The American Dental Association recommends that children make their initial visit to a dentist by their first birthday or within six months of the child’s first tooth. Choosing the right dentist is a cornerstone of good dental health. However, one in 10 children in the United States ages 5 to 11 have never visited a dentist, according to the American Academy of Pediatrics.

Parents are urged to look for a dentist who specializes in the care of children, also known as a pediatric dentist (pedodontist). These dentists are experts in the specific issues that arise in caring for a child’s teeth, and offer care that helps prevent dental problems while maintaining good dental health. Their expertise also helps them to know when it is appropriate to recommend other dental experts such as orthodontists or oral surgeons.

Parents of children with heart conditions are urged to consult their child’s new dentist and cardiologist about the need to take antibiotics prior to the dental appointment. Dental procedures such as teeth cleaning, scaling or periodontal surgery lead to an increased risk of bacterial infection for such patients. A dose of antibiotics one hour before the appointment and six hours after can help reduce this risk. Other conditions that may require use of antibiotics before dental visits include sickle cell anemia, immune system problems and rheumatic fever.

During the initial visit, the dentist examines the baby’s teeth. Oftentimes, the baby remains on the parent’s lap throughout this initial examination. The dentist also instructs the parent on how to care for a child’s teeth. This includes proper brushing techniques and suggestions for flossing, which should begin as soon as two teeth appear adjacent to one another.

Early visits to a dentist not only help ensure good dental health, but also have the benefit of making children more comfortable around the dentist beginning at a young age. Children should visit the dentist at least twice a year, or more often if the dentist recommends it.

Around the age of 30 months, all of a child’s primary teeth will have emerged through the gums. At this time, a dentist is likely to begin applying topical dental fluoride to the teeth. This will help to strengthen the teeth by hardening the enamel and making it less vulnerable to cavities, also known as caries. Cavities occur when bacteria and food left on teeth create acid that collects and begins to soften and break down the enamel. Eventually, a hole forms, and is known as a cavity. Fluoride may also be applied in the form of a varnish. Fluoride varnishes are painted onto the teeth and generally need to be re-applied each year.

Fluoridation of teeth is another important part of dental health. About 60 percent of children in the United States live in communities in which tap water is fluoridated to provide extra protection for residents’ teeth. Fluoridated water can reduce cavities by 35 percent to 40 percent.

Families living in communities that do not fluoridate their water – or families who use purified water – are urged to consult with their dentist about using fluoride supplements. These supplements can reduce tooth decay by up to 50 percent, according to the American Academy of Pediatric Dentistry. Dentists will often prescribe fluoride tablets for children who are 6 months old and older and who are not receiving adequate fluoride through their water. These supplements – which come in chewable tablet or liquid form – should be used carefully, as too much fluoridation can lead to a type of  tooth discoloration (e.g., bright white spots on teeth) called fluorosis. Fluoride treatments usually continue until the child is about 16.

Dentists may recommend applying a thin wash of resin to a child’s back teeth once the child’s permanent teeth come in. This clear, odorless protective plastic coating is known as a dental sealant, and it helps prevent bacteria from damaging crevices in the molars. A combination of fluoride tablets and sealants can reduce the incidence of cavities by about 90 percent, according to the American Academy of Pediatrics.