When should I schedule my child’s first visit and what can I expect?

The first dental visit should be when your child’s first tooth erupts or by age one. Having cavities is not related to how old a child is, but rather if they have teeth or not. We will discuss if there are any developmental abnormalities, congenital dental defects, your child’s diet and if they have any dental habits such as thumb sucking or prolonged pacifier use. We will examine your child’s teeth and gums. X-rays will be taken when it is determined necessary to check for decay and to evaluate the progress of the permanent teeth under the gums. We may clean your child’s teeth and apply fluoride to help protect the teeth against decay. Most importantly, we will review with you how to clean and care for your child’s teeth.

We will use the Tell-Show-Do method during your child’s appointment. It is just as the name suggests, TELL your child what you are going to do, SHOW them what we are going to do or what instrument we will be using, and then DO it. This decreases your child’s anxiety and eliminates fear of the unknown as they know what will be used and what to expect next. Tell-Show-Do builds the trust between the provider and the patient and allows us to have a fun and successful appointment.

Our goal is to provide a safe and fun environment while building trust with our patients and their families. That is why we have a special “on deck” area in our hygiene bay for our parents to watch their children during their appointments. It allows your child to know you are there, while giving them the opportunity to build confidence in themselves, as well as showing you that they can do it “on their own”. They will receive a token at the end of the appointment so they can get a prize for being a great patient!

Pediatric Dentist Coralville


With so little time in the day for all the activities your children are doing, it can be tempting to stop and get fast food instead of making a well-balanced meal at home. Some of the most common foods that result in tooth decay for children are apple juice, sugary energy drinks, soft processed or sticky foods (such as crackers, cereal or fruit snacks) that linger on the teeth or sweetened coffee and tea drinks.


Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Some tips for cavity prevention:

  • Limit frequency of meals and snacks

  • Encourage brushing, flossing and rinsing

  • Watch what you drink

  • Avoid sticky foods

  • Make treats a part of meals

  • Choose nutritious snacks


Thumb and/or finger sucking and pacifier use are natural comforting actions for babies. Most infants stop the habit by age two, however, if your child does not stop, you should help to curb the habit as soon as possible. If your child continues past the age when permanent teeth start to erupt, they may develop crooked teeth and a malformed roof of their mouth. Prolonged thumb sucking can create crowded teeth, permanent bite problems or even speech impairment. We encourage parents to break the habit as early as possible by using positive reinforcement.

Suggestions to break the habit:

  • Wait until the time is right (low stress)

  • Motivate your child (show examples of what could happen to their teeth)

  • Use a reward system, small incentives will encourage your child to stick to it!

Habit Appliances

Customized thumb/finger appliances can be placed in the child’s mouth to prevent/deter the child from causing a lasting effect to the developing dentition. They are very effective when left in place 3-6 months. They are inserted using dental cement and will be removed by our doctor once the habit has been broken.


Infant Gum Care

Even before your child gets teeth there are several habits that you should work on to help ensure good oral health. Getting in the habit of wiping your baby’s mouth with a wet washcloth after nursing or feeding is a great routine to help establish good oral health. There are also products that can be slipped onto a finger that are made of soft material that work well also.


As teeth begin to erupt in the mouth, many children experience some discomfort or sleepless nights. There are multiple options to help relieve their discomfort such as teething rings or a cold wet washcloth. Or you could simply rub the baby’s gums with a clean finger. Symptoms your child may experience during teething include:

  • Excessive drooling, which may lead to a rash on the face or chest
  • Gum swelling and sensitivity
  • Irritability or fussiness
  • Low grade fever (rare)
  • Refusing to eat
  • Rubbing of ears and cheeks
  • Sleep problems
  • Urge to bite on hard objects

Tooth Eruption

The first baby teeth that come into the mouth are the two front bottom teeth. You will notice this when your baby is about six months old. Next to follow will be the two upper front teeth and the remainder of your baby’s teeth will appear periodically. They will usually appear in pairs until the child is about 2 ½ years old. Around 2 ½ years old, your child should have all 20 baby teeth. Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don’t. Don’t worry if some teeth are a few months early or late as all children are different. Baby teeth are important as they not only hold space for permanent teeth, but they are important for chewing, biting, speech and appearance. For this reason, it is important to maintain a healthy diet and daily hygiene.

Early Childhood Tooth Decay

What causes tooth decay? Several specific types of bacteria that live on the teeth can cause decay. When sugar is consumed, the bacteria use the sugar and then manufacture acids that dissolve the teeth and cause an infection in the tooth. This infection is called decay. What is early childhood tooth decay? Babies who go to bed with a bottle of milk, formula or juice are more likely to get tooth decay. Because the sugar in formula, milk or juice stays in contact with the teeth for a long time during the night, the teeth can decay quickly. Some tips to avoid early childhood tooth decay:

  • Put your child to bed with a bottle of plain water, not milk or juice
  • Stop nursing when your child is asleep or has stopped sucking on the bottle
  • Try not to let your child walk around using a bottle of milk or juice as a pacifier
  • Start to teach your child to drink from a cup at about 6 months of age. Plan to stop using a bottle by 12 or 14 months at the latest
  • Don’t dip your child’s pacifier in honey or sugar

Brushing Instruction

As your child begins to get teeth, you may use an appropriate sized toothbrush designed for children with soft, rounded bristles for gentle cleaning. After the first tooth erupts, you can use a smear amount of a fluoridated toothpaste. Children at the age of three may begin to use more toothpaste, but parents must always be in control of the amount of toothpaste being used, up to a pea sized amount. You can start flossing when the spaces between your child’s teeth have closed. As children approach the age of two, many parents experience difficulty while brushing their child’s teeth. Children begin reaching cognitive milestones and want to become more independent. It is good to allow your child to brush their teeth, but until they can tie their shoes on their own, a parent must always finish for them. Your child may cry or fuss while doing this, that is normal. It is important to build routines with your child and reinforce that you are helping clean their teeth. With time, the routine will become expected and your child will not protest. Suggestions to make tooth brushing less of a battle include:

  • Have a stash of a few toothbrushes with their favorite characters, then let them choose which one they want to use each time (this gives them some feeling of control over the situation)
  • Let your child brush on their own first knowing you will help out afterwards
  • Read some children’s books about tooth brushing
  • Have everyone brush their teeth at the same time

Adolescence and Teen Oral Care

There is evidence that periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene. Children who maintain good oral hygiene through their teen years are more likely to continue brushing and flossing than children who were not taught proper oral care. Teens are caring and intelligent people with a sense of independence. Our goal is to create a trusting environment where they feel comfortable asking questions about their oral health. We want to help them make great choices on their own with knowledge behind their choices. Teens and young adults face risk factors for the development of tooth related health problems. Sports and energy drinks, as well as coffee drinks are loaded with sugar. These sugars lead to the breakdown of tooth enamel and permanent risk for future tooth decay. Water or flavored water without added sugar is always a better choice. Healthy food choices over fast food or sugary foods help contribute to their oral health as well as their overall health. Stress is another contributor for teens and young adults on their oral health. Stress can lead to clenching and tooth grinding. The pressure can result in soreness or pain in the jaw joint and wearing of tooth structure. We might recommend a mouthguard or other options in these cases.

Advice for Parents

It is important to establish good oral health habits with your child early. Serve as a good role model by practicing good oral health care habits yourself and schedule regular dental visits for family check-ups, periodontal evaluations and cleanings. Check your child’s mouth for signs of periodontal disease, including bleeding gums, swollen and bright red gums, recession and bad breath. If your child currently has poor oral health habits, work with them to make changes. It’s much easier to modify these habits in a child than in an adult. A healthy smile, good breath and strong teeth all contribute to a young person’s sense of personal appearance, as well as confidence and self-esteem.