Baby's First Tooth to First Visit: A Toronto Parent's Guide

Your baby's first dental visit should happen by their first birthday, or within six months of that first tooth poking through -- whichever comes first. That's the Canadian Dental Association's recommendation, and it's the one I follow with every family who walks into our Bloor West Village practice. Here's what to expect from the first tooth through that first appointment, and what we're actually looking for when we see your baby.

Key Takeaways

• First tooth typically erupts between 6 and 10 months -- usually the lower front teeth first
• First dental visit by age 1, or within 6 months of the first tooth, whichever is sooner (Canadian Dental Association)
• Early-childhood tooth decay affects roughly 1 in 4 Canadian kids under 5 (Public Health Agency of Canada)
• The first visit is mostly conversation, education, and a gentle lap exam -- not drilling or invasive treatment
• Brushing starts the moment that first tooth appears -- a smear of fluoride toothpaste, twice a day

When does the first tooth come in?

Most babies cut their first tooth between 6 and 10 months. The two lower central incisors usually erupt first, followed by the two upper central incisors, then lateral incisors, then first molars, then canines. By age three, most children have all 20 primary teeth.

Some babies are born with a tooth already through (a "natal tooth," found in roughly 1 in 2,000 births according to the Canadian Paediatric Society). Others don't show a tooth until 12-15 months. Both are within normal range. If your baby has no teeth by 18 months, it's worth a visit -- not because something is necessarily wrong, but to rule out a few rare conditions like ectodermal dysplasia where teeth fail to develop normally.

When should I book baby's first dental visit?

The Canadian Dental Association recommends the first dental visit by age 1, or within six months of the first tooth -- whichever comes first. The American Academy of Pediatric Dentistry says the same thing, and Health Canada echoes it. So if your baby's first tooth came in at 7 months, we want to see them by 13 months. If they're a late teether and that first tooth doesn't show up until 12 months, we want to see them by 18 months.

That feels early to a lot of parents. The reasoning is simple: by the time we can see decay on a baby's tooth, it's already advanced. Early-childhood tooth decay -- formerly called "baby bottle decay" -- affects about 23% of Canadian kids aged 2-5 per a 2019 Statistics Canada Canadian Health Measures Survey. Many of those kids ended up needing treatment under general anaesthesia in a hospital, which costs the Ontario health system roughly $21 million a year (CDA). Almost all of that is preventable with one early visit and good home habits.

What actually happens at the first visit?

For most babies, the first visit is gentle, short, and mostly a conversation. Here's what we do:

1. The knee-to-knee exam. Parent and dentist sit facing each other, knees touching. Baby lies back across both laps, looking up at the dentist. The whole exam takes 60-90 seconds.
2. Tooth count and surface check. I'm looking for white-spot lesions (early decay), unusual eruption patterns, frenum attachment (the little flap of tissue under the tongue), and bite alignment.
3. A fluoride varnish, if appropriate. A tiny brush, a small dab. Done in under 30 seconds. Painless. Tastes mild.
4. Conversation with you. This is the bulk of the visit. Brushing technique, bottle habits, what counts as a "no-thank-you" food before bed, how to handle a child who hates having teeth brushed, when to expect the next eruption.
5. No X-rays for most one-year-olds. We don't routinely image baby teeth at age 1 unless something specific shows up on exam.

Most first visits in our practice are 20-25 minutes including paperwork. The baby is usually back in your arms within 5 minutes of starting.

How do I brush a baby's teeth?

Start the moment the first tooth appears. Use a soft infant toothbrush (or even a clean cloth wrapped around your finger for the very first weeks) and a smear of fluoridated toothpaste the size of a grain of rice. Twice a day. Last brushing right before bed -- after that, nothing but water.

The technique is less important than the consistency. You don't need to scrub. You need to physically remove the plaque, which is a soft film. Two minutes is overkill at this age -- 30-60 seconds gets the job done. The harder thing is making it a calm, non-fight ritual, which we get into in when babies should start brushing.

What do I do about teething pain?

Teething is real but it's usually milder than internet forums suggest. The Canadian Paediatric Society says low-grade fussiness, mild gum redness, drooling, and a slight rise in temperature (but not above 38C) are normal teething signs. High fever, diarrhea, or vomiting are not teething -- those need a paediatrician. Most teething pain responds to:

• A clean, cold (not frozen) silicone teething ring
• A clean finger to rub the gum
• Acetaminophen (children's Tylenol) if your paediatrician approves it
• A cold washcloth to chew on

What to avoid: amber teething necklaces (choking and strangulation risk per Health Canada's 2018 advisory), benzocaine teething gels (FDA contraindicated under age 2, methemoglobinemia risk), homeopathic teething tablets containing belladonna (Health Canada recall, 2017).

For the full picture on what's normal versus when to worry, see what's normal during teething.

What about bottles, sippy cups, and bedtime feeding?

Three rules that prevent most early-childhood decay:

1. Nothing but water in the bottle after the bedtime brush. Milk, formula, juice, and breast milk all contain sugars that ferment overnight against teeth. The risk window is the long bedtime stretch where saliva production drops.
2. Transition off the bottle by 12-18 months. Open cup or straw cup is fine.
3. Limit juice to under 125 ml/day, diluted, with meals. The Canadian Paediatric Society recommends no juice at all before 12 months and very limited after.

The pattern that causes the most cavities I see in toddlers is not candy -- it's a bottle of milk or formula at bedtime that the child holds in their mouth while falling asleep. Even breast milk, if the baby falls asleep latched and unlatches with milk pooled against the upper front teeth, can drive decay. This is covered in detail in early childhood tooth decay.

When should I worry?

Bring your baby in sooner than the 12-month milestone if you see:

• White or chalky patches on teeth, especially near the gumline. Earliest sign of decay.
• Brown spots or pits in tooth enamel.
• Persistent bleeding from gums that isn't from teething.
• A tooth that's clearly out of position (overlapping a neighbour, growing sideways).
• A bump or swelling on the gum above or near a tooth.
• A tooth knocked loose or out from a fall.

For knocked-out baby teeth specifically: don't try to reinsert. Call the dentist. (Adult teeth are different -- reinsert ASAP. Different protocol.)

Comparison: First visit timing across major guidelines

Source	First dental visit guidance
Canadian Dental Association (CDA)	By age 1, or within 6 months of first tooth
American Academy of Pediatric Dentistry (AAPD)	By age 1
American Dental Association (ADA)	By age 1, or within 6 months of first tooth
Royal College of Dental Surgeons of Ontario (RCDSO)	By age 1
Health Canada	By age 1
Canadian Paediatric Society	By age 1

Every major North American authority agrees on the age-1 milestone.

From Dr. Kaur

"Parents apologize a lot at first visits. They apologize for their baby crying, for not flossing yet, for not knowing whether the bottle-at-bedtime was OK. None of that is helpful -- and none of it is what I'm there to judge. I'm there to look at the teeth, set you up with the right brushing technique for your specific kid, and answer the questions you've been Googling at midnight. That's the whole job at visit one. The dental work, if any is ever needed, comes much later." > -- Dr. Abinaash Kaur, DDS, RCDSO, ODA -- The Village Dentist, 750 Annette St, Toronto

Frequently Asked Questions

Q: Does my baby really need to see a dentist at one year old? Yes. The Canadian Dental Association, American Academy of Pediatric Dentistry, and Health Canada all recommend the first visit by age 1. Roughly 1 in 4 Canadian kids under 5 have decay; early visits catch the warning signs years before treatment becomes invasive.

Q: My baby cries at strangers -- how will they handle a dentist? Most first visits are over in 5 minutes of actual exam time, with the baby in your lap the whole time. We expect tears. We work fast. The point of visit one is not to make your baby love the dentist -- it's to give you the tools and let your baby get used to the chair and the lights.

Q: Is fluoride toothpaste safe for babies? Yes, in the recommended amount. A rice-grain smear twice daily for under-3s, a pea-sized amount for ages 3-6. Health Canada and the Canadian Dental Association both endorse fluoride toothpaste from the first tooth.

Q: Are amber teething necklaces safe? No. Health Canada has issued an advisory against them. The choking risk if the necklace breaks and the strangulation risk if it tangles are real, and the supposed pain-relief mechanism is not supported by evidence.

Q: How much does the first visit cost in Toronto? For families covered under the Canadian Dental Care Plan (CDCP), eligible children under 12 are fully covered. For families with private insurance, most plans cover the routine exam and fluoride varnish in full. See CDCP coverage for details on the 2026 expansion.

Q: What if I'm scared of the dentist myself? That's more common than you think. Parents who had bad dental experiences as kids often bring that anxiety into their kid's visits. We work with that -- often having one parent stay home and the less-anxious caregiver bring the baby. See dental anxiety guide for how we help adults who avoid the dentist.

Q: My baby's tooth came in grey/yellow/with a stain. Normal? Sometimes. Mineralization variations show up as patches and shouldn't be ignored. Send a photo to the practice or book a visit -- it's the kind of question that's safest to look at, not guess at.

References

1. Canadian Dental Association. Your Child's First Visit. https://www.cda-adc.ca/en/oral_health/cfyt/dental_care_children/first_visit.asp
2. American Academy of Pediatric Dentistry. Policy on the Dental Home. https://www.aapd.org/research/oral-health-policies--recommendations/dental-home/
3. Health Canada. Tips for Your Child's Oral Health. https://www.canada.ca/en/health-canada/services/healthy-living/your-health/lifestyles/oral-health-tips-children.html
4. Public Health Agency of Canada / Statistics Canada. Canadian Health Measures Survey, oral health component (2019). https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00006-eng.htm
5. Canadian Paediatric Society. Caring for Kids -- Teething. https://caringforkids.cps.ca/handouts/health-conditions-and-treatments/teething
6. Royal College of Dental Surgeons of Ontario. Dental Care for Children. https://www.rcdso.org/
7. Health Canada advisory. Health Risks Associated with Amber Teething Necklaces. 2018.

Bottom line

Your baby's first dental visit belongs on the first-year checklist, right alongside the 12-month paediatrician check. Book it by age 1 or six months after the first tooth -- whichever is sooner. The visit is mostly a conversation, not a procedure. The earlier we see your baby, the easier every subsequent visit gets, and the more likely your kid grows up without the dental fear that haunts so many Toronto adults.

Related posts

• When Should Baby Start Brushing? A Toronto Pediatric Dentist Guide
• Bottle Decay in Infants: Signs, Prevention, and When to See a Dentist
• Teething 101: What's Normal, What's Not, and What Helps

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Book your baby's first visit at The Village Dentist -- 750 Annette St, Toronto. Dr. Abinaash Kaur, DDS welcomes families across Bloor West Village, High Park, the Junction, and the Annex. Request an appointment or call (416) 769-4441.