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 cavities can develop as soon as your baby has teeth? Since baby teeth will eventually fall out, it might not seem that important to take good care of them. Surprisingly, your child's first teeth are essential to the health of their permanent teeth — and the foundation for lifelong health.
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.
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 proper diet and dental hygiene habits during a child's infant and toddler years reduce the risk of tooth decay as they become older.
Even though we have made great strides in preventing tooth decay, it is the most common chronic health problem in children. In fact, 23% of all kids will get cavities before their fifth birthday. Consider:
— 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
— 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
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 breakthrough, 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 two times daily for two 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 microbiome (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 four ounces per day and mix them with water (half-water, half-juice is best).
— Limit sticky fruits and treats. 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 two to four times a year that can continue as your child grows.
When your baby's first tooth appears, it is time to schedule their first dental visit. This is the ideal time to learn more about dental care for kids and what you will 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 mouthguard.
Since babies see the doctor several times before their first birthday, pediatricians should 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, 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.
Kids learn from the adults around them. That is 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 are away from home. Mark dental appointments on the family calendar, which shows kids that regular checkups are a priority. Some children benefit from going to the dentist more than every six 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.
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ABOUT THE WRITER
Dr. Patricia Braun is a professor of pediatrics at the University of Colorado Schools of Medicine and Dentistry and a mother of two. For more than 25 years, Dr. Braun has treated the underserved Colorado community as a practicing pediatrician. Within the American Academy of Pediatrics, she sits on the Section on Oral Health Executive Committee.
