The First Baby Visit and Toddler Dentistry

First Infant Dental Exam and Toddler Dentist Visits:
Babies should see a pediatric dentist by their first birthday or when their first tooth erupts, whichever comes first. The first few dental appointments are mainly to talk to parents and give oral hygiene tips for their babies. We sit the babies in a knee-to-knee position with a parent and complete an oral exam, cleaning with a toothbrush, and apply fluoride varnish. Toddlers will visit the dentist every 3 or 6 months, depending on how at risk they are for getting cavities.

Talking with your toddler about visiting the dentist using positive terms is important. Practicing saying “Ah” and opening wide is a great start. Stating to your child, “Nothing will hurt,” actually makes them think something will hurt. Instead, let them know they will be in a safe environment with you present. Parents are always allowed in our exam rooms, and we encourage anyone taking care of the child to be present for these exams. There are several books available that can help you talk to your child about their first dental visit.

The steps to a routine infant or toddler dentist visit are:
1. Parent Discussion: We will first discuss your child's pertinent medical or dental history. We then go over good oral habits to practice with your infant or toddler.

Good dental habits for your baby and toddler Include:
Nursing/Bottle Habits: Do not put them to bed with a bottle of anything other than water in their bottle (milk, chocolate milk, juice, etc.)
Feeding: Once teeth erupt, avoid nursing as often as they want and set a feeding schedule. They should have at least one hour between nursing sessions so that their oral environment becomes less prone to cavities.
Brush: Parents should help their kids brush their teeth. Toddlers may want to be independent and do this themselves. Allow these children to start brushing on their own, but finish brushing for them to ensure all teeth and surfaces have been adequately cleaned. If your child cannot tie their own shoes, then they do not have the manual dexterity to clean all of their teeth properly, and they need an adult’s help each time.

Floss: Most toddlers have spacing between their teeth, so you do not have to floss. However, if teeth erupt close together, they need to be flossed.
Avoid Sugar: Young children should not be given sugary foods throughout the day. Things like soda, lollipops, and sticky candy are unhealthy for their growing bodies and cause cavities to form very quickly on their teeth.

2. Oral Exam: We will place the child in an age-appropriate position that is most comfortable for them. For infants and toddlers, this is often either in the knee-to-knee position with the doctor or on a parent’s chest in the dental chair. During the exam, we are assessing several things, including:
- The number of teeth 
A full complement of primary (baby) teeth is 20, 10 on top and 10 on the bottom.
The first baby teeth to come in are typically the lower central incisors, and the average age for their eruption is 8 months.
- The quality of the teeth (do they have cavities)
Do they have cavities?
Do they have any other concerning abnormalities of tooth quality (see MIH)
- The health of the gums
Children rarely get serious gum disease, but they need to be taught to brush their gums gently. This helps cleanse the area where the gums meet the teeth (gumline), which is a very common place for food to stick. Food causes bacteria to eat, and where bacteria eat, they poop and cause cavities.
Gum health is also important to avoid painful areas of gingivitis. Kids with gingivitis will avoid brushing in these areas, causing more food to stick and more bacteria until the situation snowballs into a huge issue. Gently brushing areas of gums, even when they hurt or bleed a little, is beneficial and necessary to avoid larger issues.
- Any abnormalities of the soft tissue (lips, gums, tongue, cheek, frenums, throat, etc.)
Frenums are the strings of tissue under the tongue or lips. The most common to have an issue is the lingual frenum, which attaches the tongue to the floor of the mouth, and the labial frenum, which attaches the lips to the gingiva. Young children commonly have a tongue-tie or lip tie that can affect their feeding efficiency, speech development, or sleep quality.
- We also assess craniofacial development for abnormalities, such as unequal jaw growth from left to right or top to bottom.

3. Brush and Varnish: We will thoroughly brush your child’s teeth with a smear of fluoride toothpaste and apply a topical fluoride treatment. The fluoride varnish treatment will help remineralize your child’s teeth and make them less susceptible to cavities. We follow the American Dental Association’s recommendations for a fluoride varnish treatment every 6 months for all adults and children.

4. Anticipatory Guidance: Lastly, we will give you some insight into your child’s oral development in the near future.
New teeth to expect
Age-appropriate milestones and how they affect their teeth
Tips on how to prevent cavities

Board-certified pediatric dentists are the experts in a young child’s oral health care.  They follow the guidelines set out by the American Academy of Pediatric Dentistry (AAPD), which is a comprehensive set of research-based fundamentals in modern pediatric dentistry.

References:

American Academy of Pediatric Dentistry. Overview. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023:7-9.