As a parent, it can be hard to know what is normal, what needs attention, and what you can stop worrying about when it comes to your child’s teeth. When should the first appointment be? Are baby teeth really that important? What do you do about thumb sucking? This page answers many questions dentists are often asked.
Getting Started
When should my child first see a dentist?
The American Academy of Pediatric Dentistry recommends that children have their first dental visit by their first birthday or within six months of their first tooth appearing, whichever comes first. This might seem early, but the first visit is less about treatment and more about establishing a relationship with the dental environment, giving parents guidance on home care, and identifying any early concerns before they become problems. Starting early also means dental visits become a normal, unremarkable part of life rather than something unfamiliar and anxiety-provoking.
What happens at a child’s first dental appointment?
The first visit is typically gentle and brief. We will take a look at your child’s teeth and gums, check for any early signs of decay or developmental concerns, and talk through brushing technique, diet, and what to expect as more teeth come in. For very young children, the examination is often done with the child sitting on a parent’s lap. The goal is a positive, calm experience that your child leaves feeling good about.
My child is nervous about the dentist. How do you handle that?
Dental anxiety in children is very common and something we have a great deal of experience with. We take our time, explain everything in age-appropriate language, never rush a child who is not ready, and never use language that might increase fear. We also encourage parents to frame dental visits positively at home in the days beforehand, avoiding phrases like “it won’t hurt” which paradoxically plant the idea that it might. Our dental anxiety page has more on how we approach nervous patients of all ages.
How often should children see the dentist?
Every six months is the standard recommendation for most children, for the same reasons it applies to adults. Professional cleanings remove buildup that home brushing misses, and regular examinations catch small problems before they become large ones. Some children with higher decay risk or developmental concerns may be seen more frequently. We will advise on the right schedule for your child based on what we find at each visit.
Baby Teeth
Do baby teeth really matter if they are just going to fall out anyway?
Yes, very much so. This is one of the most common misconceptions in children’s dental health. Baby teeth serve several critical functions. They hold space in the jaw for the permanent teeth developing beneath them. If a baby tooth is lost too early due to decay or infection, the surrounding teeth can drift into the gap, causing crowding and alignment problems that may require orthodontic treatment later. Baby teeth also help children chew properly, support speech development, and contribute to facial structure. Decay in baby teeth can also spread to permanent teeth and cause infections that affect overall health. They deserve the same care as adult teeth.
When do baby teeth come in?
Most children get their first tooth between four and seven months of age, though anywhere from three months to a year is within the normal range. The lower front teeth typically appear first, followed by the upper front teeth. By around age three, most children have their full set of twenty baby teeth. Timing varies significantly between children and is not generally a cause for concern unless teeth are significantly delayed, in which case it is worth mentioning at your next visit.
When do baby teeth fall out?
Children typically start losing baby teeth around age six, beginning with the lower front teeth. The process continues until around age twelve or thirteen when the last baby teeth are replaced. The permanent molars at the back of the mouth come in without replacing baby teeth, appearing between ages six and twelve. The sequence and timing vary between children and some variation is entirely normal.
My child has a wobbly tooth. Should I pull it out?
In most cases it is best to let a wobbly tooth fall out on its own rather than pulling it. A tooth that is naturally loose will come out when it is ready, and forcing it out before then can occasionally leave root fragments behind or cause unnecessary discomfort. Encourage your child to wiggle it with their tongue. If a tooth has been very wobbly for several weeks without coming out, or if a permanent tooth is coming through before the baby tooth has fallen out, it is worth having it checked.
What causes tooth decay in young children?
The most common cause of early childhood tooth decay is prolonged exposure to sugary liquids, particularly putting a child to bed with a bottle of milk, formula, or juice. The liquid pools around the teeth during sleep when saliva production is reduced, creating ideal conditions for decay-causing bacteria. This pattern of decay is sometimes called baby bottle tooth decay and it can progress very quickly in young children. Frequent snacking on sugary or starchy foods throughout the day is another significant contributor. Water is the safest drink between meals and at bedtime.
Brushing and Home Care
When should I start brushing my child’s teeth?
As soon as the first tooth appears. Before teeth come through, you can wipe the gums with a damp cloth. Once the first tooth erupts, use a soft infant toothbrush with a tiny smear of fluoride toothpaste, about the size of a grain of rice. At age three, increase to a pea-sized amount. Children generally need help with brushing until around age seven or eight, when they develop the manual dexterity to do it effectively on their own. Even then, supervision is a good idea for a while longer.
Should I use fluoride toothpaste on my child’s teeth?
Yes. Fluoride is safe and effective for children when used in age-appropriate amounts. For children under three, a tiny smear is the right amount. For children three and over, a pea-sized amount is appropriate. The concern about fluoride in young children is swallowing excess amounts before they can reliably spit, which is why quantity matters. Using the right amount eliminates that concern while delivering the cavity-protection benefits fluoride provides.
When should children start flossing?
Flossing becomes relevant once two teeth are touching, because that is when a toothbrush can no longer clean between them. For many children this happens around age two or three for the back teeth. You will need to floss for your child initially. Floss picks designed for children can make this easier. Around age eight to ten, most children can start learning to floss independently with supervision.
My child refuses to brush their teeth. What can I do?
This is one of the most common challenges parents face. A few approaches that tend to help: letting your child choose their own toothbrush and toothpaste flavour gives them a sense of ownership. Using a timer or a two-minute brushing song makes it feel like a game rather than a chore. Brushing together so they can copy you normalises it as something everyone does. Praise and consistency matter more than perfection. If resistance is severe and ongoing, mention it at your next visit and we can talk through it with your child directly.
Diet and Decay Prevention
What foods and drinks are worst for children’s teeth?
Sugary drinks including fruit juice, squash, soda, and flavored milk are among the most damaging because they expose teeth to sugar continuously if sipped throughout the day. Sticky foods including dried fruit, gummy sweets, and chewy snacks cling to tooth surfaces and are harder to clear with saliva. Frequent snacking of any kind, even on relatively healthy foods, keeps the mouth in a more acidic state for longer periods. Water and plain milk are the safest drinks, and limiting food to mealtimes with fewer snacks in between gives teeth recovery time between acid exposures.
Is fruit juice bad for my child’s teeth?
Yes, more than most parents realize. Fruit juice, even 100% pure juice, contains significant amounts of natural sugar and is acidic. The dental community has moved toward recommending that juice be limited or avoided for children under one, limited to four ounces a day for children aged one to three, and offered at mealtimes rather than sipped throughout the day. Whole fruit is nutritionally superior to juice in any case, because the fibre in whole fruit slows sugar absorption and the chewing action stimulates saliva.
Do dental sealants work?
Yes. Dental sealants are thin protective coatings applied to the chewing surfaces of the back teeth, where most childhood cavities occur. The deep grooves of these teeth trap food and bacteria in ways that brushing cannot always reach, and sealants effectively seal those grooves. They are quick to apply, painless, and have good evidence behind them for reducing decay in children. We typically recommend them when the permanent molars come through, around ages six and twelve.
Development and Orthodontics
How do I know if my child will need braces?
Some signs that orthodontic assessment may be needed include crowded or overlapping teeth, teeth that do not come together properly when biting, early or late loss of baby teeth, mouth breathing, and jaw shifting when biting. An orthodontic assessment is generally recommended around age seven, not necessarily to start treatment at that age, but because certain problems are much easier to address while the jaw is still growing. We will flag any concerns we notice during your child’s regular examinations.
What is the right age for Invisalign or braces?
Traditional braces and Invisalign are typically most appropriate once most of the permanent teeth have come through, generally from age twelve or thirteen onwards. However, early interceptive orthodontic treatment in younger children can sometimes simplify or reduce later treatment by guiding jaw development. Every child’s situation is different, which is why early assessment matters even if treatment does not begin immediately.
My child sucks their thumb. Should I be worried?
Thumb sucking is very common in infants and young children and is generally not a concern before age four. Most children give it up on their own. If thumb sucking continues beyond age four or five and is frequent and vigorous, it can begin to affect the position of the teeth and the development of the jaw and palate. If you are concerned, mention it at your next appointment. We can assess whether it is affecting dental development and discuss approaches that help children stop without making it a stressful issue.
My child breathes through their mouth. Does that affect their teeth?
Chronic mouth breathing can affect dental and facial development in children. It reduces saliva flow around the teeth, which increases decay risk. It is also associated with changes in jaw development and tooth positioning over time. Mouth breathing is often connected to enlarged tonsils or adenoids, allergies, or nasal obstruction. If your child consistently breathes through their mouth, it is worth raising with both their dentist and their paediatrician.
Accidents and Emergencies
My child knocked out a tooth. What do I do?
The answer depends on whether it is a baby tooth or a permanent tooth. If it is a baby tooth, do not try to reimplant it as this can damage the developing permanent tooth beneath. Clean the area gently and contact us. If it is a permanent tooth, time is critical. Pick the tooth up by the crown, not the root, rinse it gently with milk or saline if it is dirty, and try to place it back in the socket if your child is old enough to keep it there safely. If that is not possible, store it in milk and get to us or an emergency dentist immediately. The chances of saving a knocked-out permanent tooth drop significantly after thirty minutes.
My child chipped a tooth. Does it need treatment?
It depends on the extent of the chip. A very minor chip affecting only the enamel may simply be smoothed and monitored. A larger chip that exposes dentin will cause sensitivity and needs prompt attention, typically with bonding to restore the tooth. If the chip is large enough to expose the nerve, urgent treatment is needed. When in doubt, contact us and we can advise based on what you describe or send a photo of the tooth.
My child has toothache. What should I do?
Do not ignore toothache in children. Even in baby teeth, toothache signals something that needs attention, most likely decay that has reached a sensitive layer of the tooth. Dental infections in children can progress quickly and, in rare cases, seriously. Rinse the mouth with warm water, check for any visible swelling, and contact us to arrange an appointment as soon as possible. Over-the-counter children’s pain relief can help manage discomfort in the meantime.
Building Good Habits for Life
The habits children develop around dental care tend to follow them into adulthood. A child who finds the dentist normal and unthreatening becomes an adult who attends regularly. A child who learns that brushing and diet matter grows into an adult who takes their oral health seriously. The investment in getting this right early pays dividends for decades.
At Chicago Style Smiles we genuinely enjoy treating younger patients and helping families build those foundations. We take the time to make every child’s visit a calm and positive experience, because we know that the memory of that experience shapes how they feel about dental care for the rest of their lives.
Contact us to book an appointment for your child or get in touch with any questions before you come in.
