The American Academy of Pediatric Dentistry (AAPD) suggests that parents should make an initial “well-baby” appointment with a dentist approximately six months after the emergence of the first tooth, or no later than the child’s first birthday.

Although this may seem surprisingly early, the incidence of infant and toddler tooth decay has been rising in recent years.  Tooth decay and early cavities can be exceptionally painful if they are not attended to immediately, and can also set the scene for poor oral health in later childhood.

What potential dental problems can babies experience?

A baby is at risk for tooth decay as soon as the first tooth emerges.  During the first visit, the hygienist will help parents implement a preventative strategy to protect the teeth from harm, and also demonstrate how infant teeth should be brushed and flossed.

In particular, infants who drink breast milk, juice, baby formula, soda, or sweetened water from a baby bottle or sippy cup are at high-risk for early childhood caries (cavities).  To counteract this threat, the pediatric dentist discourages parents from filling cups with sugary fluids, dipping pacifiers in honey, and transmitting oral bacteria to the child via shared spoons and/or cleaning pacifiers in their own mouths.

Importantly, the hygienist and dentist can also assess and balance the infant’s fluoride intake.  Too much fluoride ingestion between the ages of one and four years old may lead to a condition known as fluorosis in later childhood.  Conversely, too little fluoride may render young tooth enamel susceptible to tooth decay.

What happens during the first visit?

During the initial visit, the hygienist and dentist will advise parents to implement a good oral care routine, ask questions about the child’s oral habits, and examine the child’s emerging teeth. 

What questions may the  dentist ask during the first visit?

The dentist will ask questions about current oral care, diet, the general health of the child, the child’s oral habits, and the child’s current fluoride intake.

Once answers to these questions have been established, the dentist can advise parents on the following issues:

• Accident prevention.
• Adding xylitol and fluoride to the infant’s diet.
• Choosing an ADA approved, non-fluoridated brand of toothpaste for the infant.
• Choosing an appropriate toothbrush.
• Choosing an orthodontically correct pacifier.
• Correct positioning of the head during tooth brushing.
• Easing the transition from sippy cup to adult-sized drinking glasses (12-14 months).
• Eliminating fussing during the oral care routine.
• Establishing a drink-free bedtime routine.
• Maintaining good dietary habits.
• Minimizing the risk of tooth decay.
• Reducing sugar and carbohydrate intake.
• Teething and developmental milestones.

If you have further questions or concerns about the timing or nature of your child’s first oral checkup, please ask.