Tooth decay and tooth loss was once the norm but public health interventions have led to major improvements for most people. Nevertheless, not all children have benefited. Dental disease in young children is unacceptably high. Tooth decay is preventable. Early childhood educators are often the first to notice the problem. Professional organizations recommend a child see a dentist at 1 year of age. Children who are at high risk benefit from optimal exposure to fluoride. Even if they drink fluoridated water, children should use fluoridated toothpaste and receive fluoride varnish treatments. Children may also benefit from treatments of topical iodine and xylitol products.