The American Academy of Pediatric Dentistry (AAPD) suggests that parents should make an initial “well-baby” appointment with dentist approximately six months after the emergence of the first tooth, or no later than the child’s first birthday.

Although this may seem surprisingly early, the incidence of infant and toddler tooth decay has been rising in recent years.  Tooth decay and early cavities can be exceptionally painful if they are not attended to immediately, and can also set the scene for poor oral health in later childhood.

The pediatric dental office should be viewed as an important source of information, help, and guidance.  Oftentimes, the pediatric dental office can provide strategies for eliminating unwanted oral habits (for example, pacifier use and thumb sucking) and can also help parents in establishing a sound daily oral routine for the child.

What potential dental problems can babies experience?

A baby is at risk for tooth decay as soon as the first tooth emerges.  During the first visit, the dentist will help parents implement a preventative strategy to protect the teeth from harm, and also demonstrate how infant teeth should be brushed and flossed.

In particular, infants who drink breast milk, juice, baby formula, soda, or sweetened water from a baby bottle or sippy cup are at high-risk for early childhood caries (cavities).  To counteract this threat, the dentist discourages parents from filling cups with sugary fluids, dipping pacifiers in honey, and transmitting oral bacteria to the child via shared spoons and/or cleaning pacifiers in their own mouths.

Importantly, the dentist can also assess and balance the infant’s fluoride intake.  Too much fluoride ingestion between the ages of one and four years old may lead to a condition known as fluorosis in later childhood.  Conversely, too little fluoride may render young tooth enamel susceptible to tooth decay.

What happens during the first visit?

During the initial visit, the dentist will advise parents to implement a good oral care routine, ask questions about the child’s oral habits, and examine the child’s emerging teeth.  If the infant’s or child's teeth appear stained, the dentist may clean them.  Oftentimes, a topical fluoride treatment will be applied to the teeth after this cleaning.

What questions may the dentist ask during the first visit?

The dentist will ask questions about the child's medical history, oral care, diet, the general health of the child, the child’s oral habits, and the child’s current fluoride intake.

Once answers to these questions have been established, the pediatric dentist can advise parents on the following issues:

• Accident prevention
• Choosing an ADA approved toothpaste.
• Choosing an appropriate toothbrush.
• Correct positioning of the head during tooth brushing.
• Easing the transition from sippy cup to adult-sized drinking glasses (12-14 months).
• Eliminating fussing during the oral care routine.
• Establishing a drink-free bedtime routine.
• Maintaining good dietary habits.
• Minimizing the risk of tooth decay.
• Reducing sugar and carbohydrate intake.
• Teething and developmental milestones.

If you have further questions or concerns about the timing or nature of your child’s first oral checkup, please ask your dentist.