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The Good, the Bad, and the Ugly: A Child’s First Dental Visit

The Good, the Bad, and the Ugly: A Child’s First Dental Visit

I am about to say something shocking. 

The American Academy of Pediatric Dentistry recommends a child see his dentist by the age of one. 

You may be thinking, “My child barely has teeth!” or, “How is he supposed to behave for a cleaning at the age of one?” These are valid concerns, but I hope you will give me the chance to explain this guideline and why the first visit has been recommended at such an early age. At the first dental visit, I like to discuss fluoride use, diet, home care, and non-nutritive sucking habits with the parents. 

A decade or so ago, the first dental visit was recommended by the age of three, but it changed to age one because many young children suffered from a condition called “baby bottle caries,” which occurs from frequent nighttime feedings or from putting a child to bed with a bottle. When we sleep, our saliva production decreases, and the teeth are more prone to developing cavities. Baby bottle caries affects the top front four teeth and can rapidly deem them non-restorable. Someone much smarter than myself determined through scientific research that it takes on average six months for a cavity to form and since the first tooth typically erupts somewhere around six months of age, in order to prevent cavities from forming, the first dental visit is recommended by the age of one.

When the baby’s first tooth erupts, it is important to begin regular cleaning of the tooth. Fluoride toothpaste has been shown to prevent dental decay and is safe in children as young as six months when used at the appropriate amounts. For a child younger than three years old, a smear or rice-sized amount can be used. When a child turns three years old, you can progress to a pea-sized amount of fluoridated toothpaste. By age six, children are not prone to ingesting too much fluoride due in most part to the child’s inexplicable ability to spit.

Many of the parents I encounter know that highly processed, sugary foods are not beneficial for teeth, but I have seen an increase in cavities in my patients that eat gummy vitamins and snack frequently on dried fruit that can stick to the teeth for extended periods of time. When a child is young, it is not uncommon for snacks and beverages to be provided to them throughout the day. Each time anything is ingested, the oral cavity becomes acidic, and our saliva struggles to return our mouth to a neutral state. If the oral cavity remains in an acidic state, i.e., with sipping on any beverage besides water throughout the day, cavities are more likely to develop. For this reason, I recommend keeping milk, juices, and sodas to mealtimes and drinking water in between meals.  

It is important to begin cleaning your baby’s teeth when the first tooth begins to erupt. One reason is to prevent cavities, but the other reason is to help your child grow accustomed to the teeth-cleaning process. It is much more difficult to get started later. The AAPD recommends a child’s teeth be brushed twice a day, after breakfast and before bedtime.  Once you notice your child’s teeth start to touch, flossing becomes important. Cavities can develop between the baby molars, and the decay process can be quite rapid if not careful.  

Another issue we need to cover is sucking a pacifier and thumb sucking. The AAPD recommends stopping these habits by age one. I am a mom of two avid thumb suckers, and I do understand choosing your battles. My goal is simply to inform the parents of the guideline and work toward an end goal. After all, we are all parents who love our children and are just trying to do the best we can. And that is okay!

Emilee Peeples Milling received her doctorate from the University of Mississippi School of Dentistry in 2014 and graduated from the University of Florida. Following graduation, she returned to her hometown Jackson to join Young and Milling Pediatric Dentistry. Find her at or visit

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