By Stephanie Vaccaro, Special Writer
If you have young children, you may be unsure how to approach dental care for them. Area dentists have a few answers to your basic dental health questions.
When should parents start bringing their children to the dentist?
“The American Dental Association recommends at age two because they’re supposed to have all of their baby teeth,” said Dr. Donna Vagnozzi-Bucci, of Family & Spa Dentistry in Pennington. “But in actuality, most do not have all of their teeth in at two, so we tell patients to bring them in if there is a problem, like if they fall or you can see an obvious cavity. But we tend to tell them between age two and three because we think two-year-olds tend to be too small.”
Dr. Abby Neville, of Princeton Dental Group in Princeton, they also start to see children around the age of three. “Ideally, we would like to see them much earlier, but realistically it’s usually age three,” she said.
But Dr. Vagnozzi-Bucci encourages her patients to bring their small children with them to their appointments to establish familiarity, which can help to assuage their fears when it’s their turn because it is familiar.
Earlier trips to the dentist office can be necessary if the child has visible cavities or decay on the front teeth from bottles or if damage or darkening has occurred because of falls, Dr. Vagnozzi-Bucci said.
What type of oral care do babies and toddlers need?
“Even before they have their teeth, we always recommend that they wipe their mouth out with at least a wet cloth at night before they go to bed,” Dr. Neville said. “Of course, we don’t want them to develop a habit of eating frequently in the middle of the night.” Even with her own children, she kept a cloth nearby so she could clean their mouths.
“They get used to you going in there and doing that,” Dr. Vagnozzi-Bucci said. “And when the teeth come in, you go in there and clean the teeth.”
“Certainly, once they have teeth, we recommend that you brush them gently, and clean them just like you would adult teeth,” Dr. Neville said. It’s okay to clean them with water or with infant toothpaste without fluoride. “Babies and toddlers tend to like the taste of it.”
“But it’s not necessary, just as long as you’re manually removing the plaque, that’s the most important thing,” Dr. Neville said, recommending that the head of the brush be very small.
How do dentists ease a child’s fear?
“You have to show a child everything that you’re doing,” Dr. Vagnozzi-Bucci said. She shows the children the instruments and lets them hold them.
Dr. Neville trades in her white coat for a colorful one. “When I talk to them, I actually go down to their level, so that I’m not standing over them, and that’s how we start it,” she said. “Usually the first time we bring them in we don’t do anything, and I’m okay with that – just as long as they are introduced to me and they realize that it’s a fun place. If we get to brush their teeth, that’s great. If we don’t, that’s okay too just as long as we establish a good relationship and everybody’s happy.”
“I never force them to do anything,” Dr. Neville said. “Because usually if you start very early – at two or three – they see you a couple of times and then they recognize you when they come in. They know exactly what to expect.”
Dr. Vagnozzi-Bucci has found the art of distraction to be a valuable tool for putting children at ease. She does so by having cartoons the children can watch during the appointment. They also take photographs of children’s first visits that they can take home with them that day. “You try to make it happy, you try to make it a positive experience,” she said. If she senses apprehension, she will take it slowly so as not to overwhelm them. They will also avoid doing x-rays on the first visit, unless it is absolutely necessary to do so.
Dr. Neville has books, cool sunglasses and other kid-friendly items to make the kids feel at ease.
“Keep it light,” Dr. Vagnozzi-Bucci said. “You can always bring them back.”
What do you use to eliminate or reduce pain?
“Usually, I explain to them in steps what’s going to happen before we start,” Dr. Neville said. “So, they know where this is headed and where it’s going to end.”
When she needs to give them an injection, Dr. Neville explains that she’s going to apply a little gel that will feel funny on the skin. She’ll then have them close their eyes and count to ten in their minds while she counts aloud. “Most of the time they don’t even know what is happening,” Dr. Neville said of the injection. “The idea is to have as little pain as possible.”
But Dr. Neville feels strongly that honest communication is essential with children. When kids ask her if it’s going to be hurt, she’ll say, “Yes, I am going to use a needle. It may pinch a little bit, just like a mosquito bite or something like that. I don’t ever lead them to believe that that’s not going to happen. If they ask me directly, I always tell them the truth. That’s when they start to mistrust you, if you say one thing and another thing happens.”
“Minimizing the pain is key,” said Dr. Vagnozzi-Bucci, who uses the numbing gel in such a way that the kids don’t realize they’re getting a needle. “You give a kid pain and they don’t want to come back. The name of the game is no pain – for an adult or a child.”
“That’s the most important thing – good numbing,” Dr. Vagnozzi-Bucci said.
When does your child need braces?
“Usually when they’re first molars come in around age seven, that’s when we recommend the first evaluation from an orthodontist,” Dr. Neville said.
“We monitor a child very early,” Dr. Vagnozzi-Bucci said. “Now we do more interceptive orthodontics.” This allows them to intercept problems before they arise. For example, if it is clear that a child’s mouth is crowded, an expander can be used to help make room for teeth so they can come in straight. “That’s diagnosed early and acted on earlier these days.”
On the first visit they can anticipate some of the potential problems and relay that information to the child’s parents, Dr. Vagnozzi-Bucci said.
But having an incorrect bite or crooked baby teeth is not an indicator of a future need for orthodontics, Dr. Neville said. They can see how the bite is going to be established once the permanent teeth, especially the molars, come in. “It’s very, very rare that you would do intervention before that,” Dr. Neville said.
How do I choose a dentist for my child?
Dr. Vagnozzi-Bucci said that parents should look at how many children a dentist works with, their comfort level with children, the modalities used to make children more comfortable. Finding an office that is kid-friendly is really important, Dr. Vagnozzi-Bucci said.

