At What Age Should a Child Have Their First Dental Appointment?
A child’s first visit to the dentist is an opportunity to advise parents on preventative care and detect any oral health problems at an early stage.
However, there remains uncertainty among parents around what age this first visit should happen.
Here is everything you need to know, along with detail on the current situation in the UK and advice on treating children.
Once you see a tooth, it's time
Children should visit the dentist as early as when their first primary tooth comes in or just before their first birthday, according to the NHS.
This is so they become familiar with the environment and get to know the dentist.
This first visit is also important for spotting early signs of gum disease or tooth decay and ensuring the child’s teeth are erupting and developing properly.
Guidelines recommend children see a dentist at least once a year thereafter. NHS dental care is completely free for all children up until the age of 18.
In England, dentists can claim (Band 1) for carrying out a dental check, even if the child is pre-cooperative (under 3).
Data analysis carried out by a team at the University of Birmingham between 2016 and 2017 showed that the UK rate of attendance in babies less than one ranged from 0-12.3%. The rate of attendance in children aged under two ranged from 3.7 to 37.6%.
The misunderstanding that exists among parents on when best to book a child’s first dental appointment has been highlighted by the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons (RCS).
“We know from parents we speak to that there is widespread confusion, even in advice given to them by NHS staff, about when a child should first visit the dentist,” says Professor Nigel Hunt, former dean of the FDS at the RCS.
He added: “With 9,220 cases of tooth extraction performed in hospitals last year for children aged between one and four (2015/16), we cannot continue in this state of confusion”.
Many of these cases can be attributed to tooth decay, which the FDS points out is 90% preventable.
Tooth decay is the most common reason for children aged five to nine to be admitted to hospital in the UK and is one of the most prevalent chronic diseases among children worldwide.
According to the American Association of Paediatric Dentists (AAPD), tooth decay affects nearly 1 in 5 children under the age of 5 in the US.
Decline in UK dentist visits among children
The Covid-19 pandemic has had a detrimental effect on children accessing a dentist. Figures released in October 2021 show the number of children aged 0-2 seeing a dentist was halved between June 2020 and June 2021.
NHS data reveals only one in seven under-fives saw a dentist in 2020, compared with one in three in 2019.
The British Dental Association (BDA) has warned that this “collapse” in access for children during the pandemic will lead to “record tooth extractions”.
This sentiment is echoed by the RCS who have highlighted the even greater impact these restrictions have had on poorer families.
“We know the pandemic has disproportionately affected children from the poorest families, and worsened health inequalities, and sadly this is also likely to be true in dentistry,” said the RCS.
Improving the situation
The Dental Check by One campaign (DCby1) was launched to the dental profession in May 2017. Its aim is to remind parents and guardians of the importance of children seeing a dentist by the age of one.
The campaign is supported by the RCS, British Medical Association, the Oral Health Foundation, Public Health England and the Society of British Dental Nurses, among others.
Pre-pandemic, the DCby1 campaign reported a 2.5% uplift in children aged 0-2 accessing a dentist between June 2017 and December 2018.
The DCby1 website has several sources available for dentists, including an Avoidance of Doubt notification which provides some clarity on dental visits for children under 3.
The notification gives the following advice for visits of children under 3:
- Undertake a clinical examination on children under 3 if it will not result in undue anxiety for the child. They can be examined in a parent’s arms, or on a parent’s lap, or you can use a knee-to-knee posture.
Also included is information on prevention messages, documentation and claim forms.
5 tips for treating child patients
The following ideas can help make a child’s first dental appointment less traumatic for them and less stressful for the dentist.
1 - Make a good impression
Meeting a dentist for the first time can be a scary event for lots of children, so it is important to make a good first impression.
Consider meeting the child for a moment in the waiting room first rather than seconds before a procedure.
Introduce yourself with a smile and by telling them something funny/silly about yourself to help calm their nerves. Try asking them some questions to make them more comfortable, for example about school, sports or siblings.
2 - Use kid talk, not dental talk
When explaining a type of procedure or piece of equipment, avoid using too much dental terminology or words that could cause anxiety.
User funnier names to describe what you are going to use, for example your air/water syringe could become a water gun and your saliva ejector a super straw.
If appropriate, consider allowing the patient to touch the objects for reassurance and so they know what to anticipate.
3 - Provide positive reinforcement
Let children know how well they are performing under these strange new circumstances with regular praise during treatment.
Young children love being praised so do not be afraid to go overboard when telling them how incredible or amazing they are doing.
Praise can inspire the child to be more cooperative, both for their first visit and future appointments.
4 - Reward
Offering incentives to child patients can help motivate them and increase the chances of compliance.
These rewards can be as simple as a roll of stickers featuring their favourite characters from Disney or Marvel.
Or consider stretching the budget by introducing a dental rewards programme, like Happy Kids Dental paediatric dentistry clinic have done.
5 - Use fun flavours
Put the power in the patient’s hands by letting them pick from several different prophy paste flavours.
Little touches like this can be another step in empowering kids to care about looking after their teeth from an early age.