When does a child need to see a dentist by?

When Should a Child First Visit a Dentist?

A child should have their first dental visit within 6 months of the eruption of their first tooth, but no later than 12 months of age, as recommended by the American Academy of Pediatric Dentistry (AAPD). 1

Timing Recommendations by Professional Organizations

• The American Academy of Pediatric Dentistry (AAPD) recommends that children should have their first oral examination within 6 months of the eruption of the first primary tooth but no later than 12 months of age 1
• The American Academy of Pediatrics (AAP) recommends a different timeline, suggesting initial dental evaluation at 24 months of age 1
• All children should have a "Dental Home" within 6 months of the eruption of the first tooth 1

Rationale for Early Dental Visits

• Early dental intervention provides an opportunity to:

  • Supplement oral health education for parents 1
  • Establish proper oral hygiene habits 1
  • Prevent dental injuries 1
  • Prevent nursing caries 1
  • Allow children to become comfortable in the dental office 1

• By 3 years of age, poor oral hygiene or improper feeding habits may already have compromised oral health, making earlier intervention critical 1

• Early childhood caries is the most common chronic disease in young children and may develop as soon as teeth erupt 2

Risk Factors Requiring Earlier Dental Visits

Children with any of the following conditions should be referred promptly to a pediatric dentist or a general dentist who maintains a high level of competence in pediatric care:

• Infants determined to have high caries risk through a caries risk assessment 1
• Children with developmental disabilities that make behavior management challenging 1
• Children with extensive dental caries requiring sedation or general anesthesia 1
• Children preparing for radiation therapy, chemotherapy, or hematopoietic stem cell transplantation 1
• Medically compromised children whose condition could deteriorate without appropriate dental treatment 1
• Children with facial swelling of unknown origin 1
• Children with oral habits (thumb sucking, pacifier use, tongue thrust) that may affect dental alignment 1
• Children with possible oral abnormalities 1
• Children with dental trauma (tooth fracture, intrusion, luxation, avulsion) 1

Current Reality vs. Recommendations

• Despite recommendations for early dental visits, research shows that most children have their first dental visit much later:

  • In one study, the average age at first dental examination was 3.6 years 3
  • Another study found that the majority of children (51.9%) had their first dental visit between 3-6 years of age 4
  • Only 1.73% of children visited a dentist before age 1 4

• The most common reason for the first dental visit is caries and its complications (59.86%), rather than preventive care 4

Consequences of Delayed Dental Visits

• Children who have their first dental visit at age 3 have a significantly higher risk of needing restorative treatment (hazard ratio: 2.05) compared to earlier visits 3
• This risk increases further for children with first visits at age 4 (hazard ratio: 3.99) 3
• About 21% of privately insured children required restorative treatment, highlighting the importance of early prevention 3

Primary Tooth Eruption Timeline

• Primary teeth typically begin to erupt at around 6-8 months of age, with lower central incisors appearing first 5
• The eruption sequence continues until approximately 24-30 months when all primary teeth have emerged 5

Oral Health Care Practices

• Oral health care should begin with the eruption of the first tooth 5
• Twice-daily brushing with fluoridated toothpaste (rice grain-sized portion for children under 36 months) is recommended 5
• The AAPD provides age-specific home oral hygiene instructions for parents to follow 1

Role of Primary Care Providers

• Family physicians and pediatricians are in a unique position to provide oral health education and referrals due to the early and frequent contact they have with children 1
• Physicians should examine children's teeth for defects and cavities at every well-child visit 2
• Collaboration between physicians and dentists can reinforce efforts to provide excellent preventive oral care 1