Dental Care for Babies

You can start caring for your baby's gums right away. But at first, the care won't involve a toothbrush and toothpaste. Instead, take these steps:

• Get a soft, moistened washcloth or piece of gauze.
• Gently wipe down your baby's gums at least twice a day.
• Especially wipe your baby's gums after feedings and before bedtime.

This will wash off bacteria and prevent them from clinging to gums. Bacteria can leave behind a sticky plaque that damages infant teeth as they come in.

When the first baby teeth start to pop up, you can graduate to a toothbrush. Your child's pediatrician may suggest waiting until four teeth in a row have come out; others recommend waiting until the child is 2 or 3 years old. Choose a toothbrush with a:

• Soft brush
• Small head
• Large handle

At first, just wet the toothbrush. Soaking the brush in warm water for a few minutes before brushing can soften the bristles even more.

As soon as teeth erupt, you can start using toothpaste in the amount of a grain of rice. You can increase this to a pea-sized amount of fluoride toothpaste when your child is age 3.

Fluoride is a natural mineral that protects and strengthens the teeth against the formation of cavities. Using it early in your child's life will provide extra protection for developing teeth. However, dentists recommend that you start fluoride toothpaste when your child can reliably spit out the toothpaste after brushing. Kids get lots of fluoride from drinking water and shouldn't swallow fluoride in the concentration it is in toothpaste.

Many children's toothpastes are flavored with child-pleasing tastes to further encourage brushing. Select your child's favorite. Also, look for toothpastes that carry the American Dental Association's (ADA) Seal of Acceptance. This shows that the toothpaste has met ADA criteria for safety and effectiveness. Finally, read the manufacturer's label. Some toothpastes are not recommended for children under a certain age. Back to school? You got this.

Brush your child's teeth twice a day -- in the morning and just before bed. Spend 2 minutes brushing, concentrating a good portion of this time on the back molars. This is an area where cavities often first develop.

Replace the toothbrush every 3 or 4 months, or sooner if it shows signs of wear. Never share a toothbrush with others.

You should brush your baby's teeth until they are old enough to hold the brush. Floss once all the baby teeth have come in. Floss sticks or picks instead of regular string floss may be easier for both you and your child. Brush and floss just before bedtime. After that, don't give your child any food or drink, except water, until the next morning.

Continue to supervise the process until your child can rinse and spit without assistance. That usually happens at around age 6. Up until this time, remember that the best way to teach children how to brush their teeth is to lead by example. Allowing your child to watch you brush your teeth teaches the importance of good oral hygiene.

After your child is 6 years old, a fluoride rinse can help prevent cavities. Ask your dentist which product is right. Make sure your child is getting enough fluoride, which helps lessen cavities. If your local water supply does not contain fluoride, ask your dentist or doctor if you need to use a supplement.

Keep on the lookout for any signs of baby tooth decay -- brown or white spots or pits on the teeth. If you or your pediatrician notices any problems, take your child to a pediatric dentist for an exam.

Even if there isn't a problem, your child should go for their first dentist visit by age 1 or within 6 months after their first tooth comes in. Early preventive care saves you money in the long run. A CDC report shows that dental care costs are nearly 40% lower over a 5-year period for children who see a dentist by age 5. The dentist can give you advice about:

• Baby tooth care
• Teething
• Fluoride
• Thumb sucking
• Sealant coatings, which can help prevent tooth decay in children
• Diet

Children's teeth emerge at different times. Check out this chart to learn more. It can take 2 years before all of the infant teeth have made their way through your baby's gums. The process as each tooth emerges is called "teething." It can be a trying time for you and your baby.

Teething is uncomfortable. That's why your baby cries and fusses in the days or weeks before each baby tooth pops up. Babies can display other teething symptoms, too, including:

• Drooling
• Swollen gums
• Slightly higher than normal temperature

Here are a few tips to relieve your baby's teething pain:

Teething rings. Let your baby chew on a clean, cool teething ring or cold washcloth. Just avoid giving your child anything that is small enough to choke on. Also avoid a teething ring with liquid inside that could break open.

Gum rubbing. Rub your baby's gums with a clean finger.

Pain relief. Topical pain relievers are rubbed on the gums. Those that contain benzocaine should not be used for teething. The FDA warns that such products can cause dangerous, potentially life-threatening side effects. Give your baby acetaminophen occasionally to relieve pain, but ask your pediatrician first. Never give your child aspirin. It has been linked with a rare but serious condition called Reye's syndrome in children.

If your baby is unusually irritable or inconsolable, call your pediatrician.

In addition to caring for baby teeth, you need to protect them. To prevent cavities, only fill your baby's bottle with:

• Formula
• Breast milk
• Water
• Special electrolyte solutions when the child has diarrhea

Don't give your child fruit juices, sodas, and other sugary drinks. Limit them to 4 ounces a day of 100% fruit juice. Give nonsugary drinks and foods at mealtimes, and use juice only as a treat.

Sweet drinks -- even milk -- can settle on the teeth. This can lead to baby tooth decay -- also known as baby bottle tooth decay. Also at risk are children whose pacifiers are often dipped in sugar or syrup. Giving an infant a sugary drink at nap time or nighttime is particularly harmful because the flow of saliva decreases during sleep. Bacteria feed on the sugar from sweet drinks and produce acid, which attacks baby's teeth.

If you have to send your baby to bed or naps with a bottle or sippy cup, fill it with water only. Also avoid putting anything sweet -- such as sugar or honey -- on your baby's pacifier.

Although baby bottle tooth decay typically happens in the upper front teeth, other teeth may also be affected.

If baby bottle tooth decay is left untreated, pain and infection can result. Severely decayed teeth may need to be removed.

If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. They will also have higher chances that adult teeth will end up being crooked.

It's never too late to break bad habits. If your child drinks sweetened liquids from the bottle or sleeps with a bottle, break the habit now and cut the risk of baby bottle tooth decay by:

• Slowly diluting the bottle contents with water over 2 to 3 weeks.
• Once that period is over, fill the bottle with only water.
• Ditch the pacifier by age 2 or 3. There are lots of good reasons to let your child use a pacifier, but in the long term, it can affect how their teeth line up. It can also change the shape of the mouth. Talk to your doctor if they are still using a pacifier past age 3.
• Watch out for sweet medicine. Children's medications can be flavored and sugary. If they stick on the teeth, the chance of cavities goes up. Children on medications for chronic conditions such as asthma and heart problems often have a higher decay rate. Antibiotics and some asthma medications can cause an overgrowth of yeast, which can lead to a fungal infection called oral thrush. Signs are creamy, curd-like patches on the tongue or inside the mouth. Talk to your dentist about how often to brush if your child is taking long-term medications. It could be as often as four times a day.

Remember that healthy baby teeth will lead to healthy permanent teeth.

Reviewed by Sabrina Felson, MD, on Nov. 2, 2021