From the Guidelines
The initial dental exam for a pediatric patient should be done at the age of 6.
Key Considerations
- The age of 6 is recommended because, at this age, permanent tooth buds, except those of the III molars, are visible in the panoramic image 1.
- This recommendation is based on the idea that radiographic examination should only be prescribed considering the patient’s medical records, clinical signs and symptoms, and the risk/benefit of exposure to a potentially harmful radiological examination 1.
- The American Academy of Pediatric Dentistry (AAPD) recommends that a child should visit a dentist by their first birthday or within six months of the eruption of their first tooth is not mentioned in the provided evidence, however, the provided evidence consistently recommends age 6 for radiological investigations for various dental anomalies, including dental impaction, numeric anomalies of teeth, dental morphology anomaly, and tooth transposition 1.
- It's essential to consider the patient’s medical history, clinical signs and symptoms, and the risk/benefit ratio before prescribing a radiographic examination 1.
Radiological Investigations
- Level I radiological investigation is advised after the age of 6 for suspected numeric anomalies of teeth, dental morphology anomaly, and tooth transposition 1.
- Orthopantomography is the indicated 2D radiological imaging technique for these investigations 1.
From the Research
Age of Initial Dental Exam
- The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that a child's first dental visit should occur during their first year of life for dental disease prevention and to decrease invasive restorative interventions 2.
- A study found that the adjusted hazard ratio of dental caries for children whose first oral health examination was at 4 years of age is 5.425 times higher than for children whose first oral health examination was before 1 year of age, highlighting the importance of early dental exams 3.
- Many professional dental organizations recommend that the first dental visit should occur by the age of one year 4.
Reasons for Delayed Initial Dental Exams
- A study in Lebanon found that children came to the pedodontist upon the decision of their parents, and a dental problem was the major reason that triggered the first visit, indicating a lack of preventive care 2.
- Another study found that the most common reason for the first dental visit was caries and its complications, followed by parents' decision to have a prophylactic examination of their child 4.
- A survey of dentists found that only 17.93% recommended that the first visit should be before the age of 1 year, and it was predominantly pediatric dentists who recommended a dentist appointment in the first year of life 4.
Importance of Early Dental Exams
- Early dental exams can help prevent dental caries and decrease the need for invasive restorative interventions 2, 3.
- A study found that performing a clinical exam on a young child was associated with willingness to see children younger than two years of age in practice, highlighting the importance of early exposure to young pediatric patients 5.
- The First Dental Home initiative encourages general practitioners to actively participate in providing care for young children under the age of 3, including infant oral exams and preventive treatment 6.