Why baby teeth matter
They fall out anyway, so why treat them? The short answer, from the clinic.
Babies, ages 0 to 2
By the first birthday, and no, you’re not early
If a baby with four teeth seems young for a dentist, you’re in good company. The visit is short, it’s gentle, and most of it is for you: what to do at home, what to keep an eye on, and what’s coming in the next six months.
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By age oneOr six months after the first tooth
About 20 minutesShort, and mostly on your lap
Open SaturdaysBoth locations, six days a week
What the first visit is really for
There’s nothing here to brace yourself for
Your child should see a dentist by their first birthday, or within six months of the first tooth appearing, whichever comes first. That is the recommendation from both the Canadian Dental Association and the American Academy of Pediatric Dentistry. It is a short appointment, your baby usually stays on your lap, and it is as much about answering your questions as examining them.
The look itself takes a couple of minutes. Your baby sits facing you on your lap and tips back so their head rests on our knees, and we check the teeth and the gums. Some babies find the whole thing fascinating. Some object, loudly, throughout. Both are normal, and neither one predicts a single thing about how they’ll be at three.
The rest of it is a conversation with you. How to clean teeth that have only just arrived, how much toothpaste, what to do about the bedtime bottle, whether the pacifier matters yet, what is coming in the next six months. Most of what causes decay in a two year old is decided long before they turn two. That is the real reason one is the right time to start.
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Ages 0 to 2
What’s easy to miss in a baby’s mouth
Almost none of this will apply to your baby. It is the short list worth checking anyway, because these things are simple to deal with early and much harder late.
Whether teeth arrive in order
Order tells us more than timing does. Teeth come through in matching pairs, lower front two first, and a few months either way is still normal.
Early decay on the front teeth
A chalky white line along the gum on the upper front teeth is the first sign. Caught there, it can still be turned around. Once it goes brown, it cannot.
How you are cleaning them
Two teeth still need cleaning twice a day. Most parents are already doing something sensible and want to hear that it counts. Usually it does.
Fluoride: one part of a healthy smile
Fluoride helps strengthen teeth and prevent cavities, but it’s only one part of keeping your child’s smile healthy. Our pediatric dentists take a personalized approach, considering your child’s cavity risk, diet, and oral hygiene habits to recommend the right preventive care.
Frenum and tongue movement
If feeding has been hard going, we watch how the tongue and the lip move. Most babies with a tight frenum need nothing done at all.
How often your baby needs seeing
Family history, medical conditions, medications and feeding patterns all change the answer. Six months is the starting point, not a rule.
The one that matters most
Nothing but water once the lights go out
The most serious decay we see in very young children comes from milk, formula or juice sitting around the teeth overnight. Saliva flow drops off during sleep, so whatever is in there stays there, against the enamel, for hours.
It starts as a chalky white band along the gumline of the upper front teeth. Easy to miss. Easy to read as a stain. Left alone it turns brown and soft, and a two year old with four decayed front teeth usually cannot have them fixed awake.
None of this is a judgement. Bedtime bottles exist because they work and because everyone is exhausted. It’s still the single most useful thing you can change at this age, so if that’s where you are right now, just say so. We’ll help you work your way off it. Nobody here is going to tell you to stop and leave it there.
At home
What to do at home right now
None of it takes long.
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Wipe the gums before there are any teeth
A clean damp cloth after the last feed of the day. It does very little for the gums and a great deal for getting your baby used to you putting something in their mouth.
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Start brushing the moment the first tooth appears
A soft baby brush, twice a day, with a smear of fluoride toothpaste the size of a grain of rice. One tooth still counts.
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Lay them down. Do not wrestle them upright
Knee to knee with another adult, or your baby lying back across your lap. You can see what you’re doing, and they can’t turn away from you.
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Water only in the bottle after lights out
Milk, formula and juice pooling overnight is the main cause of decay at this age. Going cold turkey isn’t the only route: dilute it down over a couple of weeks.
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Lift the lip once a week and look
Pull the upper lip up and run your eye along the gumline of the front teeth. A chalky white line is worth a phone call while it can still be turned around.
Fluoride: how much is right for your child?
Fluoride can play an important role in protecting your child’s teeth from cavities, but the right amount matters.
Under 3 years old: use a tiny smear of fluoride toothpaste, about the size of a grain of rice.
Ages 3 and older: use a pea-sized amount of fluoride toothpaste, with adult supervision to minimize swallowing.
We understand that fluoride is a topic many parents have questions about, and we’re always happy to have an open, informed conversation about its benefits and appropriate use.
Fluoride is only one piece of the cavity-prevention puzzle. Your child’s diet, frequency of snacking, sugary drinks, brushing habits, and individual risk for tooth decay all play important roles in maintaining a healthy smile.
At Children’s Dental Health Centre, our pediatric dentists take a personalized, risk-based approach to prevention. We assess your child’s cavity risk, discuss dietary and oral hygiene habits, and recommend preventive strategies, including appropriate fluoride use, based on their individual needs.
Our goal isn’t just to prevent cavities with fluoride. It’s to help families understand what causes cavities and build healthy habits that protect their child’s teeth for life.
Questions
What parents ask at this age
Why does a baby with four teeth need a dentist?
Because almost everything that causes decay in a preschooler is set up in the first two years. The first visit is where you get the information. It is not where we go hunting for problems. Coming early also means the office is a familiar place before your child is old enough to find it frightening, and children who start at one are noticeably easier at three than children who start at three.
What happens in those twenty minutes?
Most of it is us talking to you. Your baby stays on your lap, either facing you or laid back with their head resting on our knees, so you are in sight the whole time. We look at the teeth and gums, clean them if they need it, and often paint on fluoride varnish. No x-rays at this age unless there is something specific to look at.
My baby will scream the whole time. Should I wait until they are older?
Plenty of babies do cry, and it is fine. A crying baby has their mouth open, which is honestly no bad thing from where we are sitting. It does not mean the visit went badly and it predicts nothing about how they will be later. Holding off until three to avoid a scene at one tends to produce the harder appointment, not the easier one.
How much toothpaste should I use?
A smear the size of a grain of rice under age three, a pea-sized amount from three up, and fluoride toothpaste from the very first tooth. It is the correction we make most often and it goes in both directions: plenty of parents use far more than they need, and plenty avoid fluoride altogether and meet decay that did not have to happen. Neither is an obvious mistake to make.
Is teething making my baby ill?
Teething brings sore gums, drooling, chewing on everything, irritability and broken nights. It does not cause a high fever, diarrhoea, vomiting or a rash. Those point to something else, and your baby should be seen by a doctor instead of having it put down to teeth. A cold clean teething ring, or a clean finger to chew on, helps more than most of what is sold for it.
Does a pacifier or thumb sucking matter yet?
Not yet. Sucking is normal and comforting in babies and toddlers, and most children give it up on their own. It starts to be worth addressing if it is still going strong around age three to four, because by then it can change how the front teeth and the palate develop. A pacifier is generally easier to stop than a thumb, which is one small point in its favour.
Does a baby need a referral to be seen?
Not necessarily, and it depends what you are coming for. If you are establishing your baby as a new patient and joining our prevention program, no referral is needed and you can book directly. If your child already has a dentist and you want a specialist opinion on one concern, we ask that dentist for a referral so we have the history, and they get a consultation letter back from us afterwards.
Watch
A minute on baby teeth
Care by age