Your child’s baby teeth are at risk for decay as soon as they first appear—which is typically around age 6 months. Tooth decay in infants and toddlers is often referred to as Baby Bottle Tooth Decay. It most often occurs in the upper front teeth, but other teeth may also be affected. In some cases, infants and toddlers experience decay so severe that their teeth cannot be saved and need to be removed.
The good news is that tooth decay is preventable! Most children have a full set of 20 primary teeth by the time they are 3-years-old. As your child grows, their jaws also grow, making room for their permanent teeth.
Cleaning Your Child’s Teeth
- Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.
- For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.
- For children 3 to 6 years of age, caregivers should dispense no more than a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to minimize swallowing of toothpaste.
- Until you’re comfortable that your child can brush on his or her own, continue to brush your child's teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.
Teething is one of the first rituals of life. Although newborns usually have no visible teeth, most baby teeth begin to appear generally about six months after birth. During the first few years of your child’s life, all 20 baby teeth will push through the gums and most children will have their full set of these teeth in place by age 3. A baby’s front four teeth usually erupt or push through the gums at about six months of age, although some children don’t have their first tooth until 12 or 14 months. As their teeth erupt, some babies may become fussy, sleepless and irritable, lose their appetite or drool more than usual. Diarrhea, rashes and a fever are not normal symptoms for a teething baby. If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.
First Dental Visit
As soon as your child’s first tooth appears, it’s time to schedule a dental visit. The ADA recommends that the first dental visit take place within six months after the first tooth appears, but no later than a child’s first birthday. Don’t wait for them to start school or until there's an emergency. Get your child comfortable today with good mouth healthy habits.
Although the first visit is mainly for the dentist to examine your child’s mouth and to check growth and development, it’s also about your child being comfortable. To make the visit positive:
- Consider making a morning appointment when children tend to be rested and cooperative.
- Keep any anxiety or concerns you have to yourself. Children can pick up on your emotions, so emphasize the positive.
- Never use a dental visit as a punishment or threat.
- Never bribe your child.
- Talk with your child about visiting the dentist.
During this visit, you can expect the dentist to:
- Inspect for oral injuries, cavities or other problems.
- Let you know if your child is at risk of developing tooth decay.
- Clean your child’s teeth and provide tips for daily care.
- Discuss teething, pacifier use, or finger/thumbsucking habits.
- Discuss treatment, if needed, and schedule the next check-up.
Fluoride is a mineral that occurs naturally in all water sources, including oceans, rivers and lakes. Fluoride is also added to some community tap water, toothpastes and mouth rinses. Infants and toddlers who do not receive an adequate amount of fluoride may be at an increased risk for tooth decay since fluoride helps make tooth enamel more resistant to decay. It also helps repair weakened enamel. Bottled water may not contain fluoride; therefore, children who regularly drink bottled water or unfluoridated tap water may be missing the benefits of fluoride. If you are not sure if your tap water has fluoride, contact your local or state health department or water supplier.
Note: Discuss your child’s fluoride needs with your dentist or pediatrician. They may recommend a fluoride supplement if you live in an area where the community water is not fluoridated.
Infants and young children may suck on thumbs, other fingers or pacifiers. Pacifiers dipped in sugar, honey, juice or sweetened drinks, can lead to tooth decay. Tooth decay can also begin when cavity-causing bacteria pass from saliva in a mother or caregiver’s mouth to the infant. When the mother or caregiver puts the baby’s feeding spoon in her mouth, or cleans a pacifier in her mouth, the bacteria can be passed to the baby.
A child's first visit to the dentist should be enjoyable. Children are not born with a natural fear of the dentist, but they can fear the unknown. Our office makes a special effort to use pleasant, non-frightening, simple words to describe each treatment. We want you and your child to feel at ease from the moment your family arrives at our office. The more you and your child know about the first visit, the better you will feel.
The American Academy of Pediatric Dentistry recommends...
Children should visit the dentist by their first birthday. It is important that your child's newly-erupted teeth (erupting at six and 12 months of age) receive proper dental care and benefit from proper oral hygiene habits right from the beginning.
Getting to know your teeth is fun!
When New Teeth Arrive
Your child's first primary or baby teeth will begin to erupt between the ages of six and 12 months, and will continue to erupt until about age three. During this time, your child's gums may feel tender and sore. To help alleviate this discomfort, we recommend that you soothe the gums by rubbing a clean finger or a cool, wet cloth across them. You may also choose to make use of a teething ring. When your child has finished teething, you can expect a total of 20 primary teeth.
Your child's primary teeth are shed at various times throughout childhood. Permanent teeth begin erupting at age six, and continue until age 21. Adults have 28 permanent teeth (32, including wisdom teeth).
Adopting Healthy Oral Hygiene Habits
As your child's teeth erupt, be sure to examine them every two weeks, looking for lines and discoloration that may be caused by decay. Remember that sugary foods and liquids can attack a new tooth, so take care that your child brushes after feeding or eating. We recommend brushing four times a day for optimal oral hygiene: after breakfast, after lunch, after dinner, and at bedtime.
Brushing can be fun, and your child should brush as soon as the first tooth arrives. When a baby's tooth erupts, parents should brush the tooth with a soft-bristled toothbrush and a pea-sized amount of toothpaste. For children younger than two, do not use fluoride toothpaste unless advised to do so by your dentist or other healthcare professional. We suggest reviewing proper tooth brushing procedures with your child.
Flossing is also a part of good oral hygiene habits, and your doctor will discuss with you the right time to start flossing. If you notice signs of decay, contact your dentist immediately.
Preventing Tooth Decay with Regular Checkups
Tooth decay is caused by sugars left in your mouth that turn into an acid, which can break down your teeth. Children are at high risk for tooth decay for a simple reason: many children and adolescents do not practice regular, good oral hygiene habits. Proper brushing and flossing routines combined with regular dental visits help keep tooth decay away.
Your child should visit the dentist every six months for regular dental cleanings and checkups. We recommend fluoride treatments twice a year along with cleanings to keep teeth their strongest. Tooth sealants are also recommended because they "seal" the deep grooves in your child's teeth, preventing decay from forming in these hard-to-reach areas. Sealants last for several years, but will be monitored at your child's regular checkups.