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Oral Health - Toddlers/Preschoolers

Taking care of your child's oral health is a key part of their overall health and well-being. Here are some resources to help you ensure your child has healthy, strong teeth to last a lifetime.

Two photos of children smiling.Why are baby teeth important?

  • Baby teeth are important for chewing food, learning to speak properly, holding space for adult teeth and general good health and appearance.
  • Your baby will develop 20 baby (primary) teeth.
  • The first tooth usually appears between 5 and 10 months of age.
  • If not properly cared for, baby teeth can get cavities (decay) and cause the child pain.
  • If baby teeth are removed too early, permanent teeth may grow in the wrong way.

What is Early Childhood Tooth Decay?

  • When your baby’s first teeth appear, you need to take care of them to prevent Early Childhood Tooth Decay (ECTD). The main cause of this problem is when the teeth are not being cleaned, and liquids (other than water) are left in the mouth over and over again.

How do I take care of my child’s mouth and teeth?

  • Before teeth have erupted (pushed through the gum), gently clean your baby’s mouth twice a day using a clean piece of gauze or the corner of a clean washcloth.
  • When baby teeth start to appear, use a small soft toothbrush to clean them.
  • For children under age 3, no fluoride toothpaste is needed unless advised by an oral health professional.
  • Oral care instructions for children are different depending on your child’s age and should be considered as your baby grows
  • Teach your child to brush at an early age to get them into the habit, even if the technique is not perfect.
  • Continue cleaning your child’s teeth at least once a day while they are learning to brush.
  • Check your baby’s teeth. Lift the baby’s top lip and look at the front and back of the top four teeth. If there are any brown or white spots between the teeth or along the gum line, take your child to an oral care provider.

What should I know about teething?

  • Teething may be associated with:
    • crankiness
    • drooling
  • Fever and diarrhea are not usually related to teething.
  • If your child experiences these symptoms consult your doctor.

How can I help my child with teething?

  • Give your baby a Canadian Standards approved teething ring that has been chilled (not frozen).
  • Do not use gels and ointments, as these can be harmful. Consult your health care professional.
  • Massage your baby’s gum with a clean finger.

What should I know about pacifiers?

  • Pacifiers can satisfy a baby’s natural need to suck, but should not be given to baby during the first 6-8 weeks when learning to breastfeed.
  • If you decide to use a pacifier, select one that is Canadian Standards approved.
  • Check it regularly to make sure it is in good condition. Replace the pacifier if it is sticky, cracked or torn.
  • Do not dip it in honey, sugar or sweet liquids as this can cause tooth decay.
  • Do not hang it around your baby’s neck with a string. Your baby could be accidentally strangled.

What do I need to know about thumb-sucking?

  • Thumb-sucking is common for children up to the age of four, but after four it can affect the positioning of the permanent teeth. If this habit continues, consult your dentist.

What about nutrition for my child?

  • Children need to eat well-balanced meals to develop healthy teeth. Follow Canada's Food Guide to Healthy Eating. Children should not have more than the recommended amount of juice in a day, as juice has sugar, which may cause tooth decay. Quench your child’s thirst with water.

When should my child go for his/her first dental visit?

  • Your child should visit the dentist before there is a problem with his or her teeth.
  • Your child's first dental visit should be between 1-3 years of age.
  • Prepare your child prior to the check-up by letting them know what happens at the dental office.
  • When talking to your child about a dental visit do not use words like hurt or pain.

Primary Teeth (Development) Chart

Primary teeth chart
Upper teeth When teeth come in When teeth fall out
Central incisor 7 - 12 month 6 - 8 yrs.
Lateral incisor 9 - 13 month 7 - 8 yrs.
Canine (cuspid) 16 - 22 month 10 - 12 yrs.
First molar 13 - 19 month 9 - 11 yrs.
Second molar 25 - 33 month 10 - 12 yrs.
Lower teeth When teeth come In When teeth fall out
Central incisor 6 - 10 month 6 - 8 yrs.
Lateral incisor 7 - 16 month 7 - 8 yrs.
Canine (cuspid) 16 - 23 month 9 - 12 yrs.
First molar 12 - 18 month 9 - 11 yrs.
Second molar 20 - 31 month 10 - 12 yrs.

Information courtesy of the Ontario Ministry of Health and Long Term Care.

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A close up image of early childhood tooth decay.Early Childhood Tooth Decay (ECTD) (PDF file) (order resource) is a dental condition where baby teeth decay quickly, which can be expensive and difficult to treat.

How does Early Childhood Tooth Decay happen?

If your child has ECTD they may experience:

  • Pain
  • Trouble eating
  • Problems with speech
  • Poor self-image
  • If baby teeth are lost too early due to ECTD, permanent teeth may come in crooked and crowded.
  • Early Childhood Tooth Decay happens when teeth are not being cleaned, and liquids other than water are left in the mouth for a long time. When liquids stay on the teeth, the bacteria in the mouth can turn the sugar in the liquid into acid, which causes tooth decay.

How will I know if my child has this condition?

  • Lift your child’s lip once a month. Look at the gum line, if you see brown or white spots between and on the teeth there may be a problem, take your child to the dentist.
  • The teeth most likely to be affected are the top front teeth.
  • You may not know there is a problem until serious damage has been done.

How can Early Childhood Tooth Decay be prevented?

  • Before teeth appear, gently clean your baby’s mouth twice a day using a clean piece of gauze or the corner of a clean facecloth.
  • When baby teeth start to appear, use a small soft toothbrush to clean them .Do not use toothpaste until your child can spit out.
  • Avoid constant sipping from a bottle or ‘sippy’ cup. .Do not put baby to bed with a bottle.
  • Do not dip pacifiers in honey, sugar or sweetened liquids because they greatly increase the risk of tooth decay.
  • Your child’s first dental visit  should be between 1 and 3 years of age.
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Photo of a young child sitting in dental chair.

When should my child go to the dentist for the first time?

By starting dental visits between the ages of 1 and 3, you will help your child build a lifetime of good dental habits, and provide your dental professional with the opportunity to prevent oral health problems.

What should I do to prepare my child for their first dental visit?

  • Have a positive attitude and set a good example.
  • Take your child along whenever you or a family member has a dental appointment.
  • Consider making a casual appointment for a friendly tour of the dental office with a “ride in the chair” and a visual check of your child’s mouth.
  • Schedule an appointment for the morning when your child is rested and fed.
  • Talk to your oral professional about your child’s oral health.

What should I NOT do when preparing my child for their first dental visit?

  • Do not wait for an emergency for the first visit.
  • Do not express any of your own fears or anxieties.
  • Do not over prepare your child or make the dental visit into a “special event”.
  • Do not use phrases like “It won’t hurt too much” or “It won’t be too bad”. Comments like these are not soothing and will only create anxiety.
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What kind of foods cause tooth decay?

  • Foods high in sugar that stay in the mouth longer, such as hard candy, sticky foods, fruit leathers, and dried fruit. Eating more sugar will produce more acid in the mouth.

What kind of foods are good for my teeth?

A healthy diet is very important for good oral health. Eating healthy foods will help reduce tooth decay and gum disease. Limiting the amount and how often sugar is eaten is very important in the prevention of tooth decay.

How to ensure a healthy mouth:

Healthy choices for between meal snacks:

Mostly nutritious and low in sugar

Occasional snacks are nutritious but contain sugar

Treats have a lot of sugar which sticks to teeth.

  • nuts
  • eggs
  • fruits
  • cheese
  • pretzels
  • popcorn
  • crackers
  • white milk
  • plain yogurt
  • raw vegetables
  • sunflower seeds
  • unsweetened fruit and vegetable juices
  • ice cream
  • fruit muffins
  • milk shakes
  • milk pudding
  • chocolate milk
  • pop
  • cake
  • raisins
  • cookies
  • candies
  • chocolate bars

*Be sure to only have treats when you can brush teeth afterwards

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thumb and finger sucking

My child sucks her thumb…Is this normal?

Thumb and finger sucking (PDF file) (order resource) is a healthy, normal and natural habit for very young children. It is soothing and helps them to cope with different situations and feelings such as:

  • Boredom
  • Loneliness
  • Worry
  • Stress

Thumb sucking is common for children up to age of four. After four, it can affect the positioning of the permanent teeth. If this habit continues, consult your oral care professional.

How can I help my child stop thumb or finger sucking?

  • Be positive and emotionally supportive.
  • Give your child attention and understanding.
  • Try to control daytime sucking first.
  • Use a glove, sock or finger guard to cover the finger or thumb.
  • Place a adhesive bandages on the finger or thumb to remind your child not to suck.
  • Remove any security blankets or toys that your child may associate with finger or thumb sucking.
  • Offer rewards like a star on a chart or an extra story.
  • Praise your child when successful.
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A close up image of sealants.What are sealants?

  • Sealants are a clear or shaded thin coating of plastic that protects the grooved or pitted surfaces of the back teeth.
  • Food and germs can get stuck in the pits of the back teeth and stay there for along time. This is because the toothbrush bristles are too large to reach inside these pits making it impossible for food to be brushed away.
  • Staying cavity-free:


    • Most dental insurance companies pay for sealants.
    • Check with your benefits provider about your child’s coverage and talk to your dentist about the exact cost of sealants for your child
  • Children with deep pits and grooves on their teeth are more likely to get tooth decay.

When should sealants be placed on teeth?

  • Sealants are most often placed on the teeth of children and teenagers between 5 years and 14 years of age.
  • Always check with your dental professional to know when and if necessary.

How long do sealants last?

  • Research shows that sealants can last for many years if properly cared for.
  • If your child has good oral hygiene and avoids biting hard objects such as pencils and ice cubes, their sealants will last even longer.
  • Your dental professional will check the sealants during routine visits and can recommend reapplication or repair. Sealants need to be checked at regular dental visits to make sure they are not chipped or worn away.

What is the treatment like?

  • The application of sealants is easy, painless, and takes only a few minutes to complete.
  • The sealant is painted on the tooth surface and it flows into the pits and grooves and bonds to the tooth.
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If your family has trouble paying for dental treatment we have financial assistance (order resource) programs to help your kids (under 18 years of age) get dental check-ups, X-rays and solve an urgent dental need.

How do I apply for assistance?

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