Oral Health for Babies and Toddlers

Good oral health begins before a child’s first tooth erupts. It’s essential to care for your child’s oral health as soon as they’re born. They can begin brushing their own teeth around age 6 or 7.

This article covers everything you need to know about oral health in children. It includes tips on preventing cavities and building habits for a healthy smile throughout adulthood.

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. 

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

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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 eventually grow into their place. 

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

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

When Do Baby Teeth Start Coming In?

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 baby (primary) teeth by the time they’re 3 years old. 

Dental Care for Babies and Toddlers

Developing an at-home dental care routine will lay the foundation for a healthy mouth throughout your child’s life. These habits help prevent cavities, gum disease, and misaligned teeth, among other conditions.

Here are some helpful tips for keeping your child’s teeth healthy: 

Birth to 6 Months of Age

Start cleaning your baby’s mouth as soon as you bring them home. Don’t wait until the first tooth emerges to begin a dental hygiene routine.

Additionally, clean your infant’s gums after every feeding and before your baby falls asleep. Gently wipe your baby’s gums with a water-moistened washcloth wrapped around your index finger. Avoid using toothpaste, mouthwash, or other substances.

Keep in mind that dental decay is transmissible. Don’t put a bottle, pacifier, or anything else in your mouth before giving it to your baby.

6 to 12 Months of Age

Your baby’s first tooth will appear between 6 and 8 months of age. 

Here’s how to care for your baby’s gums and their first teeth:

• Continue cleaning your child’s gums after every feeding
• Brush with a soft-bristled infant toothbrush and water once the first tooth appears
• Provide a clean, cool teething ring or cold washcloth to relieve teething symptoms
• Schedule your child’s first dental appointment
• If your drinking water isn’t fluoridated, ask your child’s dentist about infant fluoride supplements  

12 to 18 Months of Age

Your child should have their first dental exam by the time they’re one year old. You should schedule an appointment if they have not seen a dentist by this time.

Continue caring for your baby’s teeth at home by:

• Brushing their teeth twice a day with a bit of fluoride toothpaste (the size of a grain of rice)
• Flossing between their teeth as soon as they have two teeth that touch
• Checking your child’s teeth for signs of decay (white or brown spots)

18 Months to Age 3

Most, if not all, of your child’s baby (primary) teeth should grow in by age 3. Babies have 20 primary teeth, with 10 on the top and 10 on the bottom.

By the time your child is 3 years old, they should have stopped using a pacifier or sucking their thumb. This is an important habit to break to avoid teeth misalignment.

Around age 3, you can start using a pea-sized amount of fluoride toothpaste, but make sure they spit it out. Supervise them as they brush at least twice a day. You will have to help them brush until they have the dexterity to do it themselves.

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, and symptoms can include:

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

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

Breastfeeding reduces the risk of baby bottle tooth decay. However, this doesn’t mean that breastfed babies can’t get cavities. 

Early Tooth Decay and 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, so early dental visits are important. With lifestyle changes, incipient tooth decay can 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 by sucking on their thumbs 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 they’re 3 years old. 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. This is partly 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 don’t erupt properly or because a child’s mouth is too small to accommodate all 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

Summary

Proper oral health care is crucial for babies and toddlers because it helps to set them up for healthy teeth throughout life. 

You should begin cleaning your child’s mouth within the first days of infancy and schedule their first oral examination before their first birthday. Continue supervising your child until they’re old enough to care for their own teeth.