Children's dentistry

Children's dentistry is dental care for babies, children and teens: checkups, cleanings, steps to prevent cavities, fillings and care after injuries. Many general dentists see children. Pediatric dentists complete two to three years of extra training after dental school and treat only children (AAPD).

Cavities are the most common chronic disease of childhood in the United States. More than half of children aged 6 to 8 have had a cavity in at least one baby tooth (CDC). The steps below can help prevent them.

The ADA and AAPD both give this timing (ADA, AAPD). An early visit can spot problems early (CDC).

The AAPD suggests a checkup every six months, and says the dentist can advise on the right schedule for your child (AAPD).

1. Health history and habits. The dentist asks about your child's health and habits, such as thumb or finger sucking (ADA).
2. Exam. The dentist checks your child's teeth, gums and bite.
3. X-rays, if needed. The ADA says there is no single schedule for X-rays. It depends on the child's age, risk of disease and symptoms (ADA).
4. Fluoride varnish. Ask about fluoride varnish as soon as the first tooth appears. The CDC says it prevents about a third of cavities in baby teeth (CDC).
5. Sealants, when the time is right. Sealants are thin coatings that fill the grooves on the chewing surfaces of back teeth (AAPD). The CDC says sealants on back teeth prevent 80% of cavities (CDC).
6. Advice. The dentist shows you how to clean your child's teeth and answers your questions.

• Babies. Wipe the gums from the first days after birth. Start brushing as soon as teeth come in (ADA).
• Under 3. Use a smear of fluoride toothpaste no bigger than a grain of rice (ADA).
• Ages 3 to 6. Use a pea-sized amount, and remind your child to spit it out rather than swallow (ADA). Watch children under 6 when they brush (CDC).
• Between teeth. Once two teeth touch, clean between them every day (ADA).
• Food and drink. Do not dip a pacifier in sugar, honey, juice or sweet drinks (ADA). Drink tap water that contains fluoride (CDC). The dentist can check the fluoride level of your water and may suggest supplements if it is low (AAPD).
• Sports. A mouthguard helps protect teeth, lips, cheeks and gums from sports injuries (AAPD).

• Thumb sucking. Most children stop on their own. If thumb or finger sucking goes on past age three, the dentist may suggest an appliance (AAPD).
• X-rays. Dental X-rays use a small dose of radiation. Dentists aim to keep the dose as low as reasonably achievable and to take X-rays only when the benefit justifies them (ADA).
• Sedation. Some children need sedation or general anesthesia for treatment. Ask who will give it, who will monitor your child, and what the risks and alternatives are.
• Injuries. If your child knocks out or breaks a tooth, read our dental emergency guide and call a dentist.

• Whether your child needs X-rays at this visit.
• Fluoride varnish and sealants, and how many teeth are sealed.
• Fillings or other treatment, and whether sedation is used.
• What your dental plan covers, and how often it covers checkups.

Medicaid covers dental services for all children enrolled. Separate CHIP programs must also cover dental care (Medicaid.gov). Before any treatment beyond the checkup, ask for a written estimate with the CDT code for each procedure (ADA).

1. How often should my child come in?
2. Does my child need X-rays today? Why?
3. Would fluoride varnish or sealants help my child?
4. Is our tap water fluoridated? Does my child need a supplement?
5. Is my child's bite developing normally? When should we think about braces?
6. If my child needs treatment, will you use sedation? What are the risks?
7. Do you accept my child's dental plan or Medicaid?