Dental Care for Infants and Toddlers
(Birth to 2 Years of Age)
Q: When should my child first see a dentist?
A: "First visit by first birthday" sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between six and twelve months of age. The earlier children begin visiting the dentist, the better the chance of preventing dental problems. Children with healthy teeth chew food easily, learn to speak clearly, and smile with confidence. Start your child now on a lifetime of good dental habits.
Q: When will my baby start getting teeth?
A: The two lower front teeth (central incisors) erupt at about six months of age, followed by the two upper central incisors. During the next 18 to 24 months, the rest of the baby teeth (total of 20) appear, although not in orderly sequence from front to back.
Q: Why are baby teeth important?
A: Healthy primary or “baby” teeth are necessary for chewing, speech development, maintaining space for and guiding the permanent teeth into the correct positions, development of the jaws and esthetics. If a primary tooth comes out prematurely, neighboring teeth may move into the empty space causing the permanent tooth to be “blocked out.” If this is the case, the teeth may look crooked or crowded.
Q: Why so early? What dental problems could a baby have?
A: The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (also know as baby bottle tooth decay or nursing caries). Your child risks severe decay from using a bottle during naps or at night or when they nurse continuously from the breast.
Q: When should I start cleaning my baby’s gums/teeth?
A: The sooner the better! Prior to having teeth, clean your child’s gums with a soft infant toothbrush and water to remove plaque after every feeding. This establishes at an early age the importance of oral hygiene and the feel of having a clean mouth. As soon as teeth begin to appear, brush twice daily utilizing fluoride toothpaste approved by the ADA (American Dental Association) and a soft, age-appropriate toothbrush. Use a "smear" of toothpaste for of a child less than 2 years of age and a "pea-sized" amount for a 2-5 year old. Remember that young children do not have the ability to brush their teeth effectively until about age 8 so parents will need to perform and/or assist until then. Remind your child to spit out and not swallow excess toothpaste after brushing to avoid ingesting excess fluoride and possible fluorosis (chalky white to even brown discoloration) of the permanent teeth.
Q: What is the correct way to brush my child’s teeth?
A: First, place a soft bristle toothbrush at a 45 degree angle towards the gum line and begin with a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.
Q: What is the most important time of the day to clean my child’s teeth?
A: The most significant time to brush is just before bedtime. The next most important time is after breakfast. Ideally, it would be fantastic if everyone could brush after every meal or snack! Avoid eating or drinking anything after nighttime brushing so teeth can stay clean and protected throughout the night.
Q: How can I prevent tooth decay from nursing or a bottle?
A: Encourage your child to drink from a cup as they approach their first birthday. Children should not fall asleep with a bottle. At-will nighttime breast-feeding should be avoided after the first primary teeth begin to erupt. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks. Drinking juice from a bottle should be avoided and when juice is offered, it should be in a cup.
Q: When should bottle-feeding be stopped?
A: Children should be weaned from the bottle at 12-14 months of age.
Q: Any advice on teething?
A: From six months to age 3, your child may have sore gums when teeth erupt. Many children like a clean teething ring, cool spoon, or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger.