A child’s first dental visit is so much more than a toothbrush prophy and fluoride. Clinicians may assume the younger the child, the less they should do, but nothing is further from the truth. Some children are still breastfeeding only when they have their first dental visit. This is the perfect time to talk to parents about what they can do to ensure healthy jaw development.
Breastfeeding
We recommend that children have their first dental visit after the eruption of their first tooth. If parents follow this advice, they’ll take their baby to the dentist between five and seven months, when the mandibular central incisors erupt.1 As the World Health Organization recommends breastfeeding for up to two years, there’s a very good chance a baby will still be nursing when they first see the dentist.2
While most health-care providers focus on the nutritional benefits of breastfeeding, it also serves as preventive functional jaw orthopedics because it forces impact on the jaw, which grows rapidly during infancy.3 Proper development of the jaw also leads to functional airway development.3 While there are benefits to nursing and suckling, there are no benefits to pacifiers and sippy cups. Tongue and gum placement during breastfeeding encourages forward force, and sucking from sippy cups and pacifiers encourages back force, which can affect proper development of the jaw and airway.3
Want to read more about pediatric patients?
Sleep apnea in pediatric and adolescent patients
A pediatric hygienist's bag of tricks
Nutrition
It’s time to introduce solid foods when a baby is about six months old.2 Many parents transition from milk to purees and cereals, which do not support jaw development. The mechanical action of chewing significantly influences tongue pressure and jaw development as it places pressure on the jaw and skull bones.4 Bone is constantly regenerating and restructuring in response to stimuli, so if a baby or toddler is eating only mushy foods, they’re susceptible to weak jaw development, which can lead to airway dysfunction, mouth breathing, bruxism, and TMD.5
Parents may be reluctant to feed babies solid foods, so dental hygienists must advocate for their pediatric patients or they’ll be prone to health problems in the future. Hygienists should advise parents to feed their children healthy and finely chopped finger foods such as cheese, vegetables, fruits, and whole grains. If the food is cut into very small pieces and the child is always supervised, choking hazards will be kept to a minimum. Many parents consider choking the biggest problem with giving their baby solids, and they rarely consider the health implications of not giving their baby solids and how that can affect jaw development. This is where the hygienist can offer invaluable guidance during a patient's first dental visit.
Pacifiers and thumb sucking
Pacifiers and thumb sucking are common soothing mechanisms for babies and toddlers. While these may provide comfort, they inhibit healthy jaw and tongue development. Soft foods, thumb sucking, pacifier use, and mouth breathing are the main causes of poor facial development and some of the most identified causes of airway dysfunction.6 If a patient has poor jaw development, it will lead to airway dysfunction, which will inevitably lead to mouth breathing, making the child more prone to caries and potential malocclusion.7
Pacifiers and thumb sucking are much more of an issue with toddlers. The American Academy of Pediatric Dentistry recommends that children stop their nonnutritive sucking habits by three years of age to ensure the position of the teeth is normalized before the permanent teeth erupt.8 If a hygienist is seeing a pediatric patient as an infant, they can check in on their pacifier habits at each appointment and help the parents formulate a plan for weaning as the child gets older.
Infant jaws grow rapidly, so it’s imperative that caregivers receive counseling on nutrition and healthy jawbone development, and how both correlate to proper breathing and systemic health. No one is better suited for this work and advocacy than dental hygienists.
