THE practise of dentistry is an art in which teachings of dental science are put to practical application. A patient usually visits the dentist for consultation on the state of health of the teeth, with the expectation that everything possible will be done not only to repair or help heal by therapeutic correction, any disease present, but also prevent disease from occurring if possible. This philosophy is especially true for young children.

The oral health of an adult is set in the pre-school period. This period ends when the child attains four years. Preventative practices set around the age of one determine one’s dental health or disease for many years to come.

The dentist has a once in a lifetime chance to offer guidance during the pre-school period by supplementing the parents’ knowledge of preventative practices. More than 90 percent of dental disease is preventable. The modern practitioner, therefore, works first to prevent disease; the dentist performs restorations (fillings) when prevention fails, rather than the reverse.

Serious dental disease can occur before the child can cooperate for dental treatment, so proper coordination with the parent is important. In fact, the motivation for the child’s oral care depends almost exclusively on the parents. They can decide what the future holds for their child as far as dental health is concerned. We tend to start late. Most of the common oral problems can happen before three years of age. Dental caries (tooth decay), trauma (accidents), and developmental anomalies can each occur before the child is old enough to cooperate for dental care. This simple fact sets the stage for health care practices. For example, bottle caries can occur by the age 18mths (occasionally before once a year) and is preventable.

The basis for practice protocols and public health programmes start with anticipation of the earliest disease. The child’s attitude toward dental care begins with pre-school experience. The child’s receptiveness to care by the dentist or dental nurse is affected by young age, caries experience and invasiveness of necessary procedures. The best situation begins with the dentally healthy child.

A receptive outlook on dental care accompanies the absence of any invasive procedures (such as extractions) during a dental visit. When the child visits the dentist for the first time for say an extraction, the fear and anxiety of the dental office may last for many years. Thus, the likelihood of a receptive child increases with the prevention of disease in an early visit. Postponing an examination because a child is uncooperative puts the child at unnecessary risk for disease, followed by decreased receptivity to the dental personnel.

The connection between the pain and behaviour centres is significant. The memory of an uncomfortable procedure experience can last for many years and this sets off a chain reaction of neglect and self-mutilation in which overcoming fear is the key. So, preventing the disease by starting early as the first access to a receptive, cooperative child.