Guide to Your Child's First Visit to the Dentist

New parents often ask, "When should my child first see a dentist?". The American Academy of Pediatric Dentistry as well as pediatricians recommend the first visit of your child to the dentist to be at the time when his or her first baby tooth appears and no later by his or her 1st birthday. 

The American Academy of Pediatrics suggests that children who are at risk of early childhood cavities visit a pediatric dentist by age 1.

The idea of such early dental visits is still surprising to many new parents. Based on our actual experience, most parents bring in their children only after most of their baby teeth have erupted after 2 years of age. However, often cavities could have developed at that time.

To prevent early childhood cavities, parents first have to find out their child's risk of developing cavities. They also need to learn how to manage diet, hygiene and fluoride to prevent problems.
But cavities aren't all that parents need to learn about their child's dental health. The age 1 dental visit lets parents discuss:

• How to care for an infant's or toddler's mouth
• Proper use of fluoride
• Oral habits, including finger and thumb sucking
• Ways to prevent accidents that could damage the face and teeth
• Teething and milestones of development 

Also just as important, it is a good idea for your children to be exposed and become comfortable coming to the dental office, and we achieve that by making their visit to the dentist a fun and non-threatening experience. The benefits of a positive first time dental check-up will have lasting benefits in the future health of a child. For more information please visit Metro Dental Care Harvest Hills

Why do baby teeth needs to be filled?

You're right, baby teeth (also known as deciduous teeth) are really just temporary and most dentists would much rather not touch a fuzzy kid. However, we do have to think about the well being of the permanent (aka adult) teeth that is sitting right underneath that baby tooth waiting to come out.

Structure of baby teeth are much like adult teeth, except they are more fragile. If you look at the diagram from the last entry, the enamal and dentin are much thinner, they are also softer than adult teeth due to degree of mineralization. They have a much larger pulp in comparison. Given all the above, cavities progress much faster in baby teeth compare with adult teeth.

Once cavities (which is really a bacterial infection) reaches the pulp, it can have access to blood stream, or the infection can be localized forming an abcess at the base of the baby tooth which is right against where the adult tooth is. In cases like this you risk having discolouration, malformation etc on the adult teeth. It is hard to predict excatly how the infection will affect the adult tooth until eruption. So we would always fix baby teeth if cavity is shallow or in some cases extract them to prevent this from happening. Another remedy for baby teeth with deep cavity are partial/complete root canals.  It's not always done depending on the situation and also practice philosophy of your dentist. The main goal of this is to keep the baby teeth for as long as possible, so the space for the adult tooth is kept until eruption. It can also provide function (so your child can eat) and esthetic (if it's in the front). Ultimately all treatment goal is to aim to remove the infection which is the most important in any kind of therapy dentists provide.

Aside from this, you probably really do not want your child to be in pain or end up with a systemic infection from a tooth (very rare but possible).

Why do I need a filling?

I've always assumed that patients understand why we recommend fillings until a friend in nursing tells me, "they always say I need fillings even though nothing was hurting".

The answer is because of the structure of the tooth. If you look at the layers, from the outermost there's the enamel, then dentin followed by pulp.
1. Enamel: is mostly composed of mainly inorganic material and has no nerve innervation (so it has no feeling). Cavity starts in the enamel and progress to the deeper layer if left long enough.
2. Dentin: have some sensation because it is connected to the nerve in the pulp by tubules (there's no nerve here but it is connected to nerves in the pulp by some complex mechanism). The closer you are to the pulp the more sensitive it gets. If cavity is shallow and barely into dentin, you may not feel much. The closer it gets to the pulp the more pain and sensitivity you will feel.
3. Pulp: where blood supply and nerve is. It supplies some nutrient to the tooth.

On your exam with the dentist, we try to catch cavities that are still within enamel and dentin by radiographs (X-rays) and tactile sensation (that's the poking most people love). A cavity has to progress to a certain degree before it will show up on the x-rays. X-rays are also the only way for us to see between the teeth. If we do not catch cavities early, when it does reach the pulp, that's when we recommend a root canal or sometimes extraction but that's a topic for another day.

It's actually not a good thing to wait until it hurts to go see a dentist! When it starts to hurt it's usually too late! So try to visit your dentist at least once a year.

Oral health for pregnant women

It had been established that a mother's oral health can impact her baby's teeth and overall health in many ways. Gum diseases (gingivitis and periodontitis) and cavities are both caused by bacteria which effect more than your teeth and gum (just like having a skin infection or an urinary tract infection affected more than just the organ but the whole body). Pregnant women with gum disease have been linked to having an increased risk of preterm birth and low birth weight, which makes babies more susceptible to brain damage, vision, hearing and other problems. So here's a few tips as to how to maintain good oral hygiene during pregnancy

1. Brush and floss twice daily. Continue to use fluoride containing toothpaste

2. Chew Xylitol containing gum.

3. It is best to visit your dentist before you get pregnant especially if you require any work. If it is unavoidable, treatment during 2nd trimester is best during pregnancy. Cleaning is still recommended during pregnancy, best done during 2nd trimester as well. It is best to have all treatment done before you get pregnant just to avoid having an emergency which may require x-ray during your pregnancy. It is important to always advise your dentist that you maybe pregnant.

Having mentioned all that, it is entirely understandable that sometimes, especially during first trimester that nausea can be so severe that the thought of having a toothbrush or the taste of toothpaste makes you want to vomit. In that case I would focus on chewing Xylitol containing gum throughout the day, especially after meals. It is best, if you can only brush once a day that you do it at night rather than in the morning. Or if you have periods during the day when you are least nauseous, brush then. Try switching to a different brand of toothpaste if the one you are using makes you nauseous. If you have to skip brushing and flossing once in a while just to avoid having your meal coming back up, don't worry about it.

If you have any questions, please free feel to contact us here or at our website www.metrodentalcare.ca.


Sources:
AAPD Releases New Perinatal and Infant Oral Health Guidelines. American Academy of Pediatric Dentistry. Accessed: July 3, 2009.

Our mission...

Metro Dental Care is a family oriented dental practice that can provide comprehensive dental treatment to your whole family. Our general dentists can provide services in English, French, Cantonese and Mandarin. We will be opening in Summer 2011 in Harvest Hills, Calgary. Please check our blog often as we post update of our construction as well as dentistry related myth/facts that may be interesting to you.