Zero to Six Months
The Big Picture
When a new baby is born, the mother is usually overwhelmed with her new responsibilities. There are three important things to remember at this stage.
At about 6 months of age, the mother should ask her baby’s doctor about fluoride supplements for the baby. Depending on the amount of fluoride in the drinking water and whether the mother is breast-feeding or bottle-feeding, the doctor may prescribe fluoride drops or a vitamin-fluoride combination for the baby. The fluoride actually affects the baby teeth and the permanent teeth while they are forming to make them stronger and more resistant to cavities. All prescriptions of fluoride should be followed through with because fluoride ingested at this age can prevent cavities later. If the drinking water is not fluoridated – or if the family uses bottled water for drinking and cooking – these supplements should be continued until the child is 16 years old and all of the permanent teeth are formed.
Preventing “Early Childhood Cavities”
The second important thing to remember with a newborn baby is to NOT put them to bed with a bottle. It is MUCH easier never to start this bad habit than it is to stop it when the baby teeth start coming in. Letting a baby sleep with a bottle – or nurse continuously, if breast-feeding – can cause serious dental cavities, called “Early Childhood Cavities.” It is important to note that while many experts agree that breast-feeding is healthier for your baby, breast milk can cause Early Childhood Cavities just as whole milk or formula can.
Early Childhood Cavities are characterized by a unique pattern of decay beginning with the upper front teeth, and followed by the primary molars, in order of eruption. This disease can result in cavities, pain, tooth loss, infections, and loss of sleep.
Cleaning Baby’s Gums
The third message for this age group is to instruct caregivers to clean their babies’ gums daily. After feedings, the caregiver should use a clean, damp washcloth, finger cot or gauze square to gently wipe baby’s gums and tongue. If the baby has teeth before six months, be sure to clean them too.
Mother’s Oral Health is Still Important
It’s also important for the mother to continue caring for her own teeth, for her own sake and her baby’s health. New research shows that the more unfilled cavities a mother has, the more cavity-causing germs she has. These cavity-causing germs can be passed on to baby by daily contact such as sharing food and letting baby stick her fingers in her mother’s mouth. This is yet another reason to have any cavities filled.
- Clean baby’s gums daily
- Avoid putting baby to bed with a bottle
- Ask your doctor or dentist about fluoride supplements.
Six to Eighteen Months
The Big Picture
At about 6 months of age, the baby teeth begin to erupt. The last baby tooth comes in at about 24 months of age.
The Importance of Baby Teeth
Many people don’t understand how important baby teeth are. Healthy baby teeth are needed for biting and chewing, which affects the nutrition of young children. Children who have their front teeth extracted early because of Early Childhood Cavities have trouble eating fresh fruit, meat, and vegetables. These are important foods! Baby teeth also hold space for the permanent teeth. If the baby teeth are lost early because of cavities, permanent teeth may come in crooked. Baby teeth are also needed for speaking clearly. Children who do not speak clearly may not do as well in school.
Preventing Early Childhood Cavities
At 6-12 months of age, babies should begin drinking from a sippee cup. Most children begin reaching for things at this age and that makes it a perfect time to introduce a drinking cup. At 12-14 months, babies should be weaned from the bottle.
Caring for Baby’s Teeth
When baby’s first teeth come in, they should be cleaned daily. Caregivers should use a soft, child-sized toothbrush or a clean, damp washcloth to gently clean the teeth and gums. But in every case, once the baby reaches the age of one, it’s time for the first dental checkup! Caregivers should also be encouraged to lift baby’s lip and check for cavities. Cavities at this age would look like small white or brown spots. If baby has suspicious spots on her teeth, a dental appointment should be scheduled immediately. If these cavities are discovered in their earliest stages, the treatment should be minor.
- Serve juice/milk in a sippee cup (at 6 months)
- Avoid letting baby walk around with a bottle
- Wean baby from the bottle at 12-14 months
- Clean baby’s teeth daily
- Visit the dentist for a checkup at 12 months
The Big Picture
Toddlers should be off the bottle by now. Caregivers who have not yet weaned their babies from the bottle need to be warned that their children may develop serious cavities if they continue using a bottle. These families should be instructed to continue to check for signs of early cavities by lifting the baby’s lip to check teeth. Early cavities are white or brownish spots. If the caregiver sees brown or white spots on the teeth, the child should see a dentist immediately.
Children this age usually snack often. Sweet and starchy snacks like chips and crackers should be limited. Constant snacking on sweet or starchy foods can cause cavities. Each time baby drinks soda pop or eats sweet or starchy foods, there is a 20 minute “acid attack” on the teeth. Constant snacking causes cavities because the slowly-eaten snack creates a longer “acid attack” on the teeth.
Caregivers should continue daily brushing of their babies’ teeth in the morning and at night, before bedtime. Use a small “pea-sized” dab of fluoride toothpaste on the brush as soon as the child is able to spit out. At this stage, children can also try to begin brushing their own teeth, but caregivers will definitely need to help the child. Most children do not have the coordination to brush effectively by themselves until they are six-to-eight years old.
- Limit the number of times toddler eats snacks each day
- Brush toddler’s teeth after breakfast and before bedtime
Common Questions and Answers
Can I transmit periodontal/gum disease to my baby?
Yes. Cavity-causing germs can be transmitted through contact – like when baby puts hands in your mouth, and then in his/her own mouth. That’s why it’s so important to keep you own teeth and gums healthy.
Is it ok if my child sucks his/her thumb?
Thumbsucking is normal for infants; most stop on their own by age 2. If your child continues, try to discourage it by age 4. Thumbsucking beyond age 4 can lead to crooked, crowded teeth and/or bite problems.
Is it ok for my baby to use a pacifier?
Yes, but don’t dip it in sugar, honey or sweetened liquid. In addition: Try to have your child give up the pacifier by age 2. Keep in mind that while a pacifier and thumbsucking create no health difference for the child, a pacifier may be a better choice because it can be easier to wean child from a pacifier than from thumbsucking.
When should I start cleaning my baby’s teeth/gums?
Begin cleaning baby’s gums within the first few days of birth. This gets baby used to having his/her mouth feel clean. Daily brushing should begin once the first tooth has erupted, but continue to clean and massage gums where there are no teeth yet.
What is the best way to brush a toddler’s teeth?
Use a small, soft-bristled brush. Use a circular or wiggling motion on all tooth surface, especially where the tooth meets the gumline. Once your toddler is able to spit out, use a pea-sized amount of fluoride toothpaste on the brush. Families should ask their dentist to demonstrate during the child’s dental visit.
When should I start using fluoride toothpaste for my child?
When your child is able to spit. Fluoride is safe and necessary to keep teeth strong, but only at appropriate levels. Younger toddlers tend to swallow toothpaste in excess amounts, and this may lead to fluorosis, which causes discoloration of the teeth.
I use bottled water at home, and it’s not fluoridated. Is this ok?
If you use bottled water for drinking and cooking, or if your community water is not fluoridated -be sure to tell your doctor or dentist. They may prescribe fluoride supplements for the baby.