At What Age Can a Children’s Oral Health Exam be Performed?

At one point, it was believed that pediatric dentistry exams should wait until a child was at least 3 years old. By this age, all of a child's baby teeth should have already come in, and the conventional wisdom was that children did not have the maturity to cooperate with a dental exam until they were older toddlers.

On the other hand, tooth decay is an extremely common chronic disease occurring in early childhood. Children are at risk for caries, another name for tooth decay, as soon as the baby teeth start emerging, typically around the age of 6 months. Therefore, it is now recommended that a child's first dental exam happen no later than their first birthday, and preferably as soon as possible after the first tooth erupts.

How does a pediatric dentistry exam take place?

Some people are mystified as to how a dentist can perform a dental examination on a small child who may not even be old enough to sit up in a chair alone. Pediatric dentists have had to modify the techniques they use for examinations of very young children to involve assistance from the child's caregiver. Depending on the child's age, the dentist may use either the knee-to-knee approach or the on-the-stool approach.

Knee-to-knee approach

When the patient is between 6 and 18 months old, they sit on the caregiver's lap in the dentist's office, facing the caregiver. The dentist sits knee to knee with the caregiver. The caregiver then leans the child back so that their head is in the dentist's lap, allowing the dentist to carry out the examination this way.

On-the-stool approach

A child over the age of 18 months may be able to sit up on their own but may still have apprehensions about the dental examination and require the reassurance of a caregiver. For children between 18 and 24 months of age, the dentist may use an on-the-stool approach. The caregiver sits on a chair, and the child sits on a stool in front of them, facing the dentist. This allows the caregiver to hold the child in place, providing any restraint and offering any reassurance they deem necessary.

What else happens during a pediatric dentistry visit?

Regardless of the child's age and the approach taken, an exam by a pediatric dentist is typically very short, perhaps no longer than five minutes. During this time, the dentist determines whether any tooth decay is already present. If not, the dentist can counsel the caregiver on caries prevention.

The rest of the visit is absorbed in obtaining the child's dental and medical history. This allows the dentist to assess the child's risk for caries and other dental problems and offer specific counseling on prevention. In particular, the dentist gives instructions to the caregiver on maintaining the child's dental hygiene, as children of this age are too young to brush and floss effectively by themselves.