A Misconception That Costs Parents: Dr. Brandice Allen on Starting Dental Visits Too Late

Why we're still hearing "baby teeth don't matter"

I still meet parents who believe their child's first teeth are just placeholders. They figure decay in a baby tooth is no big deal because it will fall out eventually. That thinking costs kids years of healthy development, and it's one of the most stubborn myths in pediatric health.

I'm Dr. Brandice Allen, a pediatric dentist trained at the University of Tennessee's pediatric dental residency program and currently serving as Dental Director for Hope Mission 360. I've spent years working with families who come in when a toddler is already in pain, and almost all of them had no idea a dental visit should have happened years earlier.

What actually happens when decay goes untreated

Baby teeth hold the space for permanent teeth. When decay destroys a primary molar before the adult tooth is ready to come in, neighboring teeth drift into that gap. The permanent tooth has nowhere to go, which sets up crowding, impacted teeth, and years of orthodontic work later.

Decay also causes pain that makes it hard for a child to eat or sleep. I've seen three-year-olds who stopped eating anything that required chewing because it hurt too much. Nutrition suffers. Speech development can lag when teeth are missing too early. And untreated infection in a baby tooth can spread to the developing permanent tooth underneath.

When the first visit should happen

The American Academy of Pediatric Dentistry recommends a first visit by age one or within six months of the first tooth coming in. Most parents I talk to are surprised by that timeline. They assume preschool is soon enough.

That first visit isn't about drilling and filling. It's about showing a child that the dental chair is a safe place, teaching parents how to clean tiny teeth, and catching problems when they're small. A cavity in a two-year-old is easier to treat than an abscess in a four-year-old.

I also use that visit to talk about sippy cups, pacifiers, and night bottles. A lot of early decay comes from juice or milk sitting on teeth overnight. Parents don't always realize that even breast milk contains sugar that bacteria can feed on if it pools in the mouth during sleep.

What good early care looks like

Start cleaning your baby's gums with a soft cloth even before teeth come in. Once the first tooth appears, use a smear of fluoride toothpaste the size of a grain of rice. At age three, move up to a pea-sized amount.

Don't wait for a problem to show up. Cavities in baby teeth often look like white or brown spots, not the black holes people expect. By the time a parent notices pain or visible damage, the decay is advanced.

Schedule that first visit early, and keep going every six months. Consistency matters more than perfection. I'd rather see a child twice a year with decent brushing at home than a child with perfect hygiene who never comes in until something hurts.

What I tell parents who feel behind

If your child is past age one and hasn't seen a dentist yet, don't let guilt keep you from scheduling now. I'm not interested in making anyone feel bad. I want to help you get on track.

Bring your child in even if you think everything looks fine. I can spot early decay, check for bite problems, and give you a realistic picture of what your child needs. Most importantly, I can help your child build a positive association with dental care before any treatment is needed.

The goal is simple: keep baby teeth healthy until they're ready to fall out on their own. Those teeth matter, and the habits you build now will carry forward into your child's adult years. Start early, stay consistent, and don't believe anyone who tells you baby teeth are disposable.