Caring for baby teeth: When should you start taking children to the dentist?.

Regular dental checkups are not commonly listed among most adults’ “favorite things,” but oral health is profoundly important. And it is best learned early. Michael Quigley, a dentist with Pediatric Dentistry and Orthodontics For All Ages in Fayetteville, is one of many local dentists who recommend establishing strong dental care routines for young children as early as possible.

Quigley, himself a new parent to 1-year-old Lilliana, recommends many of the traditional features of dental care for his youngest patients. As a certified pediatric dental specialist, he is also committed to making their initial forays into routine dental care as comfortable as possible.

Quigley has been with Pediatric Dentistry and Orthodontics since 2012. He recently spoke with Family Times about the importance of establishing good care habits. (This interview has been edited and condensed.)

It is commonly recommended that children have their first dental visit around age 2. What would warrant a visit before that?

Michael Quigley: Actually, the American Academy of Pediatric Dentistry recommends that the first dental visit be after the first tooth erupts and no later than 12 months of age. This allows the pediatric dentist an opportunity to provide oral hygiene counseling for parents, assess and provide counseling regarding the child’s fluoride exposure, provide dietary counseling related to oral health. The main goal of a first dental visit is prevention. It is much easier to prevent dental problems in children than it is to treat them once they’ve occurred.

What are you looking for during a typical first visit?

MQ: Typically, a complete clinical and oral examination is performed to assess the child’s growth and development and diagnose any possible pathology. This can be completed with the child in the dental chair alone, or on the parent’s lap.

Are dental X-rays required every year for young children?

MQ: The frequency of X-rays should be determined by the child’s history, clinical findings and susceptibility for oral disease. For caries detection, some high-risk patients may require X-rays more frequently than once per year.

Are pacifiers as bad for dental structure development as parents are often led to believe?

MQ: Non-nutritive sucking habits (pacifier or finger) are considered normal in infants and young children under 3 years of age. They can, however, have a significant negative impact on oral growth and development. To prevent this, it is recommended that parents help their children to stop sucking habits by age 36 months or earlier.

Some parents seem, perhaps, a little less concerned about the care of their children’s’ “baby teeth” than their “permanent teeth.”

MQ: Dental decay is the single most common chronic childhood disease. It is five times more common than asthma, four times more common than obesity, and 20 times more common than diabetes. It is transmissible: It can be passed from tooth to tooth and even from person to person.

Tooth decay is painful. Untreated decay can lead to infections and tooth loss. It compromises the child’s ability to eat well, sleep well, and function well at home and at school.

Baby teeth help guide the adult teeth into position. Early loss of baby teeth leads to problems during the transition from baby teeth to adult teeth, requiring orthodontic intervention and possibly even future removal of adult teeth.

I am a devoted flosser; my children are not. Reports released last year suggest I may be wasting my time encouraging them. What is your advice on this?

MQ: The bottom line is that dental decay and gum disease develop when plaque is allowed to build up on and in between teeth and along the gum line. Brushing and flossing have been shown to remove this plaque. I can usually tell instantly if the patient is a regular flosser based on the health of their gums. I floss daily, and I recommend my patients to do the same.

Are fluoride rinses necessary for most children?

MQ: Fluoride rinses are a great tool in the prevention and treatment of dental decay, but they may not be appropriate for all children. Very young children, who have not mastered the ability to “spit,” are at risk for swallowing fluoride. Children who are at a low caries risk and use fluoridated toothpaste may not need a fluoride rinse.

What about sealants?

MQ: Dental sealants are great, and not just for kids! I recommend them for patients of all ages who have teeth with deep pits/grooves. They cover up the grooves and prevent plaque, bacteria and food debris from accumulating. This prevents decay.

Children are being referred to orthodontic specialists at very young ages. What has prompted this?

MQ: Orthodontics not only straightens crooked teeth but can also guide the growth and development of the patient’s face and jaws. Many jaw growth discrepancies and asymmetries can be detected at a very early age. Pediatric dentists begin preliminary orthodontic evaluations as soon as the child has teeth. The American Association of Orthodontists recommends that children have their first orthodontic evaluation no later than 7 years of age.

What about the popularity of sport drinks? Some parents still consider them to be healthier alternatives to soda, but most contain a lot of sugar.

MQ: I have noticed a huge correlation between sports drinks and dental decay, but I will expand that to include fruit juice as well. Sugary beverages can be extremely damaging to teeth. They are very acidic and have high levels of simple sugars that the cavity-causing bacteria love. This combination leads to erosion of the tooth enamel and progression of decay. Most of my patients that experience rampant decay are routine juice/soda/sports drink consumers.

What is the most common piece of dental advice you give to your young patients, and their parents?

MQ: Brush a minimum of twice daily and floss at least once daily before bed. Limit simple sugar intake. Drink lots of water! It helps the mouth to recover from the acid attack experienced after eating a meal and helps to wash food debris out of your mouth. If you play a sport, wear a mouth guard—even if it’s not required. Most dental injuries occur in sports where mouth guards are not mandatory. Ask questions, and talk with your dentist. We really do want to help you!

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