Perhaps your pediatrician has recommended that your toddler have her first visit with a dentist. Although all seems well with her first teeth, you understand the importance of prevention and take those first steps to follow up on the recommendation—only to find that no one in your area will see her. Now what do you do?
This frustrating scenario is one of many that unfortunately plays out in medicine; too often, the ideal and the real are two different things. The American Academy of Pediatrics tells us that visiting a dentist around the time of the first tooth, say around 6 months of age, is not too early; the first visit should certainly take place by a year of age. Yet many dentists, even those who see children, restrict their practices to school age and above. And like medical providers, some dental providers may not accept the insurance you have for your child. Let’s talk about some workarounds for this problem. But first, a short review on why we care.
Dental Review (or, Dental Caries Is Still a Thing)
Cavities—or dental caries in medical-speak—still happen. In fact, even with all the preventive care that is available, after a decline through approximately the turn of the millennium, the percentage of kids who get caries hasn’t changed much. And they start early: just over a quarter of children ages 2 to 5 have caries in their baby (“primary”) teeth.
Caries are more than just painful and unsightly. Untreated caries can lead to infection, which can turn out to be serious. And there’s now increasing evidence that good oral health and preventive care can help avoid an array of medical problems later in life; even heart disease has some links to oral health.
Knowing the Ideal and Dealing with the Real
OK, so maybe you’re convinced (or knew all along) that regular dental care is important for young children and even infants. If you run into a roadblock (bite block?!) finding a dentist for your child, let’s brainstorm some options:
- First of all, it’s important to give your little one’s teeth the best home care. This of course means brushing the teeth, but also realize the importance of not having a bottle in the bed. Almost all pediatricians would also advise against any juice under the age of 2, with limited amounts after that. (See more advice here.)
- Realize that your baby’s dental care starts when you’re pregnant with him, so keep your own visits current and follow your dentist’s advice.
- Although pediatricians are, for the most part, not dentists, there is much that they can do to help ensure your baby’s good dental health. They can monitor her fluoride intake: fluoride helps ensure healthy tooth development. Many metropolitan areas have fluoride in their local water supply (although I practiced in an area that did not); it may be less available in rural areas, and your provider may recommend a fluoride supplement. Also, many pediatric offices will now provide protective dental sealants for young children.
- Check national and local websites such as that of the American Academy of Pediatric Dentistry for pediatric dentists in your area. Also, check with your insurer and your city or county health department. Don’t limit the search to one entity: I recently found that one national website omitted one of the few dentists in my area that would see children with Medicaid.
- Don’t hesitate to negotiate with your own dentist, especially if he sees your older children. A lot can be gained by even a quick examination of a young child’s mouth. Some dentists, particularly if they get a lot of business from you, may be able to do a quick exam for free, or for a reasonable or even discounted fee.
- If you have a dentist in your area that will see young children but doesn’t take your dental insurance, check their fees. Many provide discounts for same-day payment. And if you, like I, live in a rural or semirural area and have to drive a long distance to see a covered dentist, weigh the cost of a routine exam for your child against the cost of the gas to get to the covered dentist!
We can only hope that pediatric dental care will become more accessible and that parents can actually follow the AAP’s recommendations. In the meantime, realize that there’s still plenty you can do to ensure your child’s oral health.