Charlotte Waite is a Community Dentist in Leicestershire. She specialises in treating vulnerable and nervous patients. Watch this video of Charlotte's approach to treating nervous patients, filmed as part of Wellcome Collection's 'Teeth' exhibition':
The story of little Isla-Rose Heasman, who needed to visit the dentist at just 12 days old, may seem somewhat unusual. But for around one in 2000 babies, who are born with a natal tooth, they will require a dental examination soon after birth.
Natal teeth are teeth which are present at birth. It's a little known fact that babies can also develop neonatal teeth which appear within the first few months after birth, and not something that most parents are expecting.
Parents are often shocked and worried when they see their baby has a natal tooth, it's really important that they get reassurance and support. Neonatal teams will have encountered this many times, and will be able to give initial advice to the parents or carers, and they will ensure the baby is referred on to a dentist.
Knowing how many adult patients are themselves anxious about going to the dentist, I'm always aware of the need for communicating well with parents and carers, especially when it comes to treating their children. In this case, taking your young baby to a dentist can be a source of great concern, so I will try to speak to the mum or dad on the phone before the appointment, to reassure them about what to expect and give them an opportunity to ask questions.
I also suggest that they can bring along a friend or relative if they'd like, as it can help to have some moral support and someone else to listen and take in the information.
When examining young babies, it is often helpful for them to be held by one of their parents. We can easily examine a sleeping baby without waking them and I have done this many times.
I always support and encourage parents to feed their baby in the dental surgery, should this be breast or bottle, and this will help to keep the baby relaxed.
It is really important to understand if the tooth is causing the baby difficulties with feeding, whether this is breast or bottle. If the baby is having difficulty feeding, then the tooth will need to be removed.
Examining the baby is usually very quick and simple and allows me to work out if the tooth is loose or causing
tramua to the soft tissues. Often, I don't even need to use a mirror and can just gently touch the tooth and tongue to find out what treatment is necessary.
If the tooth is loose or causing trauma to the soft
tissues, then removal will probably be required. A loose tooth could potentially be inhaled by the baby and enter their lungs, although this is a very rare complication, it would mean that the tooth will need to be removed.
The baby can have the tooth removed with some topical anaesthetic (numbing cream) and the tooth will be out within a couple of seconds. There is no need for an injection.
It is a very straight forward procedure and actually, completely painless for the baby.
I ask a mum or dad to cuddle the baby during the procedure and sit with them on the dental chair. I also recommend feeding the baby soon after to provide comfort, even though they are young, it's important to make them feel that the dentist is not a traumatic experience and they are reassured.
If the tooth isn't causing any irritation to the surrounding gum (or tongue) and is not loose, then we would generally recommend keeping an eye on the tooth closely but leaving it in place.
I make sure parents have our phone number and out-of-hours contact number, so that if they have any concerns, we can offer immediate advice.
And all parents should remember that it's great for young children to get used to the dental environment, and Public Health England recommend that a child should see a dentist from the age of six months' old – your dentist can give you preventative advice and help ensure that your children's teeth stay healthy - see our myth-busters on teeth brushing!
Charlotte Waite, Chair
England Community Dental Services Committee
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