The year they turn six is the busiest one

Almost certainly, and almost every parent does. They are the first permanent molars, and they arrive around age six at the very back of the mouth, behind all the baby teeth. Because no baby tooth is pushed out to make room, nothing gets loose and there is no tooth fairy visit, so they turn up unannounced. They are permanent, they have to last a lifetime, and their chewing surface has grooves narrower than a toothbrush bristle, which makes them the most cavity-prone teeth your child has.

Most children benefit from them on the permanent molars, and the best moment is shortly after each molar arrives: around age six, then again around twelve. A sealant is a thin coating painted into the deep grooves of the chewing surface, where the large majority of cavities at this age begin. There is no drilling and no freezing, and it takes a few minutes per tooth. They wear down over time, so we check them at every visit.

Earlier than you might think! The American Association of Orthodontists recommends that children have their first orthodontic assessment by age 7, but that doesn’t mean they need braces right away.

At Children’s Dental Health Centre, our pediatric dentists monitor your child’s teeth, bite, and jaw development from their earliest visits. During regular checkups, we look for signs of crowding, spacing concerns, bite problems, and jaw growth differences that may benefit from early intervention.

Some children may benefit from Phase 1 orthodontic treatment, which can help guide jaw development, create space for incoming permanent teeth, or correct certain bite problems while they are still growing. Others may simply need continued monitoring until more permanent teeth have erupted.

Timing matters because growth matters. Once growth is completed, there are limitations in what orthodontics can do to help align teeth or improve function.

The goal isn’t to start braces early. It’s to identify the right time for treatment, if treatment is needed at all.

With regular visits, our pediatric dentists can help guide your child’s developing smile and recommend orthodontic care at the most appropriate stage.

Not necessarily! Every child’s smile develops at its own pace. Most children begin losing their baby teeth around age 6, but some start later. Children whose baby teeth erupted later than average may also lose them later.

However, it’s important to make sure the permanent teeth are developing normally beneath the gums. Approximately 2–4% of children have one or more congenitally missing permanent teeth, meaning those adult teeth never developed.

Around age 7, or when your child’s first permanent teeth begin erupting, our pediatric dentists assess their dental growth and development. When appropriate, we may recommend a panoramic X-ray, which provides a broader view of the developing teeth and jaws. This helps us evaluate:

Missing permanent teeth: Confirm whether the adult teeth are developing beneath the baby teeth.

Eruption concerns: Identify permanent teeth that may be growing in the wrong direction (ectopic eruption) or are having difficulty erupting.

Jaw development: Look for unusual findings, including cysts or other abnormalities that may require further evaluation.

This is another reason regular dental visits are so important. By monitoring your child’s growth and development, our pediatric dentists can identify potential concerns early, provide reassurance when everything is progressing normally, and recommend treatment only when necessary.

Our goal isn’t to rush your child’s teeth. It’s to make sure their growing smile is developing in the right direction.

Don’t worry! This is a common part of dental development, especially with the lower front teeth. Often called “shark teeth,” this happens when a permanent tooth begins erupting behind a baby tooth that hasn’t fallen out yet.

In many cases, the baby tooth gradually loosens and falls out naturally, allowing the permanent tooth to move forward into a better position as your child’s mouth continues to develop.

However, sometimes a little help is needed. Our pediatric dentists may recommend removing the baby tooth if:

Your child is experiencing pain or difficulty eating because of the retained baby tooth.

The baby tooth isn’t becoming loose, and an X-ray shows that its roots have not resorbed (dissolved) as expected.

The permanent tooth is erupting in an unfavourable direction, and the retained baby tooth may be interfering with its normal eruption.

This is why regular dental checkups are so important! At Children’s Dental Health Centre, our pediatric dentists monitor how your child’s baby teeth fall out and permanent teeth develop. By identifying potential concerns early, we can determine when it’s best to allow nature to take its course and when a little intervention may help.

Our goal is to guide your child’s developing smile while avoiding unnecessary treatment.

Act quickly! A knocked-out permanent tooth is a dental emergency, and the first 30–60 minutes can make a big difference in saving the tooth.

If your child knocks out a permanent tooth:

Find the tooth and hold it by the crown (the white part), never the root. Touching the root can damage the delicate cells needed for successful healing.

If the tooth is dirty, gently rinse it with milk or saline. Do not scrub, scrape, or use soap.

If possible, carefully place the permanent tooth back into its socket immediately, ensuring it is facing the correct direction. Have your child gently bite on a clean cloth to help hold it in place. Only attempt this if your child is alert, cooperative, and able to do so safely.

If you cannot reinsert the tooth, keep it moist in milk or a tooth-preservation solution. Avoid storing it in plain water or allowing it to dry out.

Seek emergency dental care immediately. Contact Children’s Dental Health Centre as soon as possible. The sooner treatment begins, the better the chance of saving the tooth.

Important: Never put a knocked-out baby tooth back into its socket. Reimplanting a baby tooth can damage the developing permanent tooth underneath. It can also cause complications, including infection or the baby tooth fusing to the surrounding bone (ankylosis), potentially interfering with the eruption of the permanent tooth.

If you’re unsure whether the knocked-out tooth is a baby tooth or a permanent tooth, do not attempt to reinsert it. Keep it moist in milk and seek immediate dental advice.

Remember: Permanent teeth may be saved with prompt treatment. Baby teeth should never be replanted.

For most children, yes. More is changing at this stage than at any other, so the visits are doing more than checking for cavities: we are tracking how teeth are being lost, how the adult ones are arriving, how the bite is developing and whether the sealants are still intact. Some children are seen every three months because of higher decay risk or a medical reason.