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When should a child first visit the dentist?

As we all know, children have baby (deciduous) teeth before the permanent teeth arrive. Some parents find a growth chart for teeth to be interesting. If you are interested, you can find a primary tooth development chart at or at many other sites on the web.

Suffice it to say that by about 6 months of age, a child usually will have the first tooth coming through the gums. The others will follow, and all 20 baby (primary or deciduous) teeth will have erupted by about 2-3 years old.

You might wonder if a young child can get a cavity. The answer to that is yes, if the child has the type of bacteria that causes tooth decay. There is really only one type of bacteria that has been found to cause tooth decay above the gum line. (As adults, when we have roots showing, there is another type that causes tooth decay on roots). The type of bacteria that causes tooth decay (Streptococcus mutans) is not found in a baby until it is transferred by someone who carries it. Nearly everyone carries Strep mutans. The bacteria spread very easily, and with today’s technology will never leave the mouth as long as the person lives. Once it is transferred to the mouth of a young child, it easily edges out harmless types of bacteria and will cause tooth decay (a cavity) in any teeth that are not properly cared for. Most children have the cavity causing bacteria in their mouths literally as soon as the teeth arrive. Because of this, a child should see the dentist or other oral health care professional with his or her regular care giver as soon as a tooth arrives for instruction on how to clean the child’s teeth and why.

Cleaning a baby’s teeth is really a simple matter. Anything that wipes off the soft white stuff (dental plaque) that forms on the tooth or teeth will do the job at this early stage. Many moms use a wet washcloth. Once there are a couple of teeth, a small toothbrush does a great job if used by someone with a reasonable amount of manual dexterity. This means junior cannot brush his or her own teeth. It will take years for a young person to be able to brush his or her own teeth. There are three surfaces of a tooth that a toothbrush can reach, the biting surface, the cheek side of the tooth, and the tongue side of the tooth. The hand has to be able to move in quite a precise way to reach each of these surfaces effectively. As a general rule of thumb, when a child can colour between the lines in a colouring book, he or she has the manual dexterity required to brush effectively and can do it if he or she understands the instructions on how to brush.

Someone should brush junior’s teeth at least twice every day. Sleep is hard on teeth because salivary flow is low when a person is sleeping. As a minimum, the teeth should be brushed just before bed and after waking up in the morning.

Some people are not concerned about baby teeth “because Johnnie is going to lose them all anyway”. While this is true, the baby teeth provide a road map for the adult teeth to follow in order to find the right place to erupt into in the young person’s mouth. Baby teeth also aid in learning proper speech patterns and in maintaining a pleasing appearance. As well, baby teeth that get a cavity can abscess just like adult teeth causing a lot of pain to the young person. An abscessed baby tooth can cause dark spots on an adult tooth erupting underneath it, or even can cause pieces to be lost from the forming adult tooth.

So, for the first child, the first dental visit should be when the first tooth comes in. For other children in the family, if you are already brushing the older children’s teeth and having good results (no cavities on the older children in the family), you may be able to wait until more of the baby teeth erupt. It is still a good idea to see the dentist by about 2 years old even if things have gone well with the older children in case there are any developmental problems with the teeth or other special concerns you should know about. Ask your dentist about what to do at home and how to do it for your children’s teeth.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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