An important part of early dental care is establishing regular visits with a dentist. The American Academy of Pediatric Dentistry recommends that children have their first dental checkup either at the appearance of their first tooth or at the latest, by their first birthday.

Early dental care for young children is important because teeth develop quickly. Infants typically cut their first tooth between 5-10 months of age, and children usually have a complete set of 20 primary, or "baby" teeth by age three.

Dental problems also can occur early. Research indicates that 25 percent of children in the U.S. have cavities by age 4.

Many young children are afraid of dentists. They may not know what will happen at a dentist’s office, and the unknown can be mysterious and scary. Some children have a fearful reaction to anyone in a medical uniform or wearing a mask.

Children may have heard frightening stories from other children or adults or seen scary media images of dentists. Other children may have seen family members experience pain after a dental procedure.

Dramatic Play

Child caregivers and families can work together to make dental visits less stressful. The early childhood curriculum offered in a childcare or preschool setting lends itself to fun, hands-on activities that give young children a better understanding of what happens at the dentist’s office and many of these activities can be repeated at home.

Children love dramatic play. It allows them to try on a variety of roles and occupations. One way to alleviate fear of the dentist’s office is to establish a pretend dental office in the dramatic play center. Depending on the space, you may be able to have both a waiting room and a dentist’s office.

Look for props that are safe and developmentally appropriate. Possible items include mirrors, large play toothbrushes, dental health posters, flashlights, gloves, scrubs for the dental "staff," play money and receipt books, clipboards, bibs, dental x-rays, dolls, and magazines for the waiting room.

You may even have a supply of stickers for the "dentists" to give "patients" as they leave the "office." Encourage the children to assume different roles as dentist, dental hygienist, and patient. They also could play the role of parent, bringing in a doll, stuffed animal, or another child for a dental appointment.

Field Trips and Guest speakers

In the early education and care setting, a visit from a dental professional can help children by talking about a trip to the dentist. Some dentist’s offices offer field trip opportunities to local childcare programs.

If a field trip is not feasible, a dentist or dental hygienist may visit your program to talk with the children about dental care and visiting the dentist. Families can prepare children before this visit by talking about dental habits.

Many childcare programs may find a guest speaker through the families of the young children. Parents may be employed in dental offices or have friends, relatives, or neighbors who are dental professionals.

Other possibilities for guest speakers are local health departments and colleges. Some health departments employ public health dentists, dental hygienists, or health educators who will visit childcare programs as guest speakers. Students in dental assisting or dental hygienist programs at colleges also may be able to visit childcare facilities to teach children about dental health and dentists.

Often the speaker will bring or wear their normal work attire (often scrubs and a mask) and bring as many dental tools as possible to show the children. If the speaker is reading a story book to the children as part of the presentation, families and childcare programs may want to read this book with the children before the visit.

The visit will be more effective if children are prepared beforehand with dental-related activities in dramatic play, art, reading, and other areas of the curriculum and parents and caregivers can work together to help children get ready for the visit.

Personal Dental History

It can be difficult to be upbeat and positive with children about visiting the dentist if you have a painful or frightening dental history. Analyze what made your dental visits scary. Was it a mouthful of cavities or sore gums?

Try to think of ways you can keep children you care for from suffering similar experiences. Teach them proper dental hygiene and help them recognize dental-healthy foods for snacks.

If, as a child, you were unprepared for your first dental visit, think of ways you can positively introduce a visit to the dentist. Even a negative dental history can give you ideas for how to approach dental health with children.

Words of Encouragement

When you talk with children about visiting the dentist, strive for a balance of reassurance and information. Give children information to prepare for the visit and to help quiet their fears but keep it simple. Too much detailed information may increase their anxiety.

Some dentists recommend describing them as a friend or health helper who keeps teeth healthy, rather than as a "tooth doctor" because some children already fear physicians by the time of their first dental visit. Positive role modeling also is effective; let children know when you have a dental appointment and that it is part of how you keep your teeth healthy.

Talk about the simple procedures and instruments involved in a visit to the dentist. When children become familiar with some of the words they will hear at the dentist’s office, they are typically less anxious and confused at their dental checkup.

Emphasize dental vocabulary with children, especially new words, like fluoride, cavity, gums, tartar, enamel, and x-ray. Avoid scary words like drill, needle, shot, or pull. Most dentists are careful to use non-frightening alternatives to those words around children.

Working Together

Families and childcare programs can work together to prepare children for their visits to the dentist. It may help to schedule dental appointments early in the day while children are well rested.

If children are very anxious, families may schedule a "pre visit" before the actual appointment. Working together, families and caregivers can ensure a smooth introduction to dental care.

Storybooks offer a positive way to introduce new experiences to children. Several books acquaint children with the dentist’s office, including The Berenstain Bears Visit the Dentist by Stan and Jan Berenstain; My Dentist, My Friend by P.K. Hallinan; Just Going to the Dentist by Mercer Mayer; What to Expect When You Go to the Dentist by Heidi Murkoff; Vera Goes to the Dentist by Vera Rosenberry; Show Me Your Smile: A Visit to the Dentist (with Dora The Explorer) by Christine Ricci; and Harry and the Dinosaurs Say "Raahh!" by Ian Whybrow. Ask your local children’s librarian for additional suggestions.

Marna Holland
Parent Educator, Asheville, NC, City Schools Preschool, and Instructor, Western Carolina University

Internet Resources

Dental Care Booklet, www.childhealthonline.org/booklets.html

Head Start Oral Health Lesson Plans, www.fha.state.md.us/oralhealth/html/hsplan.cfm

PBS Kids, pbskids.org/rogers/parentsteachers/theme/1626_p_art.html

Visit the Dentist with Marty, www.ada.org/public/games/index.asp

Your Child’s First Dental Visit, www.drjay.com/1stvisit.htm

Resources

Healthy Smiles Healthy Children, 211 E. Chicago Ave., Ste. 1700, Chicago, IL 60611-2663; 312-337-2169; www.aapd.org/foundation/hints.asp