The loss of the first primary tooth is an exciting experience for some children, but, for others, this biological milestone is anything but fun. Oral health professionals and parents/caregivers can help create a more positive experience for children, according to a study led by University of Zurich researchers that reports previous dental visits play a crucial role in shaping a child’s experience when it comes to shedding the first tooth.
The study, “Emotions Experienced During the Shedding of the First Primary Tooth,” published in the International Journal of Paediatric Dentistry, highlights that physiologic tooth loss is anything but trivial. In fact, a team of dental researchers and developmental and health psychologists, in partnership with the city of Zurich’s School Dental Services, identified a multitude of emotions associated with the event.
Investigators surveyed 1,274 parents of children who had lost one of their primary teeth. Of those surveyed, 82% reported the child expressed positive feelings, with 22% citing negative emotions. According to researchers, previous visits to the dentist’s office, as well as parental background and level of education, affect how children experience the loss of their first tooth.
Children typically anticipate the loss of their first tooth once they enter kindergarten, as classmates proudly show off the gaps in their smiles and describe what the tooth fairy left them. But there’s more than bragging rights and anticipation of a monetary gift that influences a child’s feelings about losing a tooth, researchers explain.
“Our findings suggest that children deliberately process previous experiences concerning their teeth and integrate them in their emotional development,” says Moritz Daum, PhD, a professor of developmental psychology at the University of Zurich. “Especially where caries are concerned, it’s worth communicating with children prudently. This way, emotions in connection with teeth and dentists can be put on the most positive trajectory possible.”
Shame and guilt were the top feelings associated with the negative experiences reported in the survey, as children whose previous visits were caries-related experienced fewer positive emotions when they lost their first tooth.
“Oral health professionals should encourage children and parents to improve oral hygiene, and advise parents not to have a destructive approach regarding caries,” notes Raphael Patcas, DMD, PhD, PD, a dental researcher at the University of Zurich Center of Dental Medicine.
Educating parents and caregivers on the multiple factors that influence caries prevalence and severity may provide insights into why some children present with caries, while others don’t. Clinicians can also develop a home-care regimen for parents and caregivers to effectively care for the child’s primary dentition, as well as demonstrate proper brushing technique. Parents/caregivers should also be advised about effective caries preventive strategies.
Clinicians can help fill in some of the blanks surrounding questions of why and what happens when it is time to lose the first tooth. “Of all negative emotions, fear and anxiety ranked highest, which means that children predominantly dread something unknown to them,” says Patcas.
However, a previous dental trauma visit (an experience accompanied with a sense of loss of control), and an extended period of noticeable tooth wiggle increased the odds of positive emotions. According to Patcas, one possible explanation is that primary teeth loosen gradually before falling out—a process that, unlike an accident, unfolds slowly and predictably.