Dental Care for Babies

When Do Children Get Primary Teeth?

Most children begin teething about 6 to 12 months after birth. In most cases, the first teeth to break through the gums are the two front bottom teeth.

Teeth tend to appear in pairs. Most children have all of their primary teeth by the time they are 3 years old. Babies have 20 primary teeth, with 10 on the top and 10 on the bottom. 

When Do Children Start Losing Teeth? 

Primary teeth begin falling out around the age of 6 or 7 and are replaced by adult or permanent teeth. Keep in mind, this is an average, and some children lose their baby teeth earlier or later in life.

Why are Baby Teeth Important? 

Some parents assume baby teeth aren’t important because they aren’t permanent. This isn’t true.

Baby teeth play an important role in a child’s long-term oral health. Baby teeth hold space for the permanent teeth that will eventually grow into their place. 

If a baby tooth comes out too early, permanent teeth can shift and eventually crowd other teeth. Losing a baby tooth prematurely can also delay the permanent tooth from erupting on time. 

Baby teeth are also a factor in a child’s overall development because they affect chewing, speaking, and smiling. 

Common Pediatric Dental Concerns

Parents should keep the following factors in mind when considering their child’s dental health:

Teething 

Teething usually begins when your child is about 6 months old. Symptoms include:

• Drooling
• Crankiness
• Excessive crying
• Chewing on objects
• Sore gums
• Slightly elevated temperature (usually no higher than 100.3 F)

Teething is normal, but it can be one of the most stressful developmental phases for babies.

There is no “cure” for teething. The discomfort of teething eases over time, and symptoms tend to be less severe during later phases. 

But there are several things you can do to soothe the discomfort of teething, including:

• Massage the gums with a clean finger or wet gauze
• Provide a chilled teething ring
• Consider over-the-counter (OTC) pain remedies based on your doctor’s recommendation

Breastfeeding 

Many parents ask if they should stop breastfeeding once their child begins teething. This is a personal decision, and the answer is different for everyone.

The World Health Organization (WHO) recommends breastfeeding for up to two years but acknowledges this isn’t possible for everyone.¹

The good news is breastfeeding reduces the risk of bottle-drinking tooth decay. However, this doesn’t mean that breastfed babies can’t get cavities. 

Early Tooth Decay & Poor Nutrition

Tooth decay is possible, even when your child is very young. Sugary foods and drinks, which cause bacteria and acids to develop, damage tooth enamel. 

Dental caries and cavities are not easily recognizable, which is why early dental visits are important. Luckily, with lifestyle changes, incipient tooth decay can usually be monitored and managed without invasive treatment.

To prevent and manage early onset tooth decay:

• Move the bottle or breast away from your baby once they finish feeding
• Never put your baby to bed with a bottle of milk or juice
• Don’t supplement formula or breastmilk with sugary juices, sodas, or other liquids
• Speak to a dentist about the proper care and cleaning of baby teeth
• Brush your child’s teeth with a finger toothbrush or child-sized toothbrush and toothpaste approved by your dentist

Thumbsucking and Pacifier Use

Many babies and young children comfort themselves with thumb sucking or pacifiers. These behaviors can lead to dental health problems.

Thumb-sucking is rarely a concern for very young children. Ideally, your child will break the habit by the time permanent teeth are ready to erupt. Otherwise, it can affect the development of the roof of the mouth and tooth alignment.

Thumb-sucking and pacifier use can also elongate the upper jaw and affect overall alignment. It’s also possible that children who suck their thumbs will have problems with overcrowding.

Knocked-Out Teeth (Emergencies) 

Dental trauma is common among young children. In part, this is because they are developing motor skills, and clumsy movements can cause injuries. Chipped, broken, or knocked out baby teeth require emergency dental treatment.

In most cases, there are fewer cosmetic issues to consider when a child knocks out a tooth. It’s normal for children to have missing teeth, but you should still be concerned about it. Missing baby teeth can affect the long-term well-being of your child’s overall dental health. 

Malocclusion (Bad Bites) 

Malocclusion occurs when someone’s teeth don’t bite together in alignment. This might occur if teeth did not erupt properly or because there is misalignment. Malocclusion can also occur because a child’s mouth is too small to accommodate all of their teeth.

Malocclusion risks are higher for children who:

• Use a pacifier after age 3
• Suck their thumb after their permanent teeth begin to erupt
• Have a cleft palate or lip
• Experience facial trauma or injury
• Have an airway obstruction from mouth breathing or tonsil or adenoid problems
• Have a tongue thrust or tongue-tie

At-Home Dental Care for Babies

You can do several things at home to maintain your child’s dental health, like: 

How to Clean Your Baby’s Mouth

It’s important to clean your baby’s mouth, even before they have their primary teeth. Parents should clean their baby’s mouths within the first few days after they’re born.

Do so by wiping the gums with a water-moistened pad or washcloth. Do not use toothpaste, mouthwash, or any other substance to clean your baby’s mouth.

Preventing Tooth Decay

Parents should introduce tooth brushing when the first tooth erupts.

Brush twice a day and encourage your child to participate in the process. Continue to supervise and assist until you’re confident your child is doing a thorough job brushing.

Preventing Misaligned Baby Teeth

As your child gets older and closer to their adult teeth erupting, encourage them to stop sucking their thumb, if they do so. Thumb sucking increases the risk of misalignment. Some people suggest putting an edible but unpleasant tasting cream on your child’s thumb to discourage sucking.

When Should a Child Start Going to the Dentist?

Children should visit the dentist after their first tooth appears or by their first birthday, whichever comes first. The initial dental visit is similar to a well-baby checkup, but for teeth. Even if you believe your child’s dental health is fine, a professional dentist should still assess your child’s teeth. 

During this initial visit, the dentist will check for normal development, cavities, and other problems. They’ll also demonstrate proper brushing. Finally, they’ll address any concerns, including thumb-sucking or pacifier use.