper brushing techniques, diet issues, pacifier use, fluoride and what to do in a dental emergency, like a knocked-out tooth.

Dr. Travis Olson, a pediatric dentist with Pediatric Dentistry Ltd., says the age 1 guideline is especially important for first-time parents.

Each week, Olson performs surgery on 2- and 3-year-olds whose teeth are badly decayed because they were regularly put to bed with a bottle of milk or juice. The vast majority are first children, he says.

“I feel like those could be avoided if they were consulted, had an examination done, at a younger age,” Olson says.

Early visits also lead to more cooperative future cleanings, he says.

Olson works to make sure the first visit as pleasant as possible. The child brushes a stuffed animal’s teeth. A brief exam is done, often in the parent’s lap. He may quickly brush the child’s teeth avoiding any instruments that are noisy.

“The first appointment is more for parents,” Olson says, “educating the parents, what to look for, what to do.”

Studies show establishing a “dental home” early will reduce the cost of dental care later on, Holman says.

“If you get a kid that early, by the time they’re 4, it’s a big social event to come see us,” Holman says. “That’s giving them a lifetime of good positive dental attitudes if you do that really early as a parent.”

Check-up Checklist

Besides the dentist, when should kids have other regular check-ups?

The American Optometric Association (www.aoa.org) recommends that a child’s first eye assessment take place at 6 months of age.

Comprehensive eye exams should be conducted beginning at age 3, before a child enters school, and then every two years, unless otherwise advised by an optometrist.

An article at KidsHealth.org says most infants and preschoolers should have their eye health checked by a pediatrician or doctor. Premature newborns, those with a family history of eye problems and those with obvious eye irregularities should be examined by an eye doctor, the article says, and after age 5, screenings should be done routinely or after the appearance of symptoms like squinting or frequent headaches.

For routine physical exams, most children follow a set well-child exam schedule, with visits typically around 1, 2, 4, 6, 9, 12, 15, 18 and 24 months, and yearly after that.

Care tips for tiny teeth

Risk factors for tooth decay include medical history, diet, home care and genetics, says Dr. Brent Holman, a pediatric dentist.

Preventing decay is a three-legged stool, he says: brushing and flossing to remove plaque, fluoride to strengthen the teeth, and diet, specifically limiting the frequency of carbohydrate consumption.

The American Dental Association offers these tips on caring for children’s teeth:

• A child’s oral health begins in the womb, so pregnant women need to eat a balanced diet with the right amounts of proteins, vitamins A, C and D and minerals like calcium and phosphorous.

• Brush and floss your child’s teeth until he or she is at least 6 years old. Use a pea-sized drop of toothpaste for children 2 to 6. Use only water for children under 2, unless your dentist recommends toothpaste. Begin using floss when your child has two teeth that touch.

• Never put your baby to bed with a bottle or use a bottle as a pacifier.

• Sippy cups should only be used until around a child’s first birthday. Pacifiers should not be used after age 2, and finger or thumb sucking should end by age 4.

• Limit between-meal snacks. Offer water or healthy foods instead of sweet or sticky foods.


Early Childhood Dental Network: ecdn.wcif.org

American Academy of Pediatric Dentistry: www.aapd.org

Readers can reach Forum reporter Sherri Richards at (701) 241-5556