Paediatric dentistry: care for milk and permanent teeth
What does a paediatric dentist do?
A paediatric dentist carries out check-ups, prevention and treatment in growing patients: from the first milk teeth, through the period of tooth replacement, to the permanent dentition. Beyond treatment itself, an important part of the work is assessing caries risk, instructing the parent and child in hygiene, and observing how the bite develops.
Why do milk teeth need treatment?
Milk teeth take part in chewing and speech, and they hold the space for the permanent teeth. Caries develops in them faster than in permanent teeth, because the enamel and dentine are thinner. An untreated cavity can lead to pain, infection and the need to remove the tooth, and the early loss of a milk tooth may affect the position of the permanent teeth.
How does treating children differ from treating adults?
The difference lies not only in the size of the teeth and the choice of materials, but above all in how the visit is run. With a child, what counts is a shorter working time, clear language, predictable next steps and a pace matched to the child's reactions. Some findings, such as assessing the development of the bite, also call for attention to what is only just taking shape.
When should a child's first dental visit take place?
The first visit should take place within about six months of the first tooth erupting, and no later than the child's first birthday. Early contact with the surgery serves to assess caries risk, discuss hygiene and diet, and let the child get to know the practice while free of symptoms.
The first tooth and the first check-up
The first milk teeth usually appear at around six months of age. A short examination in an infant covers the erupting teeth, the mucosa and the way the parent cleans the teeth.
What if an older child has never been to a dentist?
Age is not an obstacle. With a child who has had no contact with a dental surgery we start with an acclimatisation visit and a check-up, and plan the scope of further treatment after the examination.
Why it is better not to wait for toothache
Caries in its early stage usually does not hurt. Pain appears later, when the lesion is already deeper and treatment more extensive. A visit prompted by pain is also harder for the child, because the first association with the surgery involves discomfort.
A child's first dental visit: how it goes
- A conversation with the parent: hygiene so far, diet, past illnesses, medication taken and any symptoms the child has.
- Examination of the mouth: milk and permanent teeth, mucosa, gums and erupting teeth.
- Assessment of caries risk based on the condition of the dentition, habits and the way the teeth are cleaned.
- Observation of the developing bite and of habits such as mouth breathing or dummy sucking.
- Hygiene instruction for parent and child: brushing technique, amount and type of toothpaste, flossing.
- A plan for what comes next: home recommendations, the procedures needed and the date of the next check-up.
If the child is calm and the situation calls for it, a simple procedure can be carried out during the same visit. This is not a rule, however, and depends on the child's readiness to cooperate.
An acclimatisation visit: what it involves
An acclimatisation visit is an appointment whose purpose is to make the child familiar with the surgery, not to carry out a procedure. The child gets to know the chair, the mirror, the lamp and the people who will be caring for them, and sees what the examination itself looks like.
What happens during an acclimatisation visit?
The child sits in the chair, we look at the teeth with a mirror, show the instruments and how they work, for example blowing air onto a hand. We announce each step before we take it.
Is any treatment carried out during acclimatisation?
Usually not. If the child responds well of their own accord, a short, simple element such as cleaning a tooth may be done. That is decided by how the visit goes, not by a plan set in advance.
How long does an acclimatisation visit take, and how many are needed?
Usually 15 to 30 minutes. For some children one appointment is enough; others need two or three before a full examination is possible.
What if the child will not allow the planned procedure?
We stop and return to what the child agrees to. The scope and pace of the visit are matched to what the child can manage, and if treatment is urgent we discuss other options with the parent.
How to prepare a child for the first visit
- Say what will happen, concretely and calmly: "The dentist will look at your teeth and show you how the chair works."
- Avoid reassurances such as "don't be afraid, nothing will hurt", and stories about your own bad experiences. Mentioning pain introduces a subject the child would not have raised.
- Do not use the visit as a punishment, and do not promise a reward conditional on "behaving well".
- Read a picture book about going to the dentist, or play at checking a toy's teeth.
- Choose a time when the child is rested, not just before a nap or after a long day.
- Bring a favourite cuddly toy and, if the child has their own toothbrush, that too.
- In the surgery, let the dentist lead the conversation. Brief, calm support helps more than explanations and questions during the examination.
You will find more practical advice on hygiene at home in our guide on how to care for your child's teeth.
A child afraid of the dentist: how we reduce stress
Fear of dental treatment is common in children and usually stems from an unfamiliar situation rather than from pain. That is why we work in stages and announce each step, instead of starting with the most difficult element.
- Gradual familiarisation: first a conversation and looking, then the examination, and treatment last.
- A scope of treatment matched to the level of cooperation on the day, with the option of stopping.
- No treatment by force: coercion entrenches fear and makes later visits harder.
- Where treatment is more extensive or fear is strong, the dentist may consider inhalation sedation with nitrous oxide, provided there are no contraindications.
- Postponing treatment when there is no urgent indication and the child is not ready. The exception is conditions that require prompt action, such as an infection.
Procedures we carry out in children
- Check-ups and diagnosis of the condition of the dentition, together with an assessment of caries risk.
- Prevention: hygiene instruction, fluoride application and fissure sealing.
- Treatment of caries in milk and permanent teeth, including coloured fillings.
- Pulp treatment in milk teeth, when the lesion reaches deeper.
- Extraction of milk teeth, if a tooth cannot be saved or does not come out on its own.
- Local anaesthesia chosen for the child's age and body weight, described in more detail on the page about anaesthesia at the dentist.
- Inhalation sedation with nitrous oxide, following medical qualification.
- Observation of the developing bite and referral for an orthodontic consultation where indicated.
The scope of procedures for a particular child is decided by the dentist after the examination, and more extensive treatment is divided into stages.
Treating caries in children
How to recognise the first signs?
Early caries may be visible as white, matt spots near the gums, and later as darker discolouration and cavities. Sensitivity to cold and sweet foods, or avoiding chewing on one side, can also be a sign.
What does treating a cavity in a milk tooth look like?
After anaesthesia the dentist removes the affected tissue and rebuilds the tooth with a filling. In children we choose materials and techniques that shorten the working time, and with larger cavities treatment may require two visits.
Can caries in milk teeth hurt?
Yes. A lesion close to the pulp causes pain, and an advanced infection may produce swelling and fever. An absence of pain therefore does not mean an absence of caries, which is why check-ups matter.
When is pulp treatment of a milk tooth needed?
When the lesion involves the pulp and the tooth should still remain in the arch. The scope of treatment is decided by the dentist after the examination and, if needed, after imaging.
Dental prevention in children
- Brushing twice a day: for younger children the parent does it, for older ones supervises. Adult supervision is usually needed until school age, and often longer.
- Fluoride toothpaste in an amount and concentration suited to the child's age. Recommendations differ for children under three and older ones, so it is worth confirming them with the dentist.
- Diet: what matters is not only the amount of sugar, but above all how often snacks and sweet drinks are consumed during the day.
- Fluoride application in the surgery as a supplement to home hygiene, repeated at intervals set by the dentist.
- Fissure sealing of molars, usually after they erupt, where the fissures are deep and hard to clean.
- Check-ups: often every six months, and more frequently where caries risk is higher. The schedule is set by the dentist.
First teeth, milk teeth and tooth replacement
The first milk teeth usually appear at around six months of age, and a child most often has the full milk dentition of 20 teeth at around the age of three. Replacement usually begins around the age of six, when the first incisors fall out and the first permanent molars erupt.
These timings are approximate and may differ from child to child. It is worth having the bite assessed when permanent teeth erupt in the wrong place, when a milk tooth does not fall out despite a visible permanent tooth, or when changes in the way of biting and breathing are apparent.
When a child needs to see a dentist promptly
- Severe or increasing toothache, including at night.
- Swelling of the gum, cheek or face.
- Injury to a tooth: fracture, displacement or loosening after a blow.
- A knocked-out permanent tooth: time matters. Do not clean the tooth with a brush, keep it in milk or saline and contact the surgery as soon as possible. A knocked-out milk tooth is not put back into the socket.
- Fever and signs of infection in the mouth.
In such situations call reception on 32 250 48 28 during opening hours and you will be told the earliest available appointment. The practice does not run a night service, so outside opening hours you may need to contact the out-of-hours health service or a hospital emergency department.
Paediatric dentistry at NL Clinic in Katowice
Children are looked after by dentists in our team who carry out conservative treatment and prevention in younger patients. The qualifications, scope of work and experience of each person are described on the page listing the dentists at NL Clinic, and reception will help choose a dentist and a type of visit at first contact.
- We run the visit at the child's pace, announcing each step.
- Imaging is carried out only where it is clinically justified.
- The parent is informed about the treatment plan, its stages and the alternatives before it begins.
- The practice is at ul. Obroki 68 in Katowice, near the Witosa and Obroki housing estates. Travel details and facilities are described on the contact and directions page.
Prices in paediatric dentistry
Prices for an acclimatisation visit, a check-up, prevention and the treatment of milk teeth are kept in one place, in the NL Clinic price list, so that no discrepancies arise between pages. The total cost depends on the scope of treatment agreed after the examination, the number of teeth requiring treatment and the imaging needed. The cost of more extensive treatment can be spread over instalments and other payment methods.
Frequently asked questions about a child's dental visit
At what age should a child first see a dentist?
Paediatric dentistry societies recommend the first visit within about six months of the first tooth erupting, and no later than the first birthday. An early check-up serves to assess caries risk and to instruct the parent in hygiene.
Should the first visit be an acclimatisation visit?
With very young children and children who are afraid of the surgery we often start with an acclimatisation visit. For a calm child, especially one with no symptoms, the first visit may include a full examination straight away.
Can I come to the dentist with an infant?
Yes. Examining an infant takes a short time, usually happens on the parent's lap and covers the erupting teeth and the mucosa.
Can a parent be present in the surgery?
Yes. We agree the rules for a parent's presence individually before treatment, because for some children having a parent close helps, while for others it makes cooperation harder.
What if the child will not open their mouth?
We do not treat a child by force. We limit the visit to what the child allows and plan another appointment. If treatment is urgent, we discuss other options with the parent, for example inhalation sedation.
How long does a child's first visit take?
Usually 20 to 30 minutes. The time depends on the child's age, their reactions and the scope of the examination.
Are teeth treated during the first visit?
Not always. If the child cooperates and the situation calls for it, a simple procedure can be carried out. More often the first visit covers the examination, an assessment of caries risk and a plan for what comes next.
Do milk teeth need to be treated?
Yes. Untreated caries in a milk tooth can cause pain and infection, and the early loss of such a tooth may affect the position of the permanent teeth and the development of the bite.
How often should a child see a dentist?
The dentist sets the intervals according to the child's age, the condition of the teeth and caries risk. Check-ups every six months are common, and more frequent ones where the risk is higher.
Can laughing gas be used in children?
Inhalation sedation with nitrous oxide is used in children following medical qualification and where cooperation allows breathing through a mask. The indications and limitations are explained by the dentist.
Book your child's dental visit in Katowice
NL Clinic, ul. Obroki 68, 40-833 Katowice. Telephone bookings Monday to Friday, 8:00–20:00. At first contact, tell us how old the child is and whether they have been to a dentist before, and reception will suggest either an acclimatisation visit or a check-up.
Published: 26 July 2026. The scope of services, the age of patients accepted and the availability of sedation are confirmed by the practice reception.