I am going to go ahead and say it. I have no time or space for “mom guilt” in my life. Every single one of us is trying to do the best we can for those that we love most. And “mom-ing” is hard. Keep in mind that the American Academy of Pediatric Dentistry guidelines are just that: GUIDELINES. You will never receive judgement from me, no matter what age your child is when he or she visits the dentist. Got it? Great! I feel better now.
“In order to prevent dental problems, a child should see the dentist within six months of the eruption of their first tooth but no later than one year of age.”
I am thrilled you brought your child to the dentist by his first birthday because you would be in the 1% of parents who followed these guidelines. Therefore, 99% of moms (or dads if “dad guilt” is such a thing) feel terrible bringing their kids in for the first time and open the conversation with an apology at their tardiness and irresponsibility.
The reason I am writing this blog post is not to make you feel guilty or anxious. I am here to set the record straight. Similarly, to the “fluoridated toothpaste” blog, the guidelines have changed in recent years, so the answers are all over the place. The old recommendation was to see the dentist by age three and still, most general dentists prefer to go by this recommendation. Typically, any child under the age of three is going to cry when a stranger gets close to looking at his teeth. And yes, rarely are children under the age of three able to tolerate a typical dental cleaning. So, why do we have the visit at one year of age? Math and science.
Scientific studies have shown that it takes an average of six months for dental decay to work its way through the enamel (hard, white outer layer) of a baby tooth. And the average age for the first baby tooth to erupt is around six months of age, so mathematically, the first dental visit should be around one year of age to prevent cavities from forming. Prevention is the goal!
The first dental visit is as important for the parent as it is for the child. It is my job to educate parents on taking care of their child’s teeth at home, discuss the amount of fluoridated toothpaste they should be using, discuss the child’s diet and habits like thumb-sucking and pacifiers, evaluate for possible growth discrepancies, and make sure the child is on track with his tooth eruption.
Why are so few parents bringing their children to the dentist by age one? First and foremost, they did not know they were supposed to and secondly, FEAR. I am going to let you in on a little secret. I did not bring my oldest daughter into my office for her first cleaning until she was two years old. Why do you think that was? I was afraid she was going to throw a temper tantrum, and I was going to look like a bad mom in front of my staff and fellow doctors. I fell into the trap of fear.
Some parents fear that their child will be traumatized by starting early and crying for each cleaning appointment. Once again, the goal is prevention of cavities! I much prefer having a young child who is nervous for cleanings, where a problem can be prevented than have a well-behaved five-year-old that comes in for his first visit, and we find a cavity requiring an injection and using the handpiece. Children’s behavior will improve for cleanings. Children’s behavior does not typically improve with multiple dental filling appointments.
But one year old… really? When I started my pediatric dentistry residency, I thought the exact same thing. I was blessed to attend a residency where the patient population is one of the most underserved populations in the nation. Many of the patient families I served in south Florida lived on a level of poverty I did not know existed. Many came from other countries and did not speak English. All my patients were on some type of government assistance and almost all these children had mouths full of cavities.
One of the most vivid memories I have from my time there was when an 18-month old child came to our office, and we had to pull all four of her front teeth because they were decayed beyond saving. It broke my heart knowing that she would go six years with a gap where her teeth should be, she would have difficulty learning to say her T’s, and kids would notice and say things about her missing teeth. But I also knew that if I left those rotten teeth in her mouth, that she could get very sick and the infection could cause damage and might discolor her permanent teeth. I do not know whether she would still have all her front four teeth if she had come to see us at one year of age. Maybe the decay would have been where we could have put crowns on the teeth and corrected the dietary choices that caused her teeth to deteriorate. Maybe we still would have had to pull them. But I will always remember that little girl and impact she made on me. This is why I will advocate for having your child seen by the dentist by the age of one.