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Question & Answer - Dental

When should baby have his or her first dental appointment, and what should you expect?

Answer from Barbara K. Tritz, RDH, BS, MSB, a Registered Dental Hygienist in Kirkland, WA, USA

May 2017


As a dental hygienist, I often get questions about baby’s dental care.  The most frequent question is when should baby have his first dental appointment? The answer surprises most folks.  The initial dental appointment should happen when baby’s between six to eight months old. Don’t wait until all 20 deciduous (baby) teeth have erupted.  Learn more about baby’s oral health and development, and what to expect from that important first dental visit!

Tooth Development and Eruption

Baby has 20 tooth buds growing in her jaw starting six weeks into embryonic development.  Baby’s oral care really starts before conception!  Mother’s good nutrition before and then throughout pregnancy is vital for baby to have strong, healthy teeth.   

Baby’s teeth will start erupting in her mouth between 6 and 12 months of age, with the average age being 8 months.  Baby teeth finish erupting around three years of age.  During this time, her permanent teeth are developing in the bone as well.  Vitamins and good nutrition are important for permanent teeth to develop properly.  The permanent teeth start erupting around age 6 years.  At that point teeth are coming and going for the next ten years.  We call this mixed dentition.  The final teeth erupt around age 18 years culminating with the third molars or as they are often called, wisdom teeth.  There are 32 total permanent or adult teeth.  

The big myth baby teeth are not important so don’t really need care is wrong on so many levels.  Baby needs healthy, strong teeth!  She uses them daily to chew food and speak, just like an adult does.  They maintain the space in her jaws for her growing/developing permanent teeth.  Tooth decay in baby teeth can be devastating to her overall health, as well as to her unerupted and still developing permanent teeth.  Decay bacteria are contagious from tooth to tooth, so decay can go from a baby tooth to the developing tooth bud underneath!  Care for her teeth as you would your own.  Hint - Never go to bed without brushing; and never, ever give baby a bottle of milk or juice in bed.

Baby’s First Dental Office Visit

Baby and the dentist should meet within the first year of baby’s life.  Why, you ask?  Baby only has a tooth or two but there’re still lots of things to see and discuss with parents.  Doctor does what we call a knee to knee visit - doctor’s knee to mom’s knee with baby laying down on their knees.  This gives doctor a great view of baby’s mouth with mom right there watching too.  Here’s what doctor will look at and discuss:  

#1. Check teeth development and eruption

#2. Look for early signs of tooth decay - measure decay bacterial levels with Cariswab from Carifree.

(Look for an office that practices what we call CaMBRA- Caries Management by Risk Assessment)

#3. Family history of tooth decay and gum infection

#4. Look for tongue and lip ties

#5. Oral hygiene instructions - teach parents and caregivers how to brush and care for baby’s teeth correctly, especially the backside of the molars.  Give parents teething tips.

#6. Review importance of nasal breathing

#7. Discuss thumb sucking and pacifier elimination

#8. Review baby’s diet/sippy cup usage/carbohydrate intake/juice intake

#9. Review proper jaw growth and facial development

#10. Establish a dental home for baby

Ten important things to review, ten vital things to share with parents.  The appointment now does not seem long enough!

Previous conventional wisdom said to wait until baby is a toddler, age three and has all his teeth.  Unfortunately, this is often too late.  We then see toddlers with advanced tooth decay, as well as crowded teeth.  Don’t wait until baby’s got cavities.  Instead, it is important for parents to learn about preventing decay, good products to use, and best ways to care for baby and her developing teeth.

Going to the dentist as well as seeing the dental hygienist should be a fun experience for baby and educational for mom and dad!   

About the Author

Barbara K. Tritz, RDH, BS, MSB is a Registered Dental Hygienist with over 35 years of clinical experience.  Her specialty is nonsurgical periodontal therapy, but her passion is patient education and creating awareness of the oral-systemic connection.  Her core belief is that the mouth must be healthy for the body to be healthy.  Oral health encompasses not only the teeth and gums, but also the airway – obstructive sleep apnea prevention, proper breathing, swallowing, and jaw development, which starts at birth.  She works one on one with her patients as an oral health coach, crafting personalized oral wellness plans.  She is the author of the blog:, and can be reached at