When should I first take my child to the dentist?

When the first baby tooth appears.

When will my child’s baby teeth come through, and at what age will their permanent teeth start to appear?

The first baby tooth breaks through usually at around 6 months and the first adult tooth at around 6 years, but it can be earlier or later.

What’s the best brush and toothpaste to clean my child’s teeth with?

  • Manual or powered toothbrush with small head.
  • Children under 3 years old should use a smear of toothpaste containing no less than 1000ppm of fluoride twice a day.
  • Children over 3 years old should use a pea size of the family toothpaste containing 1,350-1,500ppm of fluoride at least twice a day.

What are the benefits of fissure sealants and how long do they last?

  • Prevention from cavities in the pits and the fissures of the teeth.
  • It depends on the oral hygiene and the diet of the child, they should be checked regularly at the routine dental examinations to assess if there is need for replacement.

How can I prevent tooth decay in my child? Can tooth decay in baby teeth affect the development of their permanent teeth?

Children aged up to 3 years

  • From six months of age infants should be introduced to drinking from a free-flow cup, and from age one year feeding from a bottle should be discouraged.
  • Sugar should not be added to weaning foods or drinks. Reducing the frequency and amount of sugary food and drinks. Sugar-free medicines are recommended.
  • As soon as teeth erupt in the mouth brush them twice daily (last thing at night and on one other occasion) with a smear of toothpaste containing no less than 1,000ppm fluoride. Parents/carers should brush or supervise toothbrushing.

Children over 3 years

  • Sugar should not be added to weaning foods or drinks. Reducing the frequency and amount of sugary food and drinks. Sugar-free medicines are recommended.
  • Brush them twice daily (last thing at night and on one other occasion) with a pea size of toothpaste containing more than 1000ppm (1,350-1,500ppm) of fluoride. Parents/carers should brush or supervise toothbrushing until the age of 7-8 years.
  • Application at the dentist of fluoride varnish to teeth two times a year.

Tooth decay in baby teeth can affect the development of the permanent teeth.

How do I prepare my child for their first dentist’s appointment?

  • Talk to your child about what’s going to happen.
  • Get some books about visiting the dentist and use storytime to start a conversation. A fun way to get children comfortable is to play “going to the dentist”, using toothbrushes, flashlights and cups for rinsing, where your child can practise being the patient or the dentist.
  • Avoid scary sentences like “it will not hurt”, remember that children pick up adults’ fears.
  • Select an appointment time when your child is alert and rested.

What’s the best routine for my child’s teeth, and what good habits should I be encouraging at home?

  • Brushing twice daily.
  • Healthy snacks, reduced intake of sugar in food and drinks.
  • Regular visits to the dentist.

At what age should my child be flossing and using mouth wash?

The fluoride mouthwash (0.05%) is recommended in patients with higher risk of caries (patients undergoing orthodontic treatment, history of cavities, dry mouth, special needs…)

What’s the difference between a paediatric dentist and a regular dentist?

The paediatric dentist is knowledgeable about young children’s oral health, growth and development, is focused on the child’s specific needs and enjoys working with children, in an environment set up to be child friendly.

When should children get their first dental X-ray?

There is not a specific age to take an X-ray, they should be taken whenever there is an indication, no matter the age.

When should my child first see an orthodontist?

Children should ideally see an orthodontist for an assessement when the adult teeth begin to erupt, ideally no later than 7 years old. The aim of the assessment is to look at the child’s current development and diagnose any abnormalities such as missing teeth, too many teeth, incorrect jaw alignments, incorrect jaw growth patterns and also crossbites.

The aim of this appointment is not to start orthodontics but to diagnose and plan possible interventions over the next 5 years.

The child will then be reveiwed periodically to ensure that the correct developments take place at the correct times and an assessment for interventional treatment will take place.

Why do some children need interventional treatment?

There are some dental problems that can be treated as a short course of interventional treatment over a 12 month duration. The aim is to intervene during the development of the teeth to ensure that the adult teeth to erupt into a better position. This often reduces the complexity of later orthodontic treatment and results in more stable results.

This can include expansion of the arches to avoid extractions later on during the teenage years and also growth modification. In some children, there is a large distance between the upper and lower front teeth. Intervention at the correct time can encourage lower jaw growth before all the adult teeth have come through. This treatment is no longer effective once general growth is complete. The only option at that point to change the jaw pattern is jaw surgery.

Some children have very crooked front teeth between the ages of 7-10 years. Intervention will encourage the side teeth to come through in a better alignment.

Some children have a reverse bite where the lower teeth bite in front of the upper teeth. Intervention at this stage is key to prevent excessive wear of the edges of these teeth which can result in shortened front teeth in the long term.

Orthodontist Dr Moira Wong and paediatric dentist Dr Carmen Colomar at Moira Wong Orthodontics have jointly answered these questions. The Mayor of Kensington & Chelsea recently opened the practice on Kensington Church Street in September 2014. The practice provides dental & orthodontic treatment to both children and adult patients. It also has a spacious play area, exclusively designed for young children to play games, make friends, and feel as comfortable and happy as in their own homes. To find out more about the practice and the treatments it offers, please see moirawongorthodontics.co.uk.

Moira Wong Orthodontics

27A Kensington Church Street
W8 4LL London


About The Author

Paediatric Dentist

Moira Wong Orthodontics is a boutique orthodontics & dental clinic located off Kensingston Church Street in London, owned by orthodontist Dr Moira Wong (right) with treatment support from paediatric dentist Dr Carmen Colomar (left). The practice strives to improve the smiles of patients of all ages using a range of orthodontic treatments from braces ”” functional, children's ceramic, fixed, adult ceramic, traditional and removable ”” to Invisalign, Incognito, Social6, retainers and mouthguards. Dr Moira Wong trained for more than 10 years in dentistry & orthodontics. She attended the prestigious consultant training programme at King's College and St George's Hospital, gaining her Fellowship in orthodontics. Currently fewer than 300 UK practitioners have this level of training, with only 5 to 10 people gaining the accreditation each year. Today, Dr Wong has acquired an excellent reputation for her highly sophisticated work and approachable, communicative manner. The clinic has its own paediatric dentist, Dr Carmen Colomar, so all children's dental needs are covered from A to Z. The spacious play area has been designed for children of any age to play games, make friends and feel as comfortable and happy as in their own homes. To find out more about the practice please visit http://moirawongorthodontics.co.uk. If you have any comments or queries on orthodontics or dental issues, feel free to email info@moirawongorthodontics.co.uk or follow the clinic at: Facebook https://www.facebook.com/MoiraWongOrthodontics Twitter http://twitter.com/MWOrthodontics LinkedIn https://www.linkedin.com/company/moira-wong-orthodontics YouTube https://www.youtube.com/user/MWOrthodontics

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