First visit by dentist and dental hygienist

‘I’ve watched so many programmes about getting the baby ready for my first visit to different doctors, but if I’m honest, I haven’t seen and heard how to prepare the little one for a dental appointment then. Maybe someone can suggest something, because I’ve already panicked to see a hole in my daughter’s tooth … Maybe there’s an amazing dentist who can’t bring fear into a child and fix his teeth through a game?” Such and other questions from concerned parents can be read on Internet portals. But what’s it like? When is the first time a child has to be brought to a dentist and dental hygienist, what are they doing on these first visits? Dr Jūlija Kalniņa, a dentist of the children’s Department of the Stomatology Institute of Rīga Stradiņš University, explains this as part of the “I have Clean teeth” campaign of the Ministry of Health and the Centre for disease Prevention and Control.

When does a child need to go to a dentist and dental hygienist for the first time?

At about six months old. For the first time, it is recommended that the child be taken to a dentist at approximately six months of age, or when the first tooth has dissolved. The baby’s first visit to the dentist is more for parents, as the dentist will tell how to tend the infant’s teeth, as well as discuss with parents questions about the impact the infant’s diet has on dental and oral health.

At the age of year and a half. During this time, a dentist can see a so-called bottle carcass (if a child under 71 months old has at least one cariosa, an uprooted or sealed tooth) and prevent it in a timely manner. The reasons for caries are most often long-term, if not continuous, feeding the baby overnight with breast milk or from a bottle. The first teeth to start faulting are the front teeth of the upper jaw from the inside, so parents need to regularly look at teeth from all sides. Preventative dentistry is recommended to visit twice a year.

Aged two and two and a half. At this age, the child should be taken prophylactically not only to a dentist, but also started to be brought to a dental hygienist – between two and a half and three years old, or at the moment when the child has a full bite of milk and the child is ready to become acquainted with another dental hygienist, in this case a dental hygienist.

At the age of three. At this age, most children already have a full bite of milk – all milk teeth have hatched, totalling 20. The moment all the milk teeth are in your mouth, a dentist can see if a child has a bite problem when assessing a child’s teeth. The sooner bite problems are identified, the sooner a dentist can predict when to start bite regulation and send to an orthodont.

How can parents prepare a child for these visits?

For one thing, it’s very important to bring a child to a first scan with a dentist to make friends with a specialist rather than giving acute help to a sore tooth. The first visit has to be exciting and fun. Parents need to explain to the child exactly what will happen in the dentist’s office. If the parents themselves have dentist fears, don’t have to pass those unpleasant feelings on to the child. Parental support on the first visits will also give the child a positive experience on future visits.

It’s very helpful to look at some cognitive material with your child about teeth, their grooming, etc. For example, you can use materials available on the www.t renizobi. LV website, including watching the animated film “I have Clean teeth.” Role-playing games will also bring fun: dentist – patient. Let the child say what he fears about these visits. A big mistake is to promise a child that “you won’t be done anything,” “you won’t be hurt by anything,” and make other such promises. Seeing your teeth is an action too, so “will do it!” Young children don’t often distinguish pain from pressure, so even a stronger touch can be perceived as pain. Let your child take some favorite toy, soft item or blanket with you for a sense of safety. Explain the words he might hear during a visit, such as caries, gums, X-rays, etc. Don’t tell your child your childhood negative experiences going to a dentist. Don’t give your child your fear. Be careful in your statements.

What does a dentist and dental hygienist do on their first visits?

The first visit should be informative and as short as possible, efforts should be made to avoid major manipulation. In a friendly environment, a child should be introduced to a dentist, no unpleasant treatment, tooth pulling, etc. It’s best to pick a time when a child is alert and relaxed rather than exhausted or squeezed. Depending on the child’s age and comfort level, parents can be asked to keep the child on their lap or wait in the waiting room for a better contact between the child and the dentist.

During reception, the dentist will inspect the baby’s oral cavity: check teeth, gum condition, bite. The dentist will also advise on dental care, caries prevention and answer questions of interest to parents. You can discuss with your dentist how best to prevent tooth decay, improve oral hygiene, prevent a child’s harmful habits such as sucking a finger, discuss how to reduce harmful dietary habits, etc.

In turn, during a visit to a dental hygienist, the child will be brushed of his teeth and fluoride-containing preparations (applied) for protection against caries will be applied. Actions taken at a hygienist can be seen as a way to get a child used not to fear the manipulation done at a dentist’s. Some children need multiple appointments with a dental hygienist to be able to prepare for a visit to a dentist and repair their teeth.

It should be remembered that parents are responsible for the oral health of their child. For the child to feel better, he needs to explain that the dentist is a friend who can help keep his teeth healthy. A child with a dental appointment should not be scared.

How do you choose a dentist and hygienist for your child?

Visit certified child dentists. You can also choose the dentist you visit yourself. Above all, the child should have good contact with the treating physician and hygienist.

Another determining factor in the choice of dentist and hygienist is finance. In Latvia, State-paid services are available to patients whose family doctor is in contractual relations with the national Health Service (SND) – within the scope of the financing granted to children under 18 years of age, the national Health Service shall pay for:

• professional dental hygiene 1 once a year (2 times at the age of 7, 11 and 12);
• dentistry (except silaneous application and orthodontics);
• counseling orthodontics 1 once a year.

In cases of under-funding, long queues are formed for these services, so frequent visits to a dentist are expected for several months.

Are there often situations where a child is taken to a dentist and never opens his mouth?

Yes, and there could be different explanations for that. Perhaps the child’s first visit to the dentist has been unfortunate, painful and full of negative memories. The child remembers all this and no more mouth open never. Another reason might be under-prepared for this meeting with a dentist. The kid doesn’t know what’s going to happen, what’s going to do to him, isn’t it painful, etc. It all creates a lot of fear and anxiety.

In cases where collaboration with the child is not possible, the only way to repair teeth is through general narcosis or sedation using nitrous oxide gas (laughing gas).

There are cases where parents bring the baby to the dentist already with a hole and when the tooth hurts …

Milk teeth matter as much as permanent teeth. Milk teeth need fixing too. Many parents only notice holes in their teeth when they are already painful.

Most often, this occurs when a dentist and dental hygienist are visited intermittently. In this case, the first experience turns out to be unpleasant. It’s much easier to prevent or repair a small hole than it is already deep and painful.

Remember that once the first tooth has emerged, a child should start brushing their teeth with a toothbrush and fluoride-containing toothpaste. Until the age of 8, even if a child has already learned to brush their teeth themselves, parents are advised to check the cleanliness of their teeth and also clean the child’s teeth if necessary, thus noticing even minor changes in them.

How do you encourage a child to be responsible for their teeth and visit a dentist and dental hygienist regularly – with delight and satisfaction – to check that their teeth are healthy and clean?

Parents are the best role model for their children. Give your children as much knowledge and skill as possible about grooming your teeth. Praise their efforts to keep their teeth healthy. Children take an example from parents and notice what parents do rather than say. Clean your teeth together so the child learns from you! Let caring for your teeth be an integral part of everyday life for you. Love and look after your children!

The campaign on children’s oral and dental health, “I have Clean teeth,” is being organised by the Department of Health and the Centre for disease Prevention and Control.