Patricia Braun, MD, MPH, FAAP
Seeing your baby's
first tooth is an exciting milestone! Most little ones will get their first (primary) teeth around 6 months of age, though tiny teeth can emerge as early as 3 months.
Did you know that cavities can develop as soon as your baby has teeth? Since baby teeth will eventually fall out, it might not seem all that important to take good care of them. But as it turns out, your child's first teeth are essential to the health of their permanent teeth—and the foundation for lifelong health.
These are just some of the reasons to take extra-good care of your child's first (primary) teeth. Read on to learn more.
How do cavities develop in baby teeth?
Cavities can form when the shiny surface of our teeth—the
enamel—is harmed by common bacteria living in our mouths. The bacteria feed on sugary substances left behind from what we eat and drink. In the process, they create acids that attack tooth enamel, opening the door for tooth decay to start.
Even the natural sugars in breast milk and formula can kick-start the process of tooth decay. And even though primary teeth start falling out when kids are around 6 years old, what happens before then will influence your child's dental health over the long term. Research shows that diet and dental hygiene habits during a child's infant and toddler years reduces the risk of tooth decay as they become older.
Why it's crucial to take good care of baby teeth
Even though we've made great strides in preventing tooth decay, it is the most common chronic health problem seen in children. In fact, 23% of all kids will get cavities before their 5th birthday. Consider that:
Decayed baby teeth may need to be taken out by the dentist, which can be painful and frightening for your child (and costly for your family).
Missing baby teeth leave gaps, causing nearby teeth to shift around. This can keep your child's permanent teeth from coming in correctly, which might mean braces later on.
Kids (and adults) need healthy teeth to speak clearly and chew their food thoroughly, the first step in healthy digestion. A bright, shining smile gives a child confidence, too—an essential part of making friends, getting along in school and enjoying life.
9 everyday steps for keeping your child's teeth healthy
Here are steps recommended by the American Academy of Pediatrics (AAP) for preventing cavities in babies and young children.
No bottles in bed. Putting your child to sleep with a bottle allows the sugars found in formula and breast milk to linger on teeth, setting the stage for tooth decay. (In fact, many doctors and dentists refer to early cavities as
baby bottle tooth decay).
Handle pacifiers, spoons and cups with care. Tooth decay-causing bacteria can easily move from mouth to mouth. So, for example, you should avoid putting a pacifier in your mouth and then giving it to your child, or tasting your baby's food before offering them a bite from the same spoon.
Cleanse little mouths after each meal. Even before your infant's first teeth break through, it is important to get into a healthy routine. Wipe the gums with a clean, damp washcloth or gauze pad after each feeding. When baby teeth come in, switch to a soft-bristled toothbrush with a smear (about the size of a grain of rice) of fluoride toothpaste. Around your child's first birthday, create a healthy routine of brushing 2 times daily for 2 minutes each time. Consider setting up a bedtime routine of brushing your child's teeth after their last feed, reading them a book and then getting them to bed at a regular bedtime—brush, book, bed.
Studies suggest that breastfeeding during a child's first year can help reduce the risk of tooth decay by half. This may be because of other effects breast milk has the immune system or
(the balance of good and bad bacteria). Still, whether you give your baby breast milk or formula, you should wipe their gums and any erupting teeth after feedings to minimize risk of decay.
Introduce a cup around your child's first birthday. Teaching young ones to drink from a cup can help prevent tooth decay. Plan to begin moving your child from the breast or bottle to a lidded cup around 12 months. Milk, breast milk and formula can be given at mealtimes, but fill your child's cup with plain water in between.
Avoid using cups or bottles to soothe your child. When little ones get fussy, it's tempting to offer them a little formula or milk, but this exposes little teeth to sugars for long periods. Use a regular pacifier to calm your child, but be sure not to dip it in honey or any other sweetener.
Skip the sugary drinks. Fruit juice, soda and sweetened drinks aren't good for your little one's teeth. In fact, the AAP does not recommend juice for babies under 12 months. After that, limit juices to 4 ounces per day and mix them with water (half-water, half-juice is best). See "Recommended Drinks for Children Age 5 & Younger.")
Limit sticky fruits and treats. Some foods can cling to a child's teeth, giving bad-guy bacteria plenty of sugar to feast on. Sticky foods that promote tooth decay include raisins and other dried fruits, gummy candies, taffy, fruit roll-ups and snack bars with honey or molasses. Try to limit these foods in your child's diet and have kids brush or rinse with plain water after eating them.
Make water the family drink of choice. Regular tap water, which usually contains fluoride to strengthen tooth enamel, is the healthiest drink for your child's teeth. Drinking plenty of water cleanses your child's mouth and helps maintain saliva flow, which also washes away decay-causing bacteria.
Learn more about fluoride. Decades of studies have shown that fluoride is
a superhero in fighting tooth decay. Most kids get the fluoride they need from tap water and toothpaste that delivers fluoride. Your pediatrician or dentist may also apply a fluoride varnish to your child's teeth, a helpful step 2-4 times a year that can continue as your child grows.
Not sure if your local water supply has fluoride? Use this
online map to find out. If you're wondering about fluoride safety, read what a
dentist who's also a mom has to say.
When should I take my child to the dentist?
When your baby's first tooth appears, it's time to schedule their first dental visit. This is the ideal time to learn more about dental care for kids and what you'll need to do as they grow.
Over time, your dentist can help you set up a healthy family routine, explaining everything from how to
teach little hands to brush and floss to fitting young athletes with the right
The role your pediatrician plays
Since babies see the doctor several times before their first birthday, pediatricians have the opportunity to check inside little mouths. It can be difficult to spot warning signs in baby teeth, so your pediatrician's expert eye is especially helpful.
As your child grows, your pediatrician will offer tips and suggestions that support the expert care your family dentist will provide. They can also apply fluoride varnish to your child's teeth in partnership with your child's dentist. In addition, In addition, pediatricians can help parents learn more about special risks that make some children more cavity-prone. For example, preemies often have weaker tooth enamel than babies born at full term. Certain health conditions and medicines can reduce saliva flow, making brushing and flossing even more important.
Making cavity prevention a family priority
Kids learn from the adults around them. That's why parents and caregivers should take excellent care of their own teeth. As one dentist puts it: "Bad teeth don't necessarily run in the family, but bad dental habits do."
Set a positive example by letting little ones watch while you brush and floss. Explain that this is something we do twice a day, morning and night, even when we're away from home. Mark dental appointments on the family calendar, which shows kids that regular checkups are a top priority. Some children benefit from going to the dentist more than every 6 months to help them avoid getting cavities or keep cavities that have already started from getting worse.
Encourage good habits by adding fun to your child's routine. Toddlers and preschoolers may enjoy
brushing to music or marking their progress on a tooth care
calendar. The American Dental Association offers free
coloring and craft sheets you can download and share, too.
Healthy baby teeth set the stage for a lifetime of good dental health. Teeth play a crucial role in helping us speak clearly, smile confidently and chew our food thoroughly, which nourishes our bodies for overall good health.
Setting a good example helps prevent tooth decay now and in the future.
Along with your family dentist, your pediatrician plays a key role in caring for your child's mouth and teeth.
About Dr. Braun
Patricia Braun, MD, MPH, FAAP is a Professor of Pediatrics within the University of Colorado Schools of Medicine and Dentistry and a mother of two. For more than 25 years, Dr. Braun has been serving the underserved Colorado community as a practicing pediatrician. Within the American Academy of Pediatrics, she sits on the
Section on Oral Health Executive Committee.