Okay, back from dentist number THREE! This one took an approach literally middle of the road from the other two. She said that we would be justified in adopting a wait and see approach, bearing in mind that an infection could occur at any time, but it could take months. She was certain that at some stage before the adult tooth erupts and the baby tooth comes out that this tooth, in its weakened stage from the chip and with the current level of decay, will need to be either restored (and this is a possibilty if there is enough of the baby tooth to bond a restorative resin to) or extracted.
As for the extraction, she said that since it is a front tooth this would carry no deleterious effects in respect of either movement of the other baby teeth into the space created by the lost tooth, or the adult tooth that is under the gum.
As far as the decay, she said, based on our description of his diet, it is likely from sugars in fruit ESPECIALLY DRIED FRUIT LIKE RAISINS, as he snacks on these daily between meals (he's a complete and utter raisin addict) and possibly also breastmilk at night. When I pushed her on the breastmilk research I had read, she said that yes, it does have elements in it to protect baby teeth, BUT these only work if the teeth are already strong, so teeth that are damaged or rendered weak by OTHER SUGARS (as is likely the case here) or by injury to the tooth, could be impacted by the sugars in the breastmilk, particularly at night when saliva is less prevalent.
This is very good education for us in regard to maintaining his teeth, so we will cut down on, and hopefully eliminate altogether, night feeds (it is time, for other reasons not least among them that I need to be getting more sleep at night), and he will only have fruit with meals (particularly raisins). Snacks will be savouries like bread, crackers, etc., and he's not allowed any sweeties, cakes, or other sugary foods, or undiluted juice.
As far as the way forward, she mentioned a few other helpful tidbits: when he goes under the GA, she would endeavor to do everything possible to restore the chipped tooth and address the signs of decay on two of his other front teeth. She would also put a coating on all of his other teeth to protect those as well. She said that as long as he's under, they might as well do all of the work they can.
This will, of course, cost quite a lot of money. She quoted us somewhere along the lines of 3000 pounds, which is a combination of hospital fees, anesthecist fees, and her fees. Thankfully our medical insurance would cover the hospital and GA fees, and we just got dental insurance that would cover the bulk of the remainder, but won't go into effect until three months from the start of the policy, so January. Also, they can only to protective work on teeth actually full erupted, and one of his molars hasn't come in fully, so hopefully by then it would have.
Bottom line, he will not be going in for the procedure with the first dentist, Mr. Breastmilk is to Blame", nor will we follow the guidance of the NHS who would have us wait until he's got an infection. Instead we will wait and see, but feel that the balance of factors (feasibility of doing protective, preventative work on all of his teeth, restoring the chipped tooth hopefully prior to its needing to be extracted, and insurance coverage of the cost), weighs in favor of our waiting until the end of January.
Obviously if he appears in pain or gets an infection at any point prior to that time, we will take him in immediately. The one drawback to the wait and see is that it takes at least a week to get a surgery booking so he might have to wait, and be in pain. In the meantime we will get baby toothpaste with flouride in, and implement the other measures described above in connection with his diet, and generally keep an eye on his teeth.
Thanks to everyone for your support and comments and helpful information. It's been quite an education for me, and hopefully has proven helpful to others as well.