Your Child’s First Check-Up

When should I bring my child in for their first check-up?

You should bring your child in to see a dentist when their first baby teeth erupt, so at about 6-8 months. The first visit is mainly for the baby to become familiar with the dental office, dentist, and staff. It also gives the dentist a chance to educate the caregivers about the baby’s oral hygiene – for example, how to clean the baby’s teeth and gums. Subsequent visits should be every 6 months. Again, each visit familiarizes the child with the dentist and the office, which teaches the child that dental visits are a fun routine, and not a “scary” experience.

When does my child need to start flossing?

You should be flossing your child’s teeth when they have teeth that touch together. Most children have baby-molars that touch. Some children also have baby-front teeth that touch together, so they will also require flossing.

Should I be using fluoride supplements for my child?

Fluoride supplements should only be used if prescribed by your dentist.

If your child has no cavities, it is recommended to brush their teeth with a very small pea-sized amount of toothpaste that contains fluoride.

Infant and Child Oral Health

Why are healthy baby teeth important?

Healthy baby teeth help children:

  • Eat food
  • Learn to talk
  • Smile and feel good about themselves
  • Hold spaces for adult teeth – some of the baby teeth remain in the mouth until the age of 12 or 13!

How can I help my child have healthy teeth?

Your baby’s teeth begin to form when you are pregnant. Eat foods with lots of calcium and vitamin D to help your baby grow strong teeth.

You can transfer bacteria that cause tooth decay to your baby’s mouth, so keep your own teeth clean and have them checked by a dentist.

Before teeth appear, use a clean, soft cloth to wipe your baby’s gums daily, beginning at birth.

When teeth appear, clean them twice a day, after breakfast and before bed, using a soft baby toothbrush. Use a tiny dab of fluoride toothpaste.

Start regular dental check-ups when your child is one-year-old.

Check regularly for white or brown spots on your baby’s teeth. Call your dentist right away if you see any spots.

What is early childhood tooth decay?

Many infants and toddlers have severe tooth decay that can:

  • Cause children pain
  • Destroy baby teeth
  • Create speech problems
  • Cause feeding problems
  • Make children feel bad about how they look

What causes tooth decay?

Tooth decay occurs when bacteria in the mouth use carbohydrates (sugars and starches) found in certain foods to make acid. This acid eats away at tooth enamel, causing pitted areas or holes. Young children are more at risk for cavities than adults because the enamel or outer surface of baby teeth is thinner than adult teeth. Tooth decay can begin in children as young as one year old.

How can I prevent tooth decay?

  • After age one, do not put children to bed with a bottle of anything but water.
  • Drinks like juice and milk have sugars that can cause tooth decay. Save these drinks for meals.
  • Give your child water to drink between meals.
  • If your baby needs to be soothed, try holding, rocking, reading, singing or rubbing your baby’s back, instead of giving a bottle.
  • Start children using a cup when they can sit up for meals and snacks.
  • Wean your baby from the bottle by 12 to 14 months.
  • Give children healthy snacks like fruit, cheese and vegetables, not foods that stick to teeth like cookies, candy or chips.
  • Start regular dental check-ups when your baby is one-year-old
  • Talk to a dental professional about the best way to brush and when to start flossing teeth.

Common Questions Parents Ask

Even if the baby teeth have cavities, what is the point of fixing them - won’t they fall out anyway?

Tooth decay is progressive and cavities get bigger when untreated. If this decay is not treated, the child may experience pain and could develop an infection such as an abscess. Children with decay may have problems eating, sleeping and focusing because of this pain and as a result, may not grow and develop normally. A child with visible decay may become self-conscious and not want to smile or laugh. There are further consequences for the next generation of teeth if the baby tooth is missing. As a result of the tooth loss, the teeth next to it can move into the space, blocking the adult tooth from coming in.

Marlene never eats any candy - How can she have 8 cavities?

Unfortunately, it is very common for a child to have cavities even while avoiding candy. Many people do not realize that other factors in the foods that their child eats has a major effect on their cavity-causing potential. Even naturally-occurring sugars can cause decay. Additionally, the frequency of eating or snacking, and the physical properties of the foods also affect the development of tooth decay.

Frequency — Each time your child eats, the mouth environment becomes more acidic, which is optimal for tooth decay to occur. Over a few hours, the acidic conditions in the mouth neutralize, which halts the tooth decay cycle. If your child is constantly snacking or having sweet drinks throughout the day, there is not enough time for the mouth to neutralize, and it constantly is in the perfect condition for tooth decay to form. These conditions are further enhanced if the foods and snacks are sweet. A good rule of thumb is to finish off a meal or snack with water to flush the mouth and start the neutralization process.

Physical Properties of Food — Foods that are sticky and sweet are the worst combination. Sticky foods adhere to teeth for long periods of time, which allows the bacteria that causes tooth decay more time to break down the tooth. Even non-candy snacks, like dried fruit, contain large amounts of natural sugars and stick to the teeth, creating the perfect environment for tooth decay.

Does breastfeeding have an impact on my baby’s oral health?

Like cow’s milk, breast milk contains sugar that can cause tooth decay if teeth are not cared for properly. To keep healthy, babies need nutrition and regular feeding times; however, using a bottle, breast or sippy cup of milk to sooth a child for an extended period of time may expose the child to ongoing cavity-causing liquids. Breastfeeding on demand during sleep time can be a risk factor for decay for the same reasons that bottle feeding can be a problem: there is less saliva in the mouth to wash away the liquid which pools in the mouth and causes multiple acid attacks.

What about soothers or pacifiers?

Soothers or pacifiers are sometimes given to infants during rest, sleep or other times when the baby has finished feeding but still wants to continue sucking. If you choose to give your baby a soother, here are a few tips:

  • Ensure that breastfeeding is well established.
  • Choose a soother that is the right size for your baby’s mouth.
  • Check the soother nipple often; if it is sticky, cracked or torn, throw it away.
  • Clean the soother with water. You can infect your child with germs that cause tooth decay if you put the baby’s soother in your own mouth to clean it.
  • Soothers dipped in honey or other sweet substances can cause tooth decay.
  • Soothers are not recommended once all of the baby teeth have grown in – usually at about three years of age.

My child is still using a pacifier – do you have any tips on how to help her quit?

Answer:  A technique called “Snip the Tip” is great for weaning your child off using their pacifier.  Each week, cut a few millimetres off the rubber tip of the pacifier, until there is no rubber tip left.  The cut end of the pacifier will be less comfortable in your child’s mouth, and as the tip gets shorter and shorter as time goes on, they will eventually have nothing left in their mouth and you will be able to take it away completely.

Jessica is still sucking her thumb – is this a problem?

Answer:  Yes and no.  It largely depends on the age of the child that is still sucking their thumb.

Children under 3-4 years of age — Thumb sucking is common, and normal, and in most cases it will stop spontaneously as the child matures.  If any changes to the teeth and/or bones around the mouth occur, it will likely resolve as the child continues to grow and develop.

An Anterior Open Bite. Notice how the back teeth are touching fully, but a significant gap remains between the upper and lower front teeth.

Children over 4 years of age — At this age, it is more important to break the habit, because the child is approaching the age where the permanent front teeth will begin to erupt.  It is likely that an open bite will develop.  An open bite occurs when a gap is present between the upper and lower front teeth, even when the back teeth are completely biting down.  This gap can cause problems with chewing food properly and speech development.  For example, when a person speaks, the sound of a letter such as “t” is conveyed by the tongue striking the back teeth. Thumb sucking at this age will actually cause the bones around the mouth to change shape to accommodate the thumb, and these changes are difficult to correct, even with braces. 

What should I expect when my child starts teething?

Teething is the process of the baby tooth erupting into the mouth and it can cause pain, fussiness and drooling. If your child is more upset or bad-tempered than usual, wants to chew on objects or has trouble sleeping, they may be teething. To help ease the pain, many babies like to chew on cold, clean face cloths or teething rings. You can also rub your child’s gums gently with a clean finger. Do not give your child teething cookies as most contain starch and sugar, which promote tooth decay.

Ashley has a new tooth coming in behind the front ones - Is this a problem?

This new tooth is probably not an issue; however, it is a possible indicator of crowding of the permanent teeth.

Nature will sometimes take care of this by itself. Usually, the teeth in the middle grow in behind the baby teeth, but when the baby teeth to the side fall out, the tongue helps to push them into the proper position. Also, the jaw will still grow in size, which makes more room for the teeth to straighten out.

When to “do something”: If the baby teeth are not loose at all, when the permanent teeth are fully erupted, or if a crossbite develops, then these are indications that intervention is needed.

Isn't 8 a little early for braces?

Eight years old is the perfect time to at least visit an orthodontist for a consult for treatment. Timing is often critical in certain situations. Orthodontic treatment does not always consist of braces. Because a child is growing so quickly, the first phase of orthodontic treatment may include retainers or headgear. These appliances can help manipulate the growth of your child’s mouth to expand and create more room for adult teeth to grow in, or even prevent the development of certain bite problems.

General Check-Up Questions

Does my child really need to come for check-ups every six months?

Yes – for children, every examination is a new patient exam because they are changing so quickly. In addition to looking for cavities (which can progress very quickly in baby teeth), we are also monitoring and looking for exfoliation and eruption of the baby and adult teeth, habits that may alter your child’s teeth development, skeletal discrepancies, and pathology. Regular, frequent visits also allow your child to become very familiar and comfortable with our dental office, and sets up a lifetime of positive, healthy attitudes and habits concerning dental visits and their oral health.

Will the shot hurt when you fill my child’s tooth?

Each child reacts differently to dental visits and procedures. Some children scream when we try to polish their teeth, while others don’t even flinch while we are giving the injection. At Kits Family Dental, we always prepare the child well before beginning the procedure by using appropriate, positive, non-scary terminology (“We are going to give you some sleepy juice,” instead of “We are going to give you a shot”). We are not being deceptive, but rather explaining things in neutral terms that they can understand. We also always use topical anesthetic to numb the tissue before the actual injection, we keep the needle away from the child’s view, and we talk and even sing for the duration of the injection, so that the child knows exactly how long it will take, and we use positive words to describe the different sensations that they will be feeling.

I really don't want my child to have x-rays taken; is it absolutely necessary?

Parents have the final say in their child’s treatment. However, you must understand that without radiographs, no examination is complete. X-rays allow detection of problems that cannot be found by simply looking in your child’s mouth. Potential problems that we are looking for are cysts, supernumerary or congenitally missing teeth, and, of course, cavities between the teeth. We follow the BC Dental Association guidelines regarding radiographs, which, at a minimum, require bitewings every other year. We never insist on annual x-rays if the caries rate and risk are low.