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nieman: infant teeth need care right from the start
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unhealthy baby teeth can result in unhealthy permanent teeth.
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the important intersection between healthy teeth and a healthy body begins long before birth, and ignoring that truth is costing canadians millions of dollars annually. holistic pediatric care is not simply a term which evokes warm, fuzzy feelings.
what a pregnant mom eats impacts the health of her baby’s teeth way before the baby is born. ideally, there should be optimal intake of vitamins, calcium, folic acid, iodine, iron, magnesium, selenium and zinc.
if a mom has periodontal disease (infections of the gums), then that preventable, and often undiagnosed condition, sets the baby up for a higher risk of being born prematurely.
baby teeth develop early in the pregnancy. the front teeth begin to develop at seven weeks into the pregnancy and calcify at about 15 weeks. the first molars begin to develop at eight weeks and calcify at about 16 weeks.
not all the baby teeth are present at birth; all the baby teeth won’t be in place until three years of age. permanent teeth begin developing at birth. they lie hidden under the gums, occupying most of the upper and lower jaw area. once the crown of a tooth is in the mouth, it does not grow larger.
baby teeth play an important role early in life. other than the obvious function of biting and chewing food, these teeth help hold up the lips; they play a role in speech development; and they act as a guide to position the permanent teeth.
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unhealthy baby teeth can result in unhealthy permanent teeth. sadly, that is not fully appreciated by many parents, doctors, and ironically, even some dentists.
i made the assumption that when parents see their dentists, they will be told to bring their babies in for dental check-ups between six and 12 months of age. but i have discovered that many parents were not aware of the ideal first dental check-up for their baby; some parents even shared with me that their own dentist suggested the first check-up should be around age three.
dr. leonard smith, one of calgary’s first pediatric dentists, who is recognized by the american academy of pediatrics and canadian pediatric dentists for being a pioneer and an advocate, has dedicated his life to raising awareness of the importance of baby teeth. still active in his 80s as a pediatric dentist and a lecturer for the prevention of early childhood caries, lenny has no plans of slowing down.
recently, i had the honour to share a meal with this legendary dentist, and with a calm but deliberate passion in his voice, he shared some of these sad truths about tooth decay.
early childhood caries (ecc) is an infectious disease. once one tooth is impacted, and the decay goes unrecognized, the infection can rapidly spread to other teeth.
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a decay-infected tooth may develop an abscess, and as soon as the nerve becomes infected, it dies, and cells degenerate into pus, which then gets swallowed.
the pain caused by the above pathology can rob the baby of sleep, contribute to suboptimal brain development and in some extreme circumstances lead to domestic abuse, thus impacting things way beyond a baby’s mouth.
ecc is preventable when parents are made aware of the value of early check-ups and which foods to avoid (mostly sweet and sticky sugary foods such as toffees, candied apples and candied popcorn, fruit roll-ups, dried fruits and sweetened carbonated beverages and juices).
even breastfed babies are at risk because when they feed at night, some of the milk remains on the teeth and causes the start of decay.
canadian national data on the prevalence of ecc is not encouraging. it affects 28 per cent of north-american children between the ages of two and five years, but in certain populations it is much higher. in canada, there seems to be huge regional discrepancies.
over the past five to 10 years, the overall incidence of ecc has not dropped; in some parts of canada, it has increased. ecc remains one of the most common chronic childhood diseases. dental surgery to repair cavities remains the most common day surgery for preschool children in canada. there is no evidence of a significant reduction in these surgeries in recent years.
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it is a myth that pediatric dentists are self-serving when they ask that the first dental check-up take place, by the latest, at age one.
for more information, see the canadian dental association’s website (www.cda-adc.ca)
dr. nieman is the founder of centre 70 pediatric. his monthly columns in the herald started in 1999.
this article was originally published in the calgary herald on march 28, 2026.
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