CDA Essentials 2017 • Volume 4 • Issue 2

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31 Issue 2 | 2017 |
Supporting Your Practice
First Visit by Age 1 and Free Under 3
There was consensus that the message about the need
for a first visit to the dentist by 1 year of age had been
lost in the FFV program’s advertising. The “free under 3”
message had eclipsed that more important message.
Dentists were consistent that the key message should be
visit your dentist before the age of 1 or 6 months after
eruption of the first tooth.
“ A lot of parents see “free first visit under 3,” and
even though in the fine print we recommend at
1 year, they think, “Oh we have until age 3 to come
in.”… Parents are surprised that it’s recommended
at 1 year…”
Impact of FFV on Dentists
Most dentists said that the MDA’s promotion of the
FFV program had not altered their awareness or practice.
There was a suggestion that the age for seeing children
had changed relatively recently. As one dentist put it,
“We used to always say years ago, that 3 years of age
was the time to come, and I think that was ingrained in
people’s minds.”
It was pointed out that most FFVs are performed by
pediatric dentists. Many pediatric dentists commented
that they wanted to see more general practice dentists
do more screening of young children.
Several specialists wondered if general dentists were
comfortable examining very young children, and
general practice dentists raised this point too. When
one dentist commented on “the general challenge of
just getting into the mouth of a 15-month-old,” heads
nodded all around the table, and someone added,
“That’s why there are specialists.”
Discussion
Overall, dentists were enthusiastic about the FFV
program and there was general support for its
continuation. Focus group participants also said the
program helped to raise public awareness about the
recommended timing for a child’s first dental visit.
A survey of Manitoba dentists conducted after the
program’s first year showed increased awareness of age
recommendations for first dental visits: 86.3%, up from
58% in past surveys.10,11 Further, the average age for a
first visit recommended in their practices has decreased
significantly over time (18.9 vs. 24.8 months) and is only
6.9 months later than the age 1 recommendation.11
Unfortunately, despite growing awareness
in the broader oral health community
about the age 1 visit, many Canadian
children are likely not benefiting from early
examinations.9 However, evidence from the
first 3 years of the FFV program indicates
that more Manitoba toddlers are benefiting
from early examinations.12
Dentists viewed the program as a good
public health measure and a way to bring in
greater numbers of young children for early
dental visits. They felt that the FFV program
helps educate parents and promote caries
prevention while also developing the
child’s comfort in the dental chair. Barriers
to taking part in the FFV program included
the expense associated with the program and not being
comfortable performing infant dental exams.
Although both general practice and pediatric dentists
participated in the FFV program and the program
was intended to increase the participation of general
dentists, pediatric dentists account for most of these
visits. Whereas general practice dentists reported seeing
an average of 7 children a week, pediatric dentists saw
16.5 preschool children a week on average.
Participants in this focus group study suggested that
increasing general practice dentists’ comfort with
performing infant examinations might lead to their
greater involvement in providing FFV visits in their
offices and increased access to care.17
Final recommendations that were presented to and
discussed with the MDA included the need to continue
with this initiative, to tailor messaging to the public and
profession so that emphasis is placed on the importance
of the first visit no later than 12 months of age and to
continue to increase general dentists’ ability to work with
young children. a
Visit
to view a Panel
Discussion about the
Manitoba Free First Visit
program with
Drs. Joel Antel, Carla
Cohn and Cory Sul
Please note: An incorrect dosage was included in the article “Antibiotic Prophylaxis: Timing is Everything”
(CDA Essentials, Issue 1, 2017. p. 25). The correct dosage should read: "2 g dose of amoxicillin."
CDA Essentials apologizes for this error.
Erratum