Your Child's First Visit

How Early Should the First Visit Be?

As soon as the first tooth shows, and no later than the first birthday. Most babies cut their first tooth at around six months, although anything between four months and a year is within the normal range, and the full set of twenty baby teeth is usually in place by about two and a half.

The point of coming this early is not treatment. It's familiarity. A baby who has been in the surgery a few times, sat on your knee and had a quick look in their mouth learns that the dentist is an ordinary place where nothing much happens, and that makes later visits far easier. It also gives us the chance to pick up early decay, which can start within months of a tooth appearing, and to talk through feeding, teething and brushing while your routines are still forming.

Parents who wait until something hurts tend to have a much harder first appointment. An early, uneventful visit is the simplest way to avoid that.

What Does a First Visit Involve?

For a baby or toddler the whole appointment may be a look around their mouth with a small mirror while they sit on your lap, and a chat with you. That counts as a complete visit. Dr Pei Xian Chen, who sees most of our younger patients, keeps these appointments short, unhurried and upbeat, and nothing is done against a child's will. If they'd rather watch you have your teeth counted first, that works too.

We'll go through how to brush, which toothpaste to choose, teething, dummies, bottles and cups, and what snacks and drinks do to teeth, and you can ask anything you like. From around age three, fluoride varnish can be painted onto the teeth, usually twice a year, at £15 per application; it takes under a minute and hardens the enamel against acid. When the adult molars come through at around six, we can protect the deep grooves on their biting surfaces with a fissure sealant, a thin coating that stops food and plaque lodging where a toothbrush can't reach. X-rays are taken only when there's a reason. As children grow, their dental examinations also track how the adult teeth are arriving and how the bite is forming.

Brushing at Home

• Twice a day for around two minutes, and the bedtime brush is the one that matters most
• Always a fluoride toothpaste. Look for at least 1,000 ppm fluoride on the tube for young children; from about seven they can move to a family paste at 1,350 to 1,500 ppm, or sooner if we suggest it
• A smear the size of a grain of rice for under-threes, a pea-sized blob from three
• Spit out the foam but don't rinse with water afterwards, or you wash the fluoride away
• An adult should do or finish the brushing until around age seven, and supervise after that. Younger children simply don't have the hand control to clean properly on their own
• Choose a small, soft-headed brush and swap it every three months, or sooner once the bristles splay

The trick is to make it ordinary rather than a nightly negotiation: same time, same place, every day. Let them start, then you take over to finish. Brushing your own teeth beside them helps, and so does standing behind a small child with their head resting back against you, which gives you a clear view of the back teeth.

Food and Drink

• Sugar does its damage by frequency, not quantity. Each sugary snack or sip lets plaque bacteria make acid for around half an hour, so grazing through the day is far worse than the same amount eaten at a meal
• Between meals, stick to water and plain milk
• Never put juice, squash or anything sweet in a bottle, and nothing but water at bedtime
• Introduce a free-flow cup from six months and aim to be done with bottles by their first birthday
• Fruit juice and smoothies are sugary drinks even when the label says no added sugar. Mealtimes only, and watered down
• Raisins, chewy sweets and biscuits cling to teeth for ages. Cheese, breadsticks, vegetable sticks and plain yoghurt are better snacks
• Read the labels on toddler snacks and fruit bars. Plenty of products marketed as healthy are mostly sugar

What Children's Dentistry Costs Here

We're a fully private practice, so there's no registration list to join and your child can usually be seen within days. A child examination is £28, and the first one can simply be a gentle introduction if that's all your child is ready for.² Fluoride varnish is £15 per application, and small X-rays, when they're needed, are £10 each. Fissure sealants are quoted before they're placed. If treatment is ever needed, such as a small filling, we explain it, put the fee in writing first, and plan it around what your child can manage.

Many families on Greenwich Peninsula and in Greenwich Millennium Village book their children's examinations alongside their own, which makes the visit feel routine. Adults can join one of our dental plans, which cover examinations and hygiene visits. To get started, request a call back, send us a WhatsApp message or book online, and tell us your child's age and anything we should know.

Helping Visits Go Smoothly

• Pick a time when your child is rested and fed, not just before a nap or at the end of nursery
• Keep your language light and avoid the words you're trying to reassure them about. "Hurt", "needle" and "drill" plant ideas; "Dr Pei is going to count your teeth" is plenty
• Let them watch your own examination first so the room, the chair and the faces are familiar
• A favourite toy or comforter is welcome, and so is sitting on your lap instead of the chair
• Praise the effort, not the outcome. Sitting in the chair and opening wide is a success, even if we did nothing else
• Tell us in advance about additional needs, sensory sensitivities or previous bad experiences so we can plan the visit around them

With an anxious child we slow right down, keep the appointment brief and show them everything before we use it, sometimes on their hand or a toy first. Nothing is forced. A short visit that ends well is worth far more than a long one they remember badly.

When Not to Wait for the Next Visit

Don't hold on for the next routine visit if you spot any of the following:

• Chalky white patches, brown marks or dark spots on the teeth, particularly near the gum on the top front teeth
• Complaints of toothache, or wincing at hot, cold or sweet things
• Gums that look swollen or bleed, or a pimple-like spot on the gum
• A bump to a tooth, even if it looks untouched. We check both the baby tooth and the adult tooth forming underneath
• A knocked-out baby tooth should never be pushed back in. A knocked-out adult tooth should be put back or kept in milk, and your child seen within the hour
• Thumb or dummy sucking still going on as the adult front teeth arrive
• Adult teeth erupting behind baby teeth that haven't fallen out, or a baby tooth that has been wobbly for months

Same-day emergency appointments are kept for knocks and accidents: call 020 8788 6688 before 9.30am and we'll see your child that day. Our dental emergencies guide explains what to do in the meantime.

Teenagers, Sport and Braces

Teenagers are welcome too. Their dental examinations cover hygiene habits, erosion, early gum problems and, from the mid teens, where the wisdom teeth are heading. Adult teeth start arriving at around six and most are through by twelve or thirteen, which is the age when crowding and bite problems become obvious. If braces are needed we'll explain the options and refer to an orthodontist where that's the right route. Older teenagers with mild crowding sometimes ask about Invisalign, which Dr Pei plans and provides here.

For football, rugby, hockey and martial arts, a custom-made mouthguard, from £135, fits closely and protects far better than a boil-and-bite one from a sports shop. It needs remaking as the jaw grows and teeth move. Energy drinks and fizzy drinks are the main cause of enamel erosion we see in teenagers, so it's worth a frank conversation about keeping them for occasions rather than every day.

Questions

This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.