The usual advice is a first dental visit by the first birthday, or within six months of the first tooth appearing, whichever comes first. That surprises most parents, who assume there is nothing to look at yet.
The point of that first visit is not really the teeth. It is getting a child comfortable in the chair before anything ever needs doing, and getting the parent some practical help.
What happens at a first visit
For a toddler it is short and informal. Often the child sits on the parent's lap, knee to knee with the dentist, for a quick look at the teeth and gums. There is counting, a look for early decay, and a conversation with you about brushing, bottles, sippy cups and diet.
There is rarely any treatment. The value is that the practice becomes a familiar place with familiar people, so that if a filling is ever needed, it is not also the first time in the building.
Bring the visit forward if you see anything you were not expecting: white or brown marks on the front teeth near the gum, a tooth that has come through in an odd place, or a child who has stopped chewing on one side. None of those are emergencies, and all of them are easier to deal with early than late.
General dentist or pediatric dentist
Plenty of general dentists see children happily and well. A pediatric dentist has additional training focused on children, including those with anxiety, additional needs or complex medical histories, and their practices are usually built around children in ways that help.
Either can be the right answer. If your child is nervous, has had a bad experience, or needs treatment beyond the routine, a pediatric practice is often worth the trip.
A pediatric dentist has done two or three extra years on treating children, and is the better choice for a child with a lot of decay, a medical condition, or real fear that a normal appointment cannot get past. For a healthy child and a routine check, a general dentist who is good with children is entirely sufficient, and staying with the family practice has its own value: the child sees you have your teeth checked too.
Brushing without a fight
Brush twice a day with fluoride toothpaste from the moment the first tooth appears, using a smear the size of a grain of rice for under threes and a pea sized amount after that. Children need help brushing until around seven or eight, when they can manage the coordination themselves.
The last brush of the day matters most, and nothing but water should follow it. Milk and juice in a bottle at bedtime is the single most common cause of early decay in small children.
- Smear of fluoride toothpaste under three, pea sized from three onwards
- Help or supervise brushing until around seven or eight
- Nothing to drink but water after the bedtime brush
- Sugary drinks with a meal do less damage than sipped across the day
- Start cleaning between the teeth once two teeth touch
Sealants, fluoride varnish and why baby teeth matter
Fluoride varnish is a quick painted on treatment that strengthens enamel, usually offered a few times a year for children at risk of decay. Sealants are a thin coating over the grooves of the back teeth, where most childhood decay begins. Both are painless and quick, and both are among the better value things in dentistry.
Parents sometimes ask why a baby tooth needs treating when it will fall out anyway. Baby teeth hold the space for adult teeth, and infection in one can affect the adult tooth forming underneath. Losing them early causes crowding problems later.
Thumb sucking, pacifiers and when braces come up
Thumb sucking and pacifier use are normal in small children and usually stop on their own. If they continue past about four, they can start to affect how the teeth and jaws develop, and that is worth raising with the dentist rather than fighting about at home.
Orthodontic assessment is commonly suggested around age seven, not because braces usually start then, but because that is when a dentist can see how the adult teeth and jaws are developing and decide whether anything needs watching.
If you have not settled on a practice for them yet, our directory lists every dental office in the United States by town or ZIP code, and practices that have claimed their listing can say whether seeing children is something they do regularly.
The short version
- First visit by the first birthday, or six months after the first tooth.
- Early visits are about familiarity, not treatment.
- Smear of fluoride toothpaste under three, pea sized after, and help until seven or eight.
- Nothing but water after the bedtime brush, and no bottle in bed.
- Baby teeth hold space for adult teeth, which is why decay in them still matters.
Looking for a dentist?
Our directory lists every dental practice in the United States, from the public federal registry. Search by town or ZIP code, or let your browser find the closest ones.
Frequently asked
My child is terrified. What can I do?
Tell the practice before the appointment so they can allow more time. Avoid words like hurt, pain or needle in your reassurance, since children hear the noun and not the negation. Some practices offer a familiarisation visit with nothing done at all, which often works better than any amount of preparation at home.
Is fluoride safe for children?
Used in the recommended amounts it is one of the best evidenced tools in dentistry for preventing decay. The amount matters: use the smear or pea sized quantity by age and supervise so that toothpaste is spat out rather than swallowed.
How do I know if my child needs braces?
A dentist watching the adult teeth come through will tell you what they are seeing and when to get an orthodontic opinion, commonly around age seven. Crowding, a bite that does not meet properly and teeth erupting in odd positions are the usual reasons for a referral.
This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.