When to come for the first time
Paediatric dentistry societies recommend the first visit around the child's first birthday, and at the latest six months after the first tooth comes through. Early, because the first visit is meant to be short and pleasant, not forced by pain. A child who knows the surgery from check-ups reacts differently to a visit where something has to be done.
Milk teeth are not teeth to wait out. They hold the space for the permanent teeth, they let the child bite and speak, and untreated decay in a milk tooth hurts just as much as in a permanent one and can damage the bud of the permanent tooth underneath.
The adaptation visit: what happens
At the clinic, a small child's first visit is most often an adaptation visit. The child comes into the surgery, sits in the chair, sometimes on a parent's lap, looks at the lamp, the mirror and the air puffer, counts teeth together with the dentist. If the child allows it, the dentist looks at the teeth. Nothing is done by force. The aim is for the child to leave convinced that nothing bad happens here, and to be one step further at the next visit.
At the same visit the parent gets specific guidance: how to brush the child's teeth, how much toothpaste and with what fluoride content to use at that age, what to do about the bedtime bottle and snacking between meals.
How to prepare the child
- Book the visit for a time when the child is rested and fed, usually the morning.
- Talk about the visit briefly and calmly: the doctor will count your teeth and see if they are clean. Do not promise that nothing will hurt, because that sentence introduces the subject of pain.
- Avoid the words injection, drilling, pulling, including in adult conversations the child overhears.
- Play dentist at home: counting a soft toy's teeth, opening the mouth wide.
- Do not threaten the dentist as a punishment for unbrushed teeth. The dentist should be someone you go to, not a penalty.
- Bring a favourite toy, and leave your own worries at the door: children read their parents faultlessly.
Prevention: what works before there is any damage
The biggest influence on a child's teeth comes from what happens at home: brushing twice a day with a fluoride toothpaste suited to the age, limiting sweet drinks and snacking, and dropping the bedtime bottle of milk or juice. At the clinic two procedures are added.
Sealing means filling the grooves on the chewing surface of the molars with a flowable material that sets and closes the places a toothbrush cannot reach. It is done soon after the tooth comes through, before decay has a chance to develop in it. Fluoride treatment is the application of a fluoride preparation that strengthens the enamel. In the clinic's price list, tooth cleaning with fluoride costs 250 zł and sealing one tooth 220 zł.
When a milk tooth needs treatment
Decay in a milk tooth is treated like in a permanent one: the diseased tissue is removed and a filling placed, under local anaesthesia if the cavity is deep. When decay has reached the pulp, a milk tooth can also be root treated, and when it cannot be saved it is extracted and the space for the permanent tooth is watched. According to the clinic's price list, a filling in a milk tooth costs from 250 zł, root canal treatment of a milk tooth 320 zł and extraction of a milk tooth from 250 zł. A dental consultation is 300 zł, an adaptation visit 250 zł.
When cooperation in the chair is not possible
Sometimes a child is too young, too frightened, or there are so many teeth to treat that a series of visits in the chair would be harder for the child than one. This is the first of the four situations in which the clinic treats under general anaesthesia, in its own anaesthesiology department.
The path starts with a joint dental and anaesthesiology consultation: a panoramic X-ray on site, a history taken with the parents, a review of what needs treating. The anaesthesiologist discusses eating and drinking before the anaesthetic, medicines and how wake-up goes. On the day, a parent is present as the child falls asleep, all the treatment happens in one visit, wake-up is with the anaesthesia nurse, and afterwards the parent receives a phone number for post-operative care. For children up to 16 with a disability certificate the treatment is funded by the NFZ, for everyone else privately.
Frequently asked questions
Can a parent be in the surgery with the child?
Yes. A small child can sit on a parent's lap, and with treatment under general anaesthesia a parent is present as the child falls asleep.
What if the child will not allow anything at the visit?
It happens and it is not a failure. The visit ends at whatever the child allowed, and the next one is a step further. In the clinic's price list such an unproductive child's visit is charged at 150 zł. When treatment is urgent and cooperation is not possible, the dentist proposes the general anaesthesia path.
Do milk teeth need treating if they fall out anyway?
Yes. A decayed milk tooth hurts, can develop an abscess and damage the permanent tooth growing underneath, and one removed too early lets the neighbouring teeth drift into its place.
How often should a child have a check-up?
Usually every six months, and more often when the dentist sees a high risk of decay. The date of the next check-up is set at the end of every visit.
An informational article. It does not replace a consultation, and treatment decisions are made during a visit.
