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How should I prepare for my child's first dental appointment (and other baby teeth questions)?

Updated: Mar 18

The ADA recommends bringing your child to the dentist by their first tooth or their first birthday.

This may seem "too young" for a child to be in the dentist's office, but the fact is that the more often your child visits the dentist and has pleasant visits, the more likely they are to view future dental visits positively. You want this, trust me. We like to take things slowly so that we make visits as positive as possible and that we don't scare your child, but we can only do that if we start early.

According to a 2014 study by the AAPD, ~60% of children in the U.S. will have tooth decay by age 5. And the NIDCR reports that ~28% of children in the U.S. ages 2 to 5 develop at least one cavity. If the first time your child visits the dentist is for tooth pain at age 5, how can we expect them to feel comfortable when they return for a check-up and cleaning?  If your child arrives for their first visit and is diagnosed with numerous areas of decay, sometimes the best option is to put your child to sleep at the hospital and complete all of their necessary treatment in one visit. If your general dentist or pedodontist is comfortable working on your child with or without nitrous and can break up the treatment into multiple appointments, then this is usually the preferred option. However, children get tired and restless after multiple visits and at some point may even refuse treatment. So the only option may become a hospital visit. This may actually be easier for your child than multiple visits and it can hit the "reset" button for their next dental appointment which, if habits change, can be a simple check-up. It's great to have a reset, but not so great when you start thinking about booking your child an operation in the hospital.

Why not just leave the cavities?

Well, I'll go deeper into that in another blog but - put simply - the cavity will eventually get infected and/or painful and, in some cases, the infection can become fatal. At some point, your child will be in pain or the tooth will be infected and you'll have no other option but to seek treatment. Imagine how fun that visit will be for your child. Now imagine, instead, that your child comes in for a visit at age one. They're probably too young to allow the dentist to take a look inside, but some actually do! Even if they don't, they now know what the office looks like, as well as the inside of the dental operatory. They get to go for "a ride" on the cool dental chair, play with some buttons, and take home a sticker or a prize. And you get to talk with the dentist about the best way to care for your child's teeth, when to stop using a bottle or pacifier, what kinds of foods to include in the diet, when to use fluoridated toothpaste, how much toothpaste to use, and the list goes on. The appointment is as important for you as it is for them. Prevention is key! If you don't know how best to care for your child's teeth, your child can't receive the best care.

Why should I care if my child likes going to the dentist? Let me count the ways...

  1. pain

  2. infection (can be fatal)

  3. malnutrition

  4. trouble concentrating in school

  5. missing school due to pain or appointments

  6. abscesses affecting the development of adult teeth

  7. early tooth loss leading to space loss and more lengthy and expensive orthodontic treatment (that may not have been necessary otherwise)

  8. dark spots and holes visible when smiling and/or speaking

  9. and the list goes on... I'm sure you can think of a dozen other reasons that are good for your child. Now let's think selfishly for a second. Is it fun for you to take time off of work to drag your child to a dental appointment as they kick and scream the whole way? Is it fun for you to do that time and again until everything is finally restored? Is it fun for you to repeat yourself over and over every night about the importance of brushing and flossing? I think we all get where I'm going with this.

What should I tell my child about the appointment? Now that we have all of that other vital information out of the way, we can get to the main point of this blog: If you've never been somewhere, you don't know what to expect. You rely on people you trust who have been there to let you know how to feel about where you're going. If they say nothing, you may be fine or you may be nervous because you don't know what to expect. If they only say positive things, you go wherever they take you and you are excited to be there. I can't stress enough the importance of speaking positively to your child. Your child will mimic your feelings. If you're scared, they will sense that and become scared too.

Tell them... ...about how easy and cool their visit is going to be. That the dentist is just going to take a look inside their mouth and count their teeth so that they know how many they have. Stimulate the conversation by asking them how many teeth they think that they have. Tell them that the dentist might brush their teeth just like they do at home and maybe even use some cool and different toothbrush that tickles their teeth. Tell them that they'll get vitamins painted on their teeth to make them nice and strong! Tell them anything but negative things! We don't use the word "needle" around kids because we hide it, use topical gel, and inject slowly so that a needle from the dentist doesn't feel like they needle they remember from the pediatrician's office. If you use the word needle, then your child will associate it with shots at the doctor, and the experience for them with us really isn't the same. The doctor doesn't use topical gel or nitrous gas. Every dentist has their own tricks. We say the tooth is going to go to sleep with the sleepy juice, warn them about a potential "mosquito bite," have them close their eyes, and move slowly. The majority of the kids have no idea for years that they ever had a shot with us! I'm not kidding. The only ones who even know that needles exist in our office are the ones who were told so by their parents, relatives, or friends.

Prepare them... playing dentist at home. Go over the appointment I described above and let them "practice" at home so that they feel prepared. Children, like adults, are more relaxed when they are prepared. reading children's books about dental appointments that help with the preparation. Most characters have a book about their visit to the dentist and some even have videos online. Some favorite books include Doctor DeSoto by William Steig, Just Going to the Dentist by Mercer Mayer, and Dora Goes to the Dentist by Random House and Robert Roper. The Bernstein Bears and Curious George have their own books too. being a good role model and choosing positive behaviors yourself. If you show your children at home the importance of keeping their mouths clean, and model that by keeping yours clean, they are much more likely to listen to your direction. Make "brushing time" fun, play a video, sing a song, do what you can to make brushing at home fun. That way, when you prepare your child for the appointment you can say things like "the dentist will get to see how clean your teeth are and what a good job you do." Kids love positive reinforcement. getting them excited by being excited yourself (fake it if you have to). Set aside a special outfit, talk about how different and cool everything in the office is, set them up for a treat after the appointment, etc. If you're bringing your child at a young age, there's really nothing to be scared about. If they're coming in excited, they're going to have a great time and - often - they can't wait to come back again!

Just remember that negative words like "hurt, painful, needle..." - even if they are accompanied with words like "only, little bit, or small" - only serve to make your child nervous and uncomfortable. Better word choices include "funny, tingly, ticklish, and sleepy juice."

If you have any questions about what to say to your child or what their first experience will be like, just ask your dentist. We always want to make dental appointments as easy as possible. So many of our young patients have no fear and have had numerous fillings placed! We have broken the "fear of the dentist" cycle with so many kids, let your dentist or pedodontist do that for you and your family too!

Dr. Stephanie Stephan DDS, Dentist in Auburn Hills and Rochester Hills, Michigan 1590 Baldwin Avenue, Auburn Hills, Michigan 48340

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