Conquering the two year old patient

In the past two weeks I have seen three patients in the two year old age range. The biggest challenge with patients in this age group is getting them to open their mouths and to stay open while you look in their mouth. I asked my son's pediatrician the other day why it is that one and two year olds don't like to open their mouths. His response was that the mouth is the one thing a child that age can control. Apparently you can put your fingers in the child's ears and eventually they will open their mouth to get you to remove your fingers. While this trick might work for the pediatrician that is just trying to take a quick look in the back of the throat, it doesn't work so well for the dentist that needs to evaluate 20 individual teeth.

Back to my story... I saw three such patients recently. The first one was a girl that was turning two in a couple of weeks. She didn't want to have anything to do with me and refused to even open her mouth. The second child I saw was a girl that had just turned two. I tried a different approach with her. First, my assistant found a cartoon on television for the girl to watch. Then I had the mom hold the daughter in her lap while we counted the mom's teeth. After we counted the mom's teeth, the little girl wanted her teeth counted as well. While counting the teeth I am able to evaluate each individual tooth for cavities. By two years of age nearly all twenty of the baby teeth have erupted. If cavities are present at this age, then they are either visually evident or are apparent when touching the tooth with a dental explorer (an instrument with a pin like end).

The third patient I saw was a three year old boy. In his case both the cartoon trick and counting daddy's teeth worked. As a three year old there was a little bit more comprehension of what was going on and I was able to polish his teeth as well.

Fortunately, in all three cases the children's parents were doing a good job assisting with the brushing and none of the children had any cavities. When kids this age do get cavities the only way to treat them is to either wait until the child is older (like age four or five) or to treat them while the child is under anesthesia. The best thing for the two and three year old patient is cavity prevention!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com