The answer to this question is still not obvious to all parents of little ones. Unfortunately, it very often happens that a child comes to the dentist only when the teeth already hurt, purulent conditions occur and treatment has to be invasive. In this way the child very easily forms permanent and negative associations with the dentist in the brain, which stay with them for life. In today's post we present how to achieve full success – healthy, strong teeth in a child and the joy connected with visiting the dentist.
When to take a child to the dentist?
The first visit to the dentist should take place between the 6th and 12th month of the child's life. During this time the first milk teeth should appear. Such a visit is called an "adaptation visit" – time we devote to the child so that they see what the practice and the chair look like and what smells can be sensed around. During this meeting the dentist should evoke and reinforce only positive emotions and do nothing by force. The child sits with a parent, can watch a cartoon, and the dentist tries to look at the milk teeth and the mouth. This is extremely important, because they can recognise decay at a much earlier stage than a "big black hole", and additionally they talk with the parent about hygiene and dietary habits that may need modifying. After the visit the child gets a reward in the form of a sticker or a toy.
How to prepare a child for the first visit to the dentist?
The most important thing is to remain calm yourself and not pass on the negative emotions we may have because of our own dentophobia. One should be very careful with vocabulary: we do not use expressions like "it won't hurt", "don't be afraid", nor words like "drilling", "pulling out", "injection". We do not talk about our own difficult dental visits. One should have a positive attitude and tell the child: "we are going to the dentist to show your little teeth". Widely available cartoons on the internet about a visit to the dentist can prove very useful, e.g. Peppa Pig, which positively model children's attitude.
Do milk teeth need to be cared for?
Of course. Healthy milk teeth are the beginning of healthy permanent teeth. Milk teeth with decay can "infect" the permanent teeth, which will start to decay as soon as they erupt – and they are, after all, programmed to be with us for life. There is a myth that "milk teeth do not hurt". Unfortunately, in the case of deep defects or the formation of purulent conditions around dead teeth, the pain can turn out to be very great. Moreover, early extractions of milk molars lead to consequences in the form of orthodontic defects. Every focus of decay is a focus of inflammation, a disease that should not be underestimated, because it affects the whole body, lowering immunity and contributing even to a more frequent occurrence of upper respiratory tract infections.
Where does decay come from?
Decay is an infectious, transmissible disease. Under the influence of sugars from the diet, bacteria create acids that dissolve the hardest tissue of our body, i.e. the enamel, and then the dentine. This leads to consequences in the form of pulp inflammation. Every tooth with decay is an inflammatory state. The bacteria in a child's mouth are passed on by parents – through kisses or licking the dummy. Decay too is passed on not only from one tooth to another but also between people. More on the mechanism of the disease in the article "How a tooth gets sick".
How to care for a newborn's mouth?
After feeding, the gums should be wiped with a damp gauze, a clean cloth or a silicone brush. We do not use toothpaste, only water.
How to care for an infant's teeth?
From the moment the first tooth appears, one should start using a brush with a small head and soft bristles. Up to around the age of 3, when the child cannot yet spit out the paste, we rub a trace amount of it into the bristles of the brush. We use paste of up to 1000 ppm of fluoride. We carefully brush every surface of the tooth with circular movements. Excess paste can be wiped off. After the age of 3, when the child can already spit, we use paste in the amount of a pea. We always brush the teeth at least twice a day.
When can a child brush their teeth on their own?
It is assumed that a child does not yet have properly formed manual dexterity until they can clearly sign their first and last name on their own. When the muscles of the hand are not yet adequately developed, brushing the teeth will not be precise, which results in the formation of decay. If the parent wants to develop independence in the child, one should let the child brush their teeth and then carefully do the same oneself. To make this activity easier for everyone, it is worth buying an electric toothbrush – the models available on the market have various cartoon designs that encourage children to use them.
Which diet is recommended in the fight against decay?
Above all, one should limit sugars and snacking between meals, as well as sweet drinks – even juices, which may seem a "healthy alternative". Drink mainly water, and sweets can be given e.g. after dinner. With age, give the child hard foods that stimulate the secretion of saliva and the work of the chewing muscles. One should ensure an adequate amount of products rich in calcium and phosphorus. A good solution is preparing home-made sweets, in which traditional sugar can be replaced with xylitol, which protects the teeth against decay and helps restore the acid-base balance of the saliva. More in the article "Diet and tooth decay".
How to care for a child's teeth professionally?
It is worth bringing the child regularly for check-ups at the dentist. According to the guidelines of the Polish Society of Paediatric Dentistry, fluoride varnishing of the teeth can be carried out without age limits, at a frequency adjusted individually by the doctor. In addition, right after the eruption of permanent teeth with deep fissures and pits in which bacteria can accumulate, they should be sealed. Check-up visits take place according to recommendations – every 3 to 6 months. We describe the scope of measures in the article on preventive treatments.
Studies
-
Fluoride toothpastes of different concentrations for preventing dental caries
Walsh T., Worthington H. V., Glenny A. M., Marinho V. C. C., Jeroncic A. (2019) · Cochrane Database of Systematic Reviews · Cochrane systematic review and meta-analysis
Fluoride toothpastes prevent caries more effectively than non-fluoride ones, and higher concentrations usually give greater protection. In children, the amount and concentration should be matched to age and caries risk to limit swallowing.
-
Effect of Fluoride Varnish in Preventing Dental Caries of First Permanent Molars: A 24-Month Cluster Randomized Controlled Trial
Wang Z., Rong W., Xu T. (2022) · International Journal of Environmental Research and Public Health · cluster randomised controlled trial
A programme of regular fluoride varnish in children reduced the increase in caries compared with standard care. The effect was practical but did not replace daily brushing, diet control or check-ups.
-
A 4-week randomized controlled trial evaluating plaque and gingivitis effects of an electric toothbrush in a paediatric population
Davidovich E., Ccahuana-Vasquez R. A., Grender J., Timm H., Gonen H., Zini A. (2024) · International Journal of Paediatric Dentistry · randomised controlled trial
In children, an electric toothbrush improved plaque and gingival control more than the manual brush it was compared with. Regularity, brushing time and a carer's help with younger children still matter most.