The Complete Parent’s Guide to Children’s Dental Care

Many parents are shocked when told that their child should have their first dental visit—on the teeth that they will inevitably lose in just a few short years—before their first birthday. Yet this is exactly what the American Academy of Pediatric Dentistry recommends. Statistics show that 1 in 4 children in the United States will develop cavities by the time that they are four years old. Some children will even have cavities by the age of two. Although these cavities afflict baby teeth—the kind that are gradually shed in favor of stronger (and permanent) adult teeth—such early dental caries are an indication of a child’s overall cavity risk. By the age of 1, your child will show the dental characteristics that signal his or her risk of developing cavities. That’s why an early childhood dental appointment is so important. A dentist will be able to assess your child’s risk—before there are any problems—and advise you on appropriate steps to take to minimize those risks.

Most training programs last from nine months to around two years, resulting in a certificate, diploma, or associate’s degree. Training can be found at dental assistant schools including junior colleges, career schools and some universities.

Value of Your Child’s First Dental Visit

But assessing your child’s risk of cavities is not the function of a dentist on this first office visit. Indeed, what happens on your child’s first dental visit can help—or hinder—proper dental care for your child. Whether such a visit helps or hinders your child is totally up to you and the quality of the questions that you ask the dentist. This visit is an opportunity for you to learn how to care for your child’s teeth. To that end, you have the option of asking the dentist such questions as:

  • Proper diet for a child’s future dental health
  • Proper brushing methods
  • When, and if, to floss
  • Proper use and application of fluoride
  • How habits such as thumb sucking may impact the teeth
  • How to avoid dental accident
  • And… The stages of your child’s teeth.

Stages of a Child’s Teeth

There are four main stages of a your child’s teeth.

  • About 6 weeks old, as a fetus, the foundation and structure of the teeth begin to form.
  • At 3 to 4 months in the womb, the hard tissue that incases the teeth develops
  • After birth (usually between 4 and 12 months old) all of the baby teeth have broken through the gums.
  • The baby teeth are “lost” to make way for the adult teeth.
  • Arrival of the Baby Teeth

Although all children are different, the following represents the common order for the arrival of the baby teeth.

The central incisor, on the lower jaw, is usually the first baby tooth to appear. (This is the middle front tooth.)

  • The second central incisor is usually next, popping up beside the first one.
  • The four upper incisors are usually the next to appear.
  • The first four molars and the two bottom lateral incisors usually come next.
  • The pointed teeth, called the cuspids, then appear.
  • The four second molars are usually the last of the baby teeth to appear, generally when the child is around two years of age.

Your child will eventually have a total of 20 baby teeth, each coming in at a rate of about one per month.

Losing the Baby Teeth

Around the age of 6-years-old, your child will begin losing his or her baby teeth. In their place, 32 adult teeth will appear. These teeth will be the last set of “natural” teeth for your child and, as such, will need continual care.

This lifetime of dental care starts with you. By helping your child to develop strong dental habits, you can help your child to avoid the pain of decaying teeth along with the premature loss of these teeth that were supposed to be permanent.

Building Strong Dental Hygiene Habits in your Child

The only way to build strong dental hygiene habits in your child is to start early—with the first tooth. The mouth is full of germs and bacteria that use the foods we eat, if not brushed away, to create plaque on our teeth. When this plaque mixes with the sugars and starches of our diets, it creates an acid that eventually degrades the enamel of our teeth—causing cavities. The only way to stop this plaque, and the resulting acid, from doing its job is by a regular regiment of brushing, flossing, and proper diet.


The American Dental Association recommends that you start brushing your child’s teeth the moment the first tooth appears. At this early stage, you should use just a little bit of water on a toothbrush for the brushing. (Toothpaste is not recommended for children under 2 years of age without a doctor or dentist’s recommendation.) You should start teaching your child proper tooth brushing techniques as soon as possible. Once your child is two years old (or older), you can start to help him to brush his own teeth. In the early years, make sure that the child only puts a dab of fluoride toothpaste on the brush and that he spit out the remaining toothpaste, and rinse with water, after brushing. Your child should be able to brush his own teeth, unassisted, after the age of 6 or 7. Help your child to form the most important dental hygiene habit—tooth brushing—by make sure that he brush twice per day, first thing in the morning and last thing before going to bed at night.


Flossing should be incorporated into your child’s dental hygiene routine as soon as he has two teeth that touch. Flossing is important for removing that enamel destroying plaque that tooth brushing tends to miss. In your child’s first visit with the dentist, ask the dentist to demonstrate proper flossing techniques for children. (The Teaching Heart website has some great, creative ways that you can teach your child about dental care. You can find them here:

Proper Diet

Feeding your child a proper diet will also discourage cavities from forming. To minimize the risk of cavities you, as the parent, should make sure that you:

  • Limit your child’s sugar intake
  • Offer your child a balanced diet
  • Minimize your child’s in-between meal snacks
  • Make sure that your child drinks plenty of water.

Choosing Your Child’s Dentist

Choosing your child’s first dentist is an important step in your child’s future dental care. Children develop their opinions of dentists from early dental experiences, so a “bad” dentist (one that scares or hurts the child) can discourage your child from attending regular dental checkups. In choosing your child’s dentist, you should look for one that has experience in working with young children because he or is will know how to handle the behavior tendencies of young children (such as fidgeting or whining). The American Academy of Pediatric Dentistry website can help you to find a list of good pediatric dentists in your area. Before choosing a dentist for your child, you may want to interview (and visit) several of them. Don’t be afraid to ask questions about the dentist’s experience in treating children.

Assessing a Dentist

Besides asking questions about the dentist’s experience in working with children, the following types of questions should be asked of all dentists.

  • Does the dentist explain the treatment options before proceeding?
  • Is the dental office clean?
  • Are the hours of service convenient to you (and to your child’s) schedule?
  • Does the dentist have some type of an emergency program in place? (Dental problems can flare up suddenly and be very painful).
  • Are the dentist’s fee structures reasonable?
  • Does the dentist devote any time to explaining good dental hygiene practices?
  • Is the dentist a member of the American Dental Association (ADA)?

Preparing your Child for the First Dental Visit

Preparing your child for the first dental visit is an important step in creating a positive relationship between the dentist and your child. You can buy children’s books that teach children what to expect from the first dental visit. You can also role-play this visit with your child. Always make sure that you stress the positives aspects of visiting the dentist (such as a free toy from the dentist) and minimize the negative aspects (such as having the dentist’s fingers probing the mouth.) For the first dental appointment, pick a time when your child is likely to be calm. Choosing an appointment that coincides with your child’s naptime, for instance, may not be a good time for a dental appointment, as the child is likely to lack patience for dental procedures. An important aspect of preparing for your child’s first dental visit is easing any dental anxiety that may exist. But what should you do if your child’s dental anxiety is severe?

When a Child’s Dental Anxiety is Severe

For whatever reason, some children’s dental anxiety is quite severe even before the first dental visit. If your child is part of this group, you may want to enlist the dentist in a psychological process for phobias called “desensitization therapy.” There are several ways that such a visit can be conducted.

The Happy Visit

A popular form of desensitization therapy, in dentistry, is called the “happy visit.” This is a dental visit that proceeds only at, or up to, the child’s comfort level. Also called a “show-and-tell” visit, it is designed to acclimate the child to the dental visit. During the happy visit, the dentist may explain the dental procedure, show the child the equipment to be used, and demonstrate how it will be used. On the first visit, however, the dentist may do no more than put a child in the chair and recline it. But if the child allows it, the dentist may proceed to a full dental examination. What the dentist does in this “show-and-tell” visit is fully dependant on how comfortable the child is with the process.


The tell/show/do uses a three-pronged approach to acclimate the child to dental procedures. Similar to the happy visit, in a tell/show/do, the dentist first explains a particular procedure (the “tell” phase). He then follows that with the “show” phase and demonstrates the procedure to the child. In the third and final part, the “do” phase, the dentist actually performs the procedure on the child, with the child’s full consent.

Systematic Desensitization

Systematic desensitization is best conducted by a trained mental health practitioner or a therapist. In this procedure, the child is taught relaxation techniques before being introduced to a hierarchy of fear-producing stimuli (such as the sound of the drill). Because the child is practicing the relaxation techniques at the time that the fear-producing stimuli occurs, the level of fear is lessened. Over time, this procedure has proven to be extremely effective in reducing phobic responses, and it should have a positive affect on your child’s dental anxiety, as well.

Regular Dental Checkups

But the best way to minimize your child’s level of dental anxiety is with regular dental appointments. Frequent visits will accustom your child to the varied procedures of the dentist. This, alone, will lessen much of the dental anxiety of your child.


Although teaching your child proper oral hygiene habits is time-consuming in the beginning, it will result in a responsible adult who makes appropriate, and timely, lifetime dental decisions for him—or her—self. As a parent, that’s something for YOU to smile about.