Your baby’s first tooth probably will appear after six months, though some babies are born with one or more teeth and in other cases teeth don’t appear until the child is almost a year old. Many mothers decide that it’s time to stop breastfeeding when they first notice a tooth. Usually this is because the baby has nipped the breast at the end of a feeding session or because the mother fears she will be bitten. Yet many babies with teeth (or those who are teething) never bite when breastfeeding. In fact, an actively nursing baby will not bite, because her tongue covers her lower teeth. A baby who nips the breast as he starts to pull away near the end of a feeding can be taught to stop. Try not to let this minor challenge get in the way of breastfeeding so early in your nursing relationship.
If your baby has sprouted a tooth and you are concerned that she may nip you as a feeding ends, keep your finger ready to break the suction and remove your breast as soon as her rhythmic suckling stops (and before she starts to drift off or feel playful). If she has already bitten, say no firmly and then remove her from your breast. Try to keep this action as bland and matter-of-fact as possible: too much anger or even amusement may interest her enough to make her want to repeat the experiment again. Once she realizes that biting means no more breast, she will learn to stifle the impulse. (Meanwhile, don’t forget to offer her a one-piece teething ring when she is not nursing.)
Baby-Bottle Tooth Decay
Once your baby’s teeth have begun to come in, it is important to keep in mind that even breastfeeding babies are sometimes susceptible to baby-bottle tooth decay (BBTD), a major cause of dental cavities in infants that can also cause serious damage to permanent teeth later on. BBTD results from teeth being coated in almost any liquid other than water for long periods, and occurs most commonly among babies who are put to bed with a bottle of formula or juice.
Research shows that human milk by itself does not promote tooth decay. But breastfeeding infants who fall asleep while nursing with unswallowed milk in their mouths are also vulnerable to tooth decay. Beyond the first year, dental caries—tooth decay—can occur in toddlers who receive sugary liquids in a bottle or who are nursing and also eating foods with sugar and carbohydrates. Make a point of removing your breast from your baby’s mouth once she has fallen asleep.
Your pediatrician will check your baby’s teeth as part of the well-child visits during the first year of life and beyond. To stimulate healthy gums and good oral hygiene, it is a good idea to wipe the gums at least once a day, beginning at birth, even before any teeth have erupted in your child’s mouth.
After teeth erupt, wiping her gums and teeth with a piece of gauze or a damp cloth after feedings and before bedtime will help maintain good oral hygiene. Once your child has several teeth, start using water and a softbristled, child-sized toothbrush for daily cleaning. Your pediatrician will advise you about when to begin using toothpaste with your child. Fluoridated toothpaste is not usually recommended until after age two, since babies tend to swallow it and can actually get too much fluoride. Some fluoride is good for strong, healthy teeth that are resistant to decay, but too much can cause a permanent, dark discoloration of the teeth. Your doctor or dentist may also apply a topical fluoride varnish at office visits to protect her teeth.