Frequently Asked Chairside Questions For Parents
Q: At what age do children typically get their first tooth?
A: The first primary (baby) tooth usually erupts around 6 months of age, though it can occur as early as 4 months or as late as 12 months. The lower central incisors are typically the first to appear.
Q: At what age do children get their last baby tooth?
A: Most children have their full set of 20 primary teeth by approximately 2.5 to 3 years of age.
Q: How many baby teeth do children have?
A: Children have 20 primary (baby) teeth.
Q: At what age do children typically lose their first baby tooth?
A: Children usually lose their first primary tooth between 5 and 7 years of age, with an average around 6 years. The lower central incisors are generally the first to exfoliate.
Q: At what age do children lose their last baby tooth?
A: The last primary teeth are typically lost between 11 and 13 years of age, with an average around 12 years.
Q: When should my child have their first dental visit?
A: The American Academy of Pediatric Dentistry recommends that a child see a dentist within six months of the eruption of the first tooth or by their first birthday, whichever comes first. This early visit helps establish a dental home and provides preventive guidance.
Q: If I can only brush my child’s teeth once a day, is it better to do so before bed or in the morning?
A: Brushing before bed is more important. Saliva flow decreases during sleep, allowing acids and bacteria to remain on the teeth longer overnight. Removing plaque and food debris before bedtime provides the greatest protective benefit.
Q: What type of toothpaste should my child use?
A: Use a fluoride-containing toothpaste appropriate for the child’s age. Fluoride helps strengthen enamel and prevent tooth decay.
Q: How much fluoride toothpaste should my child use?
A:
- For children under 3 years of age: A smear approximately the size of a grain of rice.
- For children 3 to 6 years of age: A pea-sized amount.
- For children 6 years and older: A pea-sized amount or slightly more, depending on the child’s size and caries risk.
Parents should supervise brushing and ensure the child spits out excess toothpaste without rinsing thoroughly to maximize fluoride benefits.
Q: My child enjoys brushing their teeth. Do I still need to brush for them?
A: Yes. Although children may enjoy brushing independently, most lack the manual dexterity to thoroughly clean all tooth surfaces until around 7 to 8 years of age. Parents or caregivers should assist or supervise brushing until the child can effectively remove plaque on their own.
Q: At what age can my child start using mouthwash?
A: Children can typically begin using mouthwash around age 6, once they can reliably swish and spit without swallowing. Always choose an alcohol-free, fluoride-containing product and follow the product’s age recommendations.
Q: What type of mouthwash should my child use?
A: An alcohol-free mouthwash that contains fluoride is generally recommended, as it provides additional cavity protection without the drying effect of alcohol.
Q: Does breast milk cause cavities?
A: Breast milk itself does not cause cavities. Exclusive breastfeeding is not associated with increased decay risk when paired with good oral hygiene. However, once complementary foods or sugary liquids are introduced—particularly if given frequently or at bedtime—the risk of early childhood caries increases. Proper oral care and limiting prolonged exposure to fermentable carbohydrates remain essential.
Q: How do I clean the white coating on my infant’s tongue?
A: If the white coating appears after feeding and wipes away easily, it is likely milk residue. Gently wipe the tongue with a soft, damp washcloth or gauze after feedings. If the coating is thick, persistent, and does not wipe off, it may be thrush (a common yeast infection). In this case, consult your pediatrician or pediatric dentist for evaluation and possible treatment.
Q: What should I do if my child is born with a tooth (natal tooth)?
A: Consult a dentist promptly for evaluation. If the tooth is not excessively mobile and does not interfere with feeding or cause injury to the infant’s tongue or the mother during breastfeeding, it is often left in place and monitored. Extraction is considered only when necessary.
Q: What if my child has a tooth erupt within the first 30 days after birth (neonatal tooth)?
A: The guidance is the same as for natal teeth. See a dentist for assessment. If the tooth does not interfere with feeding and is stable, no immediate treatment is usually required.
Q: My child saw the dentist, and now the cavity looks black. Why did this happen?
A: This is a common and expected effect of silver diamine fluoride (SDF), a safe, non-invasive treatment used to arrest (stop) the progression of tooth decay, especially in young children or when immediate restoration is not feasible. SDF turns the treated decay area black but helps prevent further damage and the need for more invasive procedures. The staining is permanent on the decayed portion but does not affect healthy tooth structure.
Q: My child has a tongue tie or lip tie. Should it be clipped?
A: Not all ties require intervention. A thorough evaluation by a qualified dentist, pediatric dentist, or specialist (often in collaboration with a lactation consultant or pediatrician) is necessary. Treatment, such as a frenectomy, is typically recommended only if the tie is causing functional issues, such as difficulty with breastfeeding, poor latch, or other feeding problems.
Q: A permanent tooth appears to be growing behind my child’s lower front baby tooth. What should I do?
A: This is a common occurrence known as “shark teeth,” where the permanent tooth erupts before the primary tooth has exfoliated. Encourage gentle wiggling of the baby tooth to help it loosen and fall out naturally. If the baby tooth remains firmly in place after a short time or causes discomfort, consult your dentist, who may recommend removal to allow the permanent tooth to move into proper position.
Q: My child’s baby tooth is loose but not falling out. What should I do?
A: Have your child (or assist them in) gently wiggling the tooth several times a day—starting with 5–10 wiggles in the morning and again at night. Consistent, gentle movement helps prevent the periodontal fibers from reattaching as the root resorbs. Avoid forceful pulling. If the tooth does not progress within a reasonable time or becomes painful, visit your dentist for evaluation and possible assistance with removal.