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      Q: When should my child visit the dentist for the first time?

      A: Tradition supports age three as the best time for the first dental visit. By this age, a child has all of his/her teeth and recognizes the difference between a dentist and a pediatrician. However, current American Academy of Pediatric Dentistry guidelines recommend you schedule your child's first visit around the first birthday. Few infants younger than one year have oral problems that require care, but almost all are at risk for oral disease. The goal of the first dental visit is to assess that risk, initiate good dental habits, educate parents and schedule future appointments. Because the first visit requires minimal examination of your child, it is non-threatening. It does provide time with you to demonstrate appropriate home care techniques. A dentist, especially a pediatric dentist, is best qualified to perform this service.

      Q: How does nursing cause tooth decay, and what can be done to prevent it?

      A: During the first year of life, infants receive most of their nutrition from breast feeding or bottles. If these feeding sessions are prolonged and baby teeth are exposed to fluid for long periods of time, bacteria in the mouth can convert the fluid to acid, leading to early tooth decay. Such tooth decay has been called "nursing bottle decay" or "nursing decay." Surprisingly, even mothers' breast milk can cause tooth decay in children who nurse themselves to sleep or for long periods.

      To prevent nursing decay, you should:

      • Use the nursing bottle as a source of nutrition, not a pacifier.
      • Fill a bottle with water if your child will be left with a bottle for an extended period of time, such as bedtime. Sweet solutions such as soft drinks, natural fruit juices or other sugar-containing drinks decrease oral pH, reduce necessary salivary flow and break down tooth enamel, which can initiate the formation of a cavity.
      • Switch from bottle to cup feeding around a child's first birthday.
      • Brush your child's teeth with a soft bristle toothbrush after the morning feeding and before bedtime. The toothbrush is more effective than wiping your child's teeth with a wash cloth. Using a drop of fluoride toothpaste about the size of a small pea is appropriate.
      • Schedule your child's first dental examination around his/her first birthday.

      Q: Is it necessary that my child receive X rays during each visit to the dentist?

      Modern X-ray machines deliver less radiation than older machines so patients are at less risk for exposure. Your dentist should cover your child's body and neck with a lead apron and shield to protect the developing thyroid gland. For most children, dental X rays are not necessary at every visit. In general, the first set of complete X rays is taken between ages 5 and 8, and the second set is completed between ages 11 and 14. However, this is not a firm rule and can vary with individual needs and office protocols. These complete dental films will diagnose such conditions as extra or missing teeth, defects in form of the upper and lower jaws, poor position of developing teeth and some rare jaw tumors. Other types of X rays include bite-wing X rays -- to detect or eliminate dental decay between teeth that cannot be seen during a visual exam -- and panographs -- to show current teeth, developing teeth and cavities.

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