Raquel Gari and her husband took their son, Jacob, for his first dental visit when he was 2.
“It was traumatizing to him,” she remembers. “He got sick to his stomach, he was so nervous.”
It didn't help that she and her husband have their own fears of the dentist, “but we knew we had to do it.”
After that bad experience, the Garis started searching for another dentist. Raquel asked about 100 parents for recommendations and found that most of them had not yet taken their young children in for treatment.
“Most of them had the same fears I had about going to the dentist,” she says, and were delaying that first visit.
That's not always possible for families who can't find a dentist who will take their insurance or have no insurance at all, but the foundation is among those advocacy groups working on that, too, because the American Academic of Pediatric Dentistry recommends that children see a dentist after the first tooth appears or by age 1.
The Garis know that now, and they know that Jacob's cavity probably was the result of on-demand breast-feeding in the night, with no cleaning of his teeth afterward, leaving milk sugars to eat away at the enamel of his teeth, making him vulnerable to decay. The same is true, say dentists, for children who toddle around all day and go to bed at night, with a “sippy” cup of juice. Juice is good for kids, but the sugary liquid constantly bathing their teeth is not.
Del Fierro says the increased attention on dental health issues specific to children came about because, while the general population is enjoying a decrease in cavities, children are not.
“The main thing for earlier visits is to educate parents to prevent progression of tooth decay. I see a 3-, 4-and 5-year-olds with rampant decay – in neighborhoods where you wouldn't think of this as being a problem.”
Some of the push for earlier visits is due to the development of the pediatric dental specialty. There are about 400 of them throughout the state of California, says Cohen. His organization, pediatric dentists and others have campaigned for more public awareness of the need for even infants to get that first assessment.
“The general thought before was the kids weren't cooperative until age 3,” says Dr. Jean Chan, a pediatric dentist in El Cajon, who treats quite a number of children 2 and younger.
The first things these professionals say to do is find a dentist, one you trust and one who makes your child feel comfortable. Even if it takes visiting several offices. And determine whether, given your insurance coverage and personal preferences, whether you want a general or pediatric dentist. That, too, may take a few visits.
Make appointments early in the day when the child is well rested.
Please do not bribe your child to go to the dentist or threaten a visit as a punishment.
Del Fierro explains that “a lot of the first visit is a routine type of exam. We look at the teeth, if they have them, and make sure they look normal, sometimes we clean the teeth or do a fluoride treatment.”
And there always is a lot of talk about diet and properly brushing and flossing. So much so, say the Reis and Gari families, that their children bug them if the parents dare to forget the rituals.
Chan's office does what she calls an orientation visit.
“It's free,” she says. “The parent comes in with the child, we walk around the office; we show on a stuffed animal what to expect at the first visit; and we mimic what we're going to do. It takes about 15 to 20 minutes.”
Chan says it's all about de-sensitizing the children, helping them feel comfortable and safe.
“I taught swim lessons when I was younger, and I had to teach children to get over their fear of water,” says Chan, who takes the same approach as a dentist. “If we do our job right, we build a relationship – with the parent and the child. We work together to get the job done.”
HELPING KIDS CARE FOR THEIR TEETH
Pediatric dentists Jean Chan and Dino Del Fierro both address the importance of brushing and flossing with new patients and their parents. And they encourage parents to not only model those behaviors but also do them for their children until youngsters are able to use dental products on their own. Here are some tips on caring for kids' teeth.
After the first teeth appear, the doctors say it's crucial for parents to wipe the teeth with a washcloth after an infant drinks milk or juice to remove the sugars inherent in both.
In between meals and after brushing your teeth at night, stick with water for drinking purposes.
When it comes to brushing, use a soft-bristle brush that is the right size for the child's mouth. “If the brush is too big, it can't angle properly in a small mouth,” Chan explains. “Look at the packaging. Usually ages are printed on the package.” The dentists says electric toothbrushes, toothbrushes that play music indicating how long to brush, and those with a favorite cartoon character all are fine if they get the child to brush.
Once there are enough teeth in the mouth, they'll contact with one another, and that's time to floss. “A toothbrush can do an effective job of cleaning the teeth, but flossing is important once those back teeth are in,” says Del Fierro, who urges parents to do the flossing on their kids. “When the time does come for them to do it on their own, it will already be part of the routine, part of the process.” Once a day, at night usually, is fine for flossing, the dentists say, and there are products that help. “A floss handle, or dental floss, whatever works for a parent in a small mouth,” says Chan. The Crest Glide Floss Pick is good for smaller mouths, she says, and the Reach Access Flosser works on older children.
The best “product” is the example set by a parent. Margaret and Juan Reis' 3-year-old son, Marcanthonee, taught them that. “If I forget, he won't let me,” says Margaret. “He'll say, 'You've got to brush my teeth and floss me!' ” The dentists agree with Marcanthonee. “Parents should be responsible to brush their children's teeth until they can write their name in cursive,” says Chan. “Kids don't know how to do it well. They can't do the gumline; they can't always hold the brush at the proper angle, until they are between 7 and 9 years old. Then they have the motor skills to do a thorough job.
– JANE CLIFFORD
