This essay is based on a conversation with Jonelle Anamelechi, a board-certified pediatric dentist who owns Children’s Choice Pediatric Dentistry & Orthodontics near Washington, DC. Edited for length and clarity.
I am a board certified pediatric dentist, something I’ve always wanted to do — I grew up pulling teeth for fun. Pediatric dentistry means working together to care for your child’s teeth from the start. Teeth develop as early as 6 weeks in the womb, and so many changes occur in the six month period between 6 months and 1 year.
The recommendation used to be that a child should see a pediatric dentist starting at age 3, but the American Academy of Pediatric Dentistry changed its recommendation about 14 years ago to help us have a better chance of preventing tooth decay.
By age 3, you have all 20 teeth and are actually back to nursing at that point. Now the recommended age is around 1, or within 6 months of the first tooth.
It’s important for parents to bring their kids to the dentist — here’s why.
What to expect on a first visit
We guide families through that first appointment on how to care for their child’s teeth. We look at growth and development, family and genetic history, and birth history, among other things.
About 95% of dental cavities are diet-related. You may be born with weaker teeth, which make up the other 5%. At the appointment, I talk to the parents about diet, such as flavored drinks and what the hidden culprits are, such as pineapples and oranges. These fruits have so much acidity that they can weaken the enamel – the outer layer – of the tooth.
I tell parents to dispel all expectations before their first date. We don’t separate a child from their parents at this age — we do a knee-to-knee exam where they lie on their parent’s lap. We do a full assessment, brush the teeth, floss if they need it and remove excess buildup.
Facts about fluoride
I have many questions about fluoride. Fluoride takes precedence over other ways we have of cavity risk management, and the AAPD recommends using fluoride from the start.
I look at a family’s history of tooth decay, the child’s diet — they eat lots of fluoride-rich green leafy vegetables or tap water, for example — or if there are other special conditions that might require a more vigorous oral hygiene routine.
For a 1-year-old who cannot spit, it should be a rice-grain-sized amount of fluoride toothpaste each time he brushes.
I have families in my practice who prefer alternatives like xylitol and are open to these discussions and options if they have low cavity risk children. But we have the most research on fluoride as a caries prevention, and it’s safe in low doses, so I recommend it.
It’s about more than just teeth
Pediatric dentistry is more than just teeth — I’m here to help educate you about healthy living. I can also help with breastfeeding if there is lip or tongue tie — and no, breastfeeding does not cause tooth decay. I also help patients with challenges, such as a recent 30-year-old patient whose cognitive function requires pediatric dentistry.
The benefits of visiting the pediatric dentist are many. Parents often come with guilt, feeling that they may be shamed or judged for the things they have chosen for their children, such as diet or pacifiers. I’m really here to educate and help.
