What to Know About Baby Teeth: A Guide for Families

Did your family just gain a little one? Congratulations!

There is a lot to know about taking care of babies, and learning to care for their teeth is one important part of their health. In this guide, we’ll help you understand the basics of infant oral health, and the steps you can take to ensure your child is set up for a lifetime of excellent oral health.

1. The First Baby Tooth Appears Around 6 Months

While every child is different, baby teeth start to appear between 6 and 12 months of age. Most babies will start to show their first tooth around 6 months.

In almost every case, the first teeth to appear are the lower front teeth, followed by the top front teeth. Most children will have all their primary teeth by age 3, and will start to lose them beginning at 6 or 7 years old.

If your baby isn’t showing teeth by their first birthday, there’s no need to be concerned: some children don’t start to grow teeth until well after they turn one. Just like other milestones, every child’s teeth grow differently. In some cases, a baby might grow molars before front teeth emerge. It all depends on the specific child.

Whether or not your baby has teeth by their first birthday, it’s important to bring them to the dentist in the first year.

2. Infants Should See a Dentist Within 6 Months of Their First Tooth

The American Dental Association and the American Association of Pediatrics both recommend that babies begin their oral healthcare early: within six months of their first tooth emerging, or by their first birthday.

Pediatric dental care is important from the very first tooth: your child’s dentist will examine their baby teeth, check the progress of dental development, and talk to you about oral health routines to start with your child. For children whose teeth are late to develop, their dentist will monitor their progress to ensure their dental health is on track.

Dentists provide many more services than treating cavities or fluoride treatments: they are a part of your child’s healthcare team to set them on a course towards lifetime health. By starting your baby on an excellent oral healthcare journey from the first year of life, you’re helping them maintain a healthy, happy smile for years to come.

3. Introduce Fluoride to You Baby’s Diet at 6 Months

Once baby teeth start to emerge around 6 months, you should add a small amount of fluoride to their diet, either in the form of fluoridated water, or fluoride drops. Talk to your child’s dentist about the best way to introduce fluoride to your baby’s diet.

Fluoride is a natural mineral with very well-documented benefits for dental health. Fluoride strengthens the dental enamel, the hard surface that coats the teeth and protects them from decay. When you introduce teeth-brushing (see below), use a fluoridated toothpaste to help your child get the fluoride their teeth need.

To boost oral health, many towns and cities add a small amount of fluoride to the tap water, which is completely safe and has been found to lead to fewer cavities. You can use this guide from the Centers for Disease Control and Prevention (CDC) to find out whether your tap water is fluoridated or not. For families in areas where the water is not fluoridated, a supplement will help protect your child’s teeth. For infants and small children, fluoride droplets can be used. Talk to your child’s dentist before introducing fluoride. (Consulting a doctor or dentist regarding fluoride is important, because too much fluoride can cause fluorosis, where white spots can appear on the teeth, damaging the enamel.)

4. For Teething Pain in Infants, Try Cold or Frozen Teething Rings or Consult with Your Doctor About Medication

When teeth begin to push through the gums, some babies will experience discomfort, pain, or tenderness. The gum around the tooth might appear swollen or red, and your baby may drool more than usual. A slight fever may also accompany teething (however, a fever above 100.4 degrees Fahrenheit or 38 degrees Celsius may be a sign of illness or infection; contact your doctor if this occurs).

To soothe your baby’s discomfort from teething, you can massage their gums with clean fingers, or offer them a solid teething ring (avoid liquid-filled teething toys, as these can leak) or clean washcloth. Cold or frozen teething devices can also help soothe irritation.

If your baby’s teething pain is causing regular discomfort, talk to your child’s doctor about administering a weight-appropriate dose of acetaminophen. After 6 months, babies can also have appropriately-dosed ibuprofen, such as Advil or Motrin. Talk to your doctor before administering any medication to your child, and avoid risky teething solutions like homeopathic gels and amber necklaces, which are not FDA-approved and can cause harm to your infant.

Teething is normal, and your baby’s constant desire to chew is a part of the teething process! Be sure to watch them carefully to prevent them from choking, and remove any small toys or foods that could present a choking hazard.

5. Start Brushing Your Baby’s Teeth As Soon As They Emerge

The first set of your child’s teeth are temporary, but that doesn’t mean they’re not important. Decay in primary (baby) teeth can cause developmental issues in permanent (adult) teeth, as well as cause pain, infection, speech impediments, or feelings of insecurity in young children.

Decay can begin as soon as the teeth emerge; for that reason, cleaning their teeth is an important habit to introduce as soon as possible. Clean your baby’s teeth every day before bed with a damp washcloth or a small, soft-bristled toothbrush designed for small children. Use a tiny smear of fluoride toothpaste, the size of a grain of rice. After 3 years of age, you can increase to a pea-sized amount; as soon as they can grasp the concept, teach them to spit out the toothpaste.

6. To Prevent Baby Bottle Tooth Decay, Don’t Put Babies or Toddlers to Sleep with a Bottle

Dental decay can occur in small children, even under one year of age. This is often due to an excess of sugar on their teeth, caused by falling asleep with a bottle (called baby bottle decay, or “milk mouth”), or sucking on a pacifier dipped in sugar or honey.

To prevent the baby teeth from rotting, never put your infant or toddler to bed with a milk bottle: the natural sugars in milk can pool around their teeth, causing the enamel to decay and damage the teeth. Never dip their pacifier in honey, sugar, maple syrup, or anything else. For children old enough to drink juice or cow’s milk, dilute both with water, or switch to water entirely. The less sugar children consume, the better for their teeth.

Keep an eye out for signs of decay on your child’s teeth: baby tooth decay often appears as small white spots on the teeth, and increased sensitivity to heat or cold on the teeth. This increases to brown spots, which get darker as the rot grows. Not all decay is visible, however – that is why it’s important to bring your baby to a dentist within 6 months of their first tooth.

7. Finding a “Dental Home” For Your Baby Will Help Support a Lifetime or Oral Health!

Research has found that children who regularly see the same dentist tend to have fewer cavities than those who don’t. That’s what dental experts refer to as having a “dental home”.

To set your child on a journey of excellent oral health, spend some time before their birth visiting dentists in your community to find a practice that’s right for your family! Get to know the dentist and their team, so you can feel confident and prepared when it’s time for your baby’s first visit. Your dentist can answer all your questions regarding your baby’s teeth, and how to maintain their oral health throughout their life.

Once the first tooth comes in, you’ll be prepared for everything that comes next!