Children's Oral Health-First Dental Visit


The First Dental Visit:

The American Academy of Pediatric Dentistry, Massachusetts Dental Society, American Dental Association, Massachusetts Academy of Pediatric Dentistry and the American Academy of Pediatrics all recommend the first dental visit at age one (within 6 months of the eruption of the first tooth and no later than the first birthday). 

The prevalence of tooth "well-visit" with a focus on parental education and decay prevention.  We will review home-care and brushing techniques, diet, and feeding recommendations.   

It is our objective to establilsh a "dental home," a place you can turn to for all of your family's dental needs.

Oral Development

The first tooth arrives at an average age of six to eight months but may take as long as 12 months to appear.  Generally the first tooth is a lower front tooth (central incisor) but it is not abnormal for the upper tooth to erupt first.  The primary first molars show themselves at around 1 year and the second molars at around 2 years.  By age 3 all twenty primary teeth are generally present.  Variations are common, and the earlier the teeth erupt, the greater the risk of tooth decay. 

Tooth Eruption

The first permanent teeth, again most commonly the lower incisors, erupt at approximately age 6, but they have been forming in the jaw since birth.  Certain medications (tetracycline in particular) when taken by a young child or by a nursing mother can discolor the developing permanent teeth.  Early childhood illness can  affect the developing permanent teeth.


Fussiness, irritability, sleeplessness and sore gums can accompany teething.  Some infants will exhibit a low fever, diarrhea, and increased salivation when teething.  Temperatures above 100.6 should be evaluated by a pediatrician for other causes. 

Sucking on a cold teething ring or washcloth can offer some relief to the teething child.  At times a non-aspirin pain reliever (Tylenol) may be helpful.

Home Care

The bacteria that cause tooth decay are transmitted by kissing, sharing utensils and by the infant putting his/her hands in Mother's mouth.  Reducing Mom's bacterial level by correcting any tooth decay and with good oral hygiene (toothbrushing and daily flossing) will help reduce the transfer of bacteria to Baby.  The children of parents with decayed teeth are more likely to suffer tooth decay.

Even before the first tooth erupts, parents should clean their infant's gums with a clean, moist washcloth or finger sponge.  Once teeth have made their appearance, a child toothbrush, with or without a small dab of non-fluoride toothpaste, should be used by the parents to brush the child's teeth twice daily.  Focus on the junction between the teeth and gums and on any grooved areas of the teeth.  The earlier brushing begins, the lower the likelihood of tooth decay.  There should be no food and only plain water to drink after night-time toothbrushing.  Parents should continue to brush the child's teeth until age eight.  When the child can write cursive letters, he is ready to brush himself.

Frequent sugar consumption, especially as related so sticky foods, juices and  soda drinks encourages bacterial growth and tooth decay.  If an infant is bottle-fed, the parent should hold the child while feeding as opposed to propping up the bottle or placing it in the crib.  Only formula or milk should be used in the bottle.  Sweetened liquids or juices in the bottle or in sippy cups will encourage decay and should be reserved for mealtime.  Milk and breast milk are high in carbohydrate content and can also induce decay.  Drinking or sipping between meals is best restricted to plain water.  A bottle at naptime or bedtime with anything in it other than water can contribute significantly to tooth decay.  It is best to discontinue bottle feeding at approximately 12 months.



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