Guest blog post by Dr. Daniya Pervaiz
Many adults have a fear of visiting the dentist, let alone taking their child to one. April is Oral Health Month in Canada, and all the more reason to address some of the most common paediatric dental inquiries I get as both a dentist and a mother.
Your baby’s teeth start forming in utero, and in rare cases your baby might be born with what is called a ‘natal’ tooth. By definition, a natal tooth, is one which appears within the first 30 days of a newborn’s life. On average, a baby’s first tooth, which is usually the lower central incisor, will erupt around the 4-6 month range. Your child’s first adult tooth, the first molar, will likely appear around age 4 to 6. However, genetics play a big role so you, the parents, are a good indicator of when your baby will cut their first tooth. My own daughter did not have a single baby tooth until after her first birthday. Often, delayed eruption is a sign of other genetic disorders, so if you are concerned do see your dentist.
Image Source: American Dental Association
There is a difference in opinion among dentists about when to introduce fluoridated toothpaste to your child. Firstly, fluoride is a mineral which helps prevent cavitation of teeth by helping remineralize the top enamel layer. Tap water in Canada is fluoridated to a regulated level, for this exact purpose. Most children’s first-stage toothpastes are not fluoridated as they do not have the ability to spit without swallowing. Excess exposure to fluoride, can result in fluorosis, which is a change in appearance of the teeth. Fluorosis, most commonly and in its mildest form, will present as small white specks on the enamel. Personally, I would wait to introduce fluoridated toothpaste until your child is able to spit instead of swallowing the paste, which is a skill I am still struggling to teach my 2.5 year old daughter! However, if your child’s first dental visit results in concerns about cavities then I would go ahead and use a rice-grain sized amount of fluoridated toothpaste while helping your child brush. Usually, by age 3 a child should be ready for fluoridated toothpaste. It is important to help your child with toothbrushing until at least age 6.
Example of fluorosis.
Image Source: National Institute of Dental and Craniofacial Research
FIRST DENTAL VISIT
The Canadian Dental Association recommends that your child’s first dental visit should be within six months of eruption of their first tooth, or by their first birthday; whichever comes first. The purpose of the first visit is mainly for the dentist to identify any problems with the teeth and more importantly to familiarize your child with their “dental home.” You and your children will be seeing the dentist on a 6 to 12 month interval for the rest of their lives and the first visit will set the stage for this.
I see many anxious adult patients in my practice, who have developed a fear of the dentist from a very young age. Bringing your child in from an early age when minimal treatment is required will allow them to be more comfortable for future visits which may be more procedure-based. Prior to your child’s first dental visit, it is important to avoid using any phrases with the words “pain” or “fear”, even in the negatory. I prepared my daughter for her first visit at age 1 by using positive words to incite excitement beforehand as well as letting her watch her father get a cleaning. This helped peak her curiosity to try something new.
Now this is a first I hope you do not have to experience with your child, however, this is an important point to discuss as a history of cavities in childhood is one of the main indicators of caries in adulthood. Early childhood tooth decay, also known as “baby bottle tooth decay” occurs when your child’s teeth have a prolonged exposure to sugary liquids, most likely due to pooling of milk in the mouth from a bottle. It is important to note that this pattern of tooth decay is also common in breast-fed babies who have a tendency to nurse through the night. If you note any brown or black spots on your child’s teeth, it is important to have them checked immediately. Preventative efforts that can be implemented include not letting your child fall asleep with a bottle of milk, switching your child to a cup by their first birthday, brushing and flossing regularly, and of course regular dental visits!
Image Source: California Dental Association
Dr. Daniya Pervaiz is a general dentist based in downtown Toronto. She graduated from Western University’s Schulich School of Medicine & Dentistry in 2013 and has been practicing since. She is also a busy mom to an energetic 2.5 year old daughter and a newborn 2 month old son.