The American Academy of Pediatric Dentistry (AAPD) advises parents to take their children to the dentist when the first tooth appears—generally between 6 and 12 months. In any case, the appointment should not be later than age 1.

Early intervention
If this advice has you scratching your head and wondering what on earth a dentist can see—much less do—in a baby’s mouth, here are some answers from Fernanda G. Fontes, DDS. Dr. Fontes, a pediatric dentist in Ann Arbor, Mich., also is assistant clinical professor at the University of Michigan School of Dentistry.

“Although we used to suggest age 3 for the first dental visit, we’ve changed that timetable,” says Dr. Fontes. “That’s because we started noticing that at 3, some kids already had many cavities. In fact, we find cavities in children at 1 year and even younger. So the process clearly starts earlier than 3. When we see kids at younger ages, we have a good opportunity to educate the parents about oral hygiene, infant diets, and creating good habits.”

Some parents regard baby teeth as temporary and so not worthy of attention. That’s a mistake, says Dr. Fontes. “These teeth are important because they hold the space for permanent teeth. Keeping baby teeth in good shape also contributes to clear speech and a confident smile.”

Tooth brushing and more
Parents should begin brushing the child’s tooth (yes, even one) as soon as it comes in. Actually, the first “brushing” can just be a wiping with a wet cloth. Another option is a brush that fits over the parent’s finger. Used to brush the gums as well, it can be especially soothing for infants who are teething.

The first real toothbrush should have bristles that are extra-soft. “Don’t use toothpaste with infants,” cautions Dr. Fontes, “only water. As the child gets older, start with a training toothpaste that has no fluoride. And because manual dexterity in kids isn’t good enough to do a thorough job, tooth brushing should be done by parents until the child is around 8 years old. In addition, flossing is advised if the child’s teeth are spaced close together.”

Consumption of hard candies and sugary snacks should be limited. “Even sports drinks have a lot of sugar,” says Dr. Fontes. “If a kid does have those or other sugary treats, a parent should brush the child’s teeth afterward or have them swish their mouth with water.” On the positive side, encourage your child to eat whole foods. Fruits and vegetables are good for the teeth, as are dairy products that are rich in calcium.

Breaking habits, mending mouths
Kids who suck their thumbs or pacifiers should drop those practices by age 5. These habits can cause lasting damage if the child persists after permanent teeth come in. “I advise parents to talk to their kids about quitting at the age of 3,” says Fernanda G. Fontes, DDS. “Before that, they won’t understand.” Dr. Fontes, a pediatric dentist in Ann Arbor, Mich.

Another common habit is tooth grinding, which most children grow out of on their own. While dentists don’t recommend any intervention with baby teeth, they may advise mouth guards at night to prevent erosion of permanent teeth.

If a baby tooth falls out prematurely, no special treatment is necessary if it’s a front tooth. If trauma or large cavities result in the loss of a back tooth, the dentist may put in a small space maintainer to make sure there’s room for the permanent tooth.

If a permanent tooth is knocked out, that’s a different matter. “Place it in milk as soon as possible,” advises Dr. Fontes. If milk isn’t available, use water or even orange juice. “The important thing is to keep it moist so that it can be reimplanted. The tooth generally is viable for up to 24 hours.”

A Mother’s perspective
Rebekah Modrak, of Ann Arbor, Mich., took her daughter, Lucy, for her first appointment with Dr. Fontes when she was 3. “Lucy was sold the minute she walked into the office,” says Rebekah. “The place is a kid’s paradise. When Lucy was in the kid-sized dental chair, she could see shelves and drawers filled with toys. She was told she could choose whichever one she wanted at the end of the examination. Everyone—from the technician to the dentist—was great with Lucy.”

And since the visit? Is Lucy still sold on preventive dentistry? “It’s still working,” says her mom. “Lucy brushes her own teeth in the morning, and we do it for her at night. While the morning brushing sometimes gets overlooked, the evening one is part of her nightly ritual—before we read to her. And although Lucy initially balked at our flossing her teeth, she’s okay with it now.