The Canadian Academy of Pediatric Dentistry (CAPD), a provider of diagnostic, preventive, therapeutic and consultative expertise for children, recommends a dental assessment within 6 months of the eruption of your child’s first tooth or by one year of age.
Once baby teeth have erupted, they are susceptible to decay because formula, breast milk, cow's milk and fruit juices contain sugar that could damage teeth, especially when babies are given a bottle at bedtime. While breastfeeding at night may increase the risk of tooth decay, it is uncommon.
The objective is to see a dentist before a problem exists.
“Sometimes people assume that baby teeth are not important because they will eventually fall out and therefore not need safeguarding. This couldn’t be further from the truth,” says Shahrzad Sajadi, a dental hygienist in Toronto, Ontario.

“Baby teeth are as important for infants and children as permanent teeth are to adults because they save the space for the permanent teeth to erupt. More importantly, baby teeth are necessary during childhood for chewing and speech development, in addition to playing an integral role in a child’s self-esteem.,” says Sajadi.


Providing your child the opportunity to have a positive and trusting relationship with the dentist and dental hygienist at a very early age will benefit your child for years to come. Should dental treatment be required in the future, your child will be more willing and accepting and not as fearful of the unknown.
Important Information
If your child has a medical condition, i.e. asthma, allergies or heart problem and is taking medications, provide your paediatrician's contact information, should it be required.
Inform your dentist if your child has been using a pacifier or baby bottle for a prolonged period of time or has developed a thumbsucking habit because it could affect your child's teeth, bite and jaw.
Preparing your Child for the First Visit to the Dentist

If your child's first visit to the dentist is at the age of 2½ when children normally cut all their teeth, you may be presented with a different set of circumstances, but with careful planning and preparation, your visit may be a success.
- Practice brushing your child's teeth until it becomes a daily routine.
- Talk to your child about your trip together to the dentist's office. There are a few videos at the end of this article you may find helpful.
The Dental Hygienist will:
- help create a pleasant first visit and build a positive experience for your child.
- provide screening of the mouth including preventive measures to protect your child’s oral health.
- explain each step of the check up with your child and present the tools that will be used - replacing words like ‘dental exam’ and ‘instruments’ with more positive introductions like ‘counting teeth’ and ‘tooth tickler’.

- encourage your child to sit on the dental chair and have a chair ride.
- put on a mask and gloves and proceed to count your child’s teeth.
- put a protective bib and goggles on your child to protect his/her eyes while teeth are being polished with a rotary brush.
- show your child how the sucking straw works to remove extra toothpaste and saliva.
- debride teeth from soft and hard deposits along the gumline.
- apply a fluoride varnish or gel if necessary, for cavity prevention.
- explain how cavities harm teeth and how eating nutritious meals and drinking plenty of water will promote healthy teeth and gums.
- answer parents’ questions regarding stages of tooth development
- provide oral hygiene instructions on brushing technique and flossing, toothpaste use and any rinses, if necessary.
- offer tips on stopping pacifier use or thumb sucking.
- recommend a recall interval of 6 months for continuous care.
“Dental hygienists are experts at helping your child have a more positive experience,” says Sajadi.
However, if your child becomes upset or anxious during the first visit, the dentist or dental hygienist may recommend cutting the visit short and trying again at another time.

X-Rays & Cavities
Your dentist may prescribe x-rays to see if your child’s teeth are coming in properly or if decay exists between teeth.
Misaligned or crowded teeth may cause problems but in many cases, misaligned teeth straighten out as the child's jaw grows and the rest of the teeth come in.
Some primary (baby) teeth will be in your child's mouth until the age of 12 so if your child has a cavity, it is highly recommended that the tooth is fixed right away because it can affect the healthy growth of the second set of teeth.

If the cavity is not fixed, the decay will spread over time causing your child pain and discomfort. If the tooth needs to be removed, your child might require a space maintainer to prevent teeth on either side from moving into this space.
To protect permanent molars from cavities, sealants may be suggested.
Dental Sealants
Many teeth have deep grooves that toothbrush bristles might not reach during daily brushing. When dental sealant is applied to these surfaces, it makes the pitted and grooved areas of a tooth much easier to clean.
Back teeth have deep crevices where food and bacteria can become trapped or lodged and cause cavities. If your child has shallow crevices, dental sealants will not be required.
Applied with a small brush, sealants bond to the enamel of a tooth and a curing light is used to help the sealant dry faster.

Fluoride Treatments
- A topical gel or varnish fluoride treatment can be applied with a brush or placed in a tray that the child bites down on and holds for several minutes. After this treatment, your child should not eat or drink anything for 30 minutes to allow the fluoride to soak into the enamel.
- Fluoride in toothpaste is much less concentrated than a fluoride treatment your child would receive in a dentist's office.

Fluoride treatments repeated at 6-month intervals is one of the most effective measures in preventing tooth decay.
Practice Healthy Habits at Home
- Check your child's teeth periodically. Lift the upper and lower lips and look for dull, white spots or lines on the necks of teeth next to the gums. Sometimes darkened teeth can be a sign of tooth decay.
- Stop sucking habits as soon as possible because they lead to potential tooth misalignment or jaw malformation.
Choose a soft, kid-size toothbrush and replace it every three months. To promote a daily routine, let children choose their own toothbrush and toothpaste.
- Help your toddler brush his/her teeth after breakfast and before bedtime.
- Let your child brush his/her own teeth and then assist with the areas that require more attention.
- A thin smear of toothpaste is adequate fluoride and protection from fluorosis, a damaging oral condition caused by over ingestion of fluoride.
- If your child is unable to brush his/her teeth, teach your child to rinse his/her mouth with water to wash away food particles and sugar.
- Replace starchy and sugary snacks that stick to teeth and increase the risk of decay with fresh pieces of fruit, vegetables and cheese slices, which promote saliva flow.
- You may want to take your child to your own dentist but unless a sizable part of your dentist's practice is for children, it is not recommended.
A Smile Says it All

We project who we are through our words and our actions but more so through our facial reactions – especially when we are smiling and laughing. Smiles are contagious and disarming and ever so welcome.
“Poor oral health can negatively affect physical and psychological health and wellbeing,” says European Health Psychology Society in an article entitled, “Factors Influencing Children’s Tooth Brushing Intention: An Application of the Theory of Planned Behaviour’ written by Jenny Davison, Marian, McLaughlin and Melanie Giles.
“As a result, those with poor oral health are more likely to have reduced quality of life, experience pain and suffering, feel embarrassment and have low self-esteem, encounter problems with eating, chewing and smiling, and have sleepless nights.”
Children with poor oral health are often subjected to bullying which causes deep, negative emotional effects on their education and attendance at school and social functions.
“Adopting adequate tooth brushing habits during early childhood is therefore essential, especially as this is a crucial stage of child development when health-related behaviours that are practised routinely are more likely to be habitual,” states the research study.

COVID-19
COVID-19 is a rapidly, evolving pandemic that has had, and continues to have, a significant impact on dentistry. Prior to making a dental appointment for your child, ensure that the dentist’s office is adhering to COVID-19 regulations and safety measures. To locate a pediatric dentist and dental hygienist in Canada, please click on Canadian Academy of Pediatric Dentistry.
About the Author

Shahrzad Sajadi, RDH, HBA, a dental hygienist in Toronto, Ontario, Canada at dentalcorp is a Primary Health Care Provider and Oral Health Promoter with a focus on social determinants of oral health, inclusivity to oral care, research, statistics, public policy development and the diagnosis, treatment and prevention of oral diseases.
Resources
For additional information, Diligencia Investigative Reporting recommends the following websites:
Canadian Academy of Pediatric Dentistry – CAPD represents over 300 pediatric dentists across Canada and provides a directory of pediatric dentists in your town, city, province and territory.
“CAPD promotes and encourages excellence in pediatric dentistry and the achievement of optimal health for infants, children, adolescents and persons with special health care needs.”
Canadian Dental Association – Your Child’s First Visit
Canadian Paediatric Society – Good Oral Health Care for Children
College of Dental Hygienists of Ontario CDHO
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