I'm a pediatric dentist. Yes, you really need to bring your child in for checkups.
- Jonelle Anamelechi, a pediatric dentist, owns Children's Choice Pediatric Dentistry & Orthodontics.
- Pediatric dentists play a pivotal role in supporting a child's overall development.
This as-told-to 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. It has been edited for length and clarity.
I'm a board-certified pediatric dentist, something I've always wanted to do — I grew up pulling teeth for fun. Pediatric dentistry means partnering in caring for your child's teeth from the start. Teeth develop as early as 6 weeks in utero, and so much change happens in the six-month period between 6 months of age and 1 year old.
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 cavities.
By age 3, you have all 20 of your teeth, and you're actually behind in care at that point. Now the recommended age is around 1, or within 6 months of the first tooth.
It is important parents bring their kids to see dentists — here's why.
What to expect at a first visit
We coach families at 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 can be born with teeth that are weaker, which makes up the other 5%. At the appointment, I talk to parents about diet, such as discussing flavored beverages and what the hidden culprits are, like pineapples and oranges. Those fruits have so much acidity they can weaken the enamel — the outer layer — of the tooth.
I tell parents to dissolve all expectations before their first appointment. We don't separate a child from their parents at this age — we do a knee-to-knee exam, where they lay in their parent's lap. We do a full evaluation, brush teeth, floss if they need it, and remove excess buildup.
Facts about fluoride
I get a lot of questions about fluoride. Fluoride trumps other modalities we have for risk management for cavities, and the AAPD recommends using fluoride from the start.
I look at a family's history of cavities, the child's diet — do they eat a lot of fluoride-rich leafy green vegetables or tap water, for example — or if there are other special conditions that might require having a more vigorous oral-hygiene routine.
For a 1-year-old who can't spit, it should be a grain-of-rice-sized amount of fluoride toothpaste every time they brush.
I have families in my practice that prefer alternative options like xylitol and are open in those discussions and options if they have low-cavity-risk kids. But we have the most research around fluoride as prevention against cavities, and it is safe in low doses, so I do recommend that.
It's about more than just teeth
Pediatric dentistry is about more than just teeth — I'm there to help educate you about healthy lifestyles. I also can help with breastfeeding if there is a lip tie or tongue tie — and no, breastfeeding does not cause cavities. I also help patients with challenges, such as a recent 30-something patient whose cognitive function requires pediatric dental handling.
The benefits of seeing a pediatric dentist are numerous. Parents often come in with guilt, feeling like they might be shamed or judged for the things they've chosen for their kids, like diet or pacifiers. I'm really here to educate and help.
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