New Patient Forms

Your child should visit the dentist by his/her 1st birthday, or by the 2nd birthday at least. You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as "needle", "shot", "pull", "drill" or "hurt". The office makes a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

An infant/toddler oral health appointment might include:

  • A review of the diet and nutrition

  • The need for fluoride supplementation considering dietary and other sources of fluoride

  • Instructions for cleaning the teeth and gums

  • Discussion about pacifier, finger, or other oral habits

  • Injury prevention and trauma

  • Oral development and normal eruption patterns

  • Risk factors for decay

In addition, a child age 3 or older should have an evaluation which includes x-rays and cleaning.

Parents in the Treatment Area

Preventive health is a family affair.  Parents may accompany their child to the treatment area if they wish to do so, however, there are some guidelines to be considered:

·         Only one parent should accompany the child for the visit.  The parent who is more comfortable with dental visits should be the choice.

·         The dentist, child and parent need to function as a team.

·         If you are present for treatment, you should be the dentist's silent partner.  You may pat your child or offer some words of support or praise, but remain calm and quiet.

·         Do not repeat the dentist's requests of your child and do not raise your voice.

·         The dentist's attention should not be divided between you and your child, and the child's attention should not be divided between you and the dentist.

Some dental procedures are the same as a minor operation.  The dentist must concentrate not only on the procedure, but on managing your child's behavior.  Try not to distract him or her.

By the age of four, an emotionally and physically healthy child should be able to separate from his parent for an examination and possibly treatment.  However, in our office this choice is up to you.

We strive to make each and every visit to our office a fun one,
the highlight of the child's day!

New Patient Forms

For your convenience prior to visiting our office, please click on the below links to print each form.  Complete the information and bring the forms with you to your first visit.

Patient Introduction and History Form
General Information Form 
Informed Consent for Behavior Management Techniques 
Dental Treatment and Financial Responsibility 
Notice of Privacy Policies

Please note... To print the forms you will need Adobe Acrobat Reader.  If you do not have Adobe Acrobat, click here to download it for free to your computer.


Dr. Rick Nichols
Pediatric Dentist Redlands, CA

Copyright © 2004-2006 Rick Nichols, D.D.S.,  Just for Kids Dentistry  ~  All Rights Reserved.
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