First tooth, first visit

First tooth, first visit

This article first appeared in the May 2011 edition of WAC Magazine
published by the Washington Athletic Club

When adults of today’s generation were growing up, a visit to the dentist was almost always because of a problem. Routine prevention was not a part of life, and it was typical to think that baby teeth weren’t important. So much for that. The American Academy of Pediatric Dentistry recently rolled out its newest campaign to change this outdated assumption with the slogan, “First tooth, first visit.” Behind this new recommendation: Why it is so important that children visit the dentist at an early age.

One of the most common questions I hear as a pediatric dentist is, “Why should a child go to the dentist before all of their baby teeth have grown in?”

Preventing dental fear

It is critical that children attach a positive association with their first dental experience. This is arguably the most important reason a child should begin dental care as soon as the first teeth emerge. If you have experienced a cavity as a child, chances are you don’t have a particularly fond memory of it. It is likely the negative experience shaped the way you feel every time you go to (or even think about) the dentist. Having children experience success at the dentist’s office before they have a dental problem allows them to conquer their fear of the unknown, builds their confidence and ultimately empowers them. Admittedly, not all parts of a check up are inherently enjoyable, especially the first time, but familiarizing kids with the process at a very young age gives them a chance to build a set of emotional coping skills. The more positive and successful visits, the less likely they will ever develop anxiety over a trip to the dentist. This is a concept known as “latent inhibition” and is best described as giving a child an emotional emergency tool kit should they ever need to undergo treatment to fix a cavity or repair an injured tooth.

The outdated recommendation, to wait until a child is older, greatly increases the chance that a child’s first visit to the dentist will be the result of a problem. If a child is introduced to dental care for the first time because of an issue like a painful tooth, swollen mouth or traumatic dental injury, it attaches a negative association (e.g., pain, fear) to the experience. This reduces the effect of latent inhibition and greatly increases the risk of developing long-term phobia and dental anxiety.

Dental disease is largely preventable

Tooth decay and gum disease are, in fact, diseases. They have an overall effect on our body just the same as Type 2 diabetes, obesity or heart disease. Like these diseases, dental disease is largely preventable. The teeth and gums are connected to all the vital structures in our body by blood vessels and nerves. If bacterial invasion of a tooth (commonly known as a cavity or decay) is not prevented, and proceeds unchecked, it can spread to nearby structures. This spread occurs first in the head, host to some of the most vital structures to life, including the brain, airway, eyes, nose and ears. Most of us consider an ear infection or strep throat a very serious problem needing immediate medical attention. A cavity is no different.

An initial visit to the dentist when the first teeth come in also allows for an assessment of a child’s risk of dental disease based on examination and family history. Consequently, recommendations can be made to implement an appropriate prevention plan to minimize the risk of developing dental disease. It also educates parents on how to care for their child’s teeth and gums and how diet plays an important role in proper oral health, and provides information on other risks and developmental milestones to consider as children grow.

Emergency dental home

Young children are especially vulnerable to dental injury as they learn to walk. The most common time in our life to sustain a dental injury is between the ages of 1 and 3. Therefore, the longer a family waits to establish a dental home for their child, the more likely the first trip to the dentist is an involuntarly one due to injury. This nearly always creates a negative association with the dentist and increases the risk that kids will develop dental fear and anxiety as they grow. Also, if a child has not already established a dental home, trying to find proper and timely treatment, especially outside of regular business hours, can greatly amplify an already distressing situation. Without a place to go, children are usually referred to a hospital emergency room where wait times can be very long and dentists are not typically available to provide care.

First tooth, first visit

It’s often expressed that a 1-year-old’s visit to the dentist is entirely underwhelming, but that it is a good thing! If we can have the next generation grow up feeling a visit to the dentist is just another part of their wellness routine, the new recommendation of “First tooth, first visit” will have done its job. Early visits to the dentist can eliminate dental fear, prevent the spread of serious disease and establish a health care home in case of emergencies. By creating a long-term relationship with their dentist, kids can overcome fear and live a cavity-free life.

Have GKD come to your school!

The GKD team is taking our show on the road! We have an a really fun, interactive presentation about oral health prepared for school-aged kids! Please give us a call if you’d like to schedule our team to come to your school or daycare and share our message. Spots are booking quickly!

WDS Newsletter featuring Shelly & Greenlake Kids Dentistry

We are so proud that Shelly and GKD were featured in Washington Dental Service’s newsletter this month!

To download the pdf of this article click here

Thank You Front Offices For Helping Grow the ABCD Program!

Front office staff are playing a pivotal role in the continued growth of Washington’s nationally recognized Access to Baby and Child Dentistry (ABCD) program. Willingness to incorporate care of Medicaid-eligible children from infancy to age 6 as part of “business as usual” is making a substantial difference, with more than 128,000 of these youngsters accessing dental care in 2009. The staff at Dr. Troy Hull’s Greenlake Kids Dentistry, Seattle, is helping lead the way. “Our whole philosophy is that everyone gets treated the same regardless of insurance and means from the moment they walk in the door,” says Offi ce Manager Shelly Grosvenor. The staff recognizes that families may be new to Medicaid, with so many families losing medical and dental coverage due to Washington’s changing economy and job market. “Having dental coverage for their children through ABCD may be a new experience,” Shelley explains. “Sometimes it’s just about being empathetic that they might not have the means or that they have transportation or language issues.” That understanding continues throughout the visit. “Some of our fi rst-time patients have had a lot of dental work already and may have been traumatized,” Shelly says. “We treat them with understanding. We take the extra time to get them at ease before we start the dental appointment. Sometimes that means that the fi rst visit is more of a show-and-tell ‘Happy Visit.’ We then book them back for a thorough exam along with family oral health education and ideas for home care.”

The same philosophy guides Dr. Craig Harder’s staff across the state at Moses Lake Family Dentistry. Appointment Coordinator Renie Melcher says everyone in the offi ce “is really on top of making sure that families know that they qualify for ABCD and assure that they take as much advantage of ABCD services as they can. “ Renie says the results speak for themselves: “ABCD families are coming back for follow-up care.” Melcher says the Moses Lake Family Dentistry team supports care to very young children, especially if this is the fi rst visit, “by making it as positive as possible.”

Greenlake’s Shelly Grosvenor agrees. “With a lot of kids (age) 3 and younger, this is a brand new experience,”she says. ”“Being understanding to families is key.” Washington Dental Service Foundation partners with dental societies, Washington State Dental Association, Department of Social and Health Services, Department of Health, University of Washington School of Dentistry and local health departments to establish and support local ABCD programs. WDS Foundation leads the statewide partnership and provides three-year start-up grants to health departments for this program, which is focused on prevention strategies and increased access to children’s dental care. More than 1,300 Washington dentists have been certifi ed in ABCD’s pediatric dental techniques and preventive services.

To learn more about ABCD, visit or contact the WDS Foundation at (206) 528-2337.

Seattle Channel visit to GKD

We’re very proud to have been featured by Seattle Channel. Watch the Video:

Parent Question about Dental Radiation

There are questions that we get all the time. One of them is without a doubt about radiation (x-rays).  I thought it might be helpful to post what my position is as well as some text from dental school so if there are concerns before the appointment, parents can come with some initial answers (the textbook pdf is here).

Our team at GKD has full faith that the benefits of using radiation as a diagnostic tool far out-weigh the risks.  Without them, we simply would not be able to provide the highest quality care our patients deserve from their health care provider.

There is also a legal aspect to consider with using X-rays.  Using radiographs as a diagnostic tool is a standard of care in my profession, and without them, I am not able to provide that expected standard.  For that reason, I am professionally obligated to use them in my practice.  If I am not providing the standard of care, even if it is at the request of a parent or guardian, I am ultimately responsible for any consequences that may arise as a result of not providing that expected standard.

I hope parents understand my position regarding this issue and feel free to call or email me with any questions they have.