Let’s Talk About Baby Teeth!

“When will my child’s first tooth erupt; When should I start brushing my child’s teeth; Is it safe to use fluoride when my child is too young to spit?” 

As a mother and a pediatric dentist, these are some of the very common questions I get asked. When the “Waiting Room” Magazine reached out for an article, I seized the opportunity to answer these questions and guide caregivers and parents through their child’s dental journey. This article tackles the child’s oral health during the first three years of life. Studies have shown if we are able to establish good oral hygiene early and follow a healthy diet, then caries (cavities) can be prevented. Yes, dental caries are preventable!

Can I transmit cavities to my baby? 

Cavity-causing bacteria like Streptococcus Mutans are transmissible. Caregivers can transmit these bacteria to their little ones through saliva by sharing food or utensils or kissing the child on the lip. To minimize this risk, caregivers need to visit their dentist regularly, brush their teeth twice a day, floss at night, and address all their dental needs. 

Are baby teeth essential to my child’s well-being?

Baby teeth, or primary teeth, are critical to a child’s health and development. They play an essential role in speaking, eating, and maintaining space for permanent teeth. The first baby tooth erupts at around six months of age. Some children might have their first baby tooth earlier, and others might not have it before their first birthday. The two bottom front teeth, the lower incisors, are the first two teeth to erupt, followed by the top front two teeth and the upper incisors. A child will usually have twenty baby teeth before turning three. 

When teething occurs, there are various ways to alleviate gum discomfort: You can dip a pacifier in water and freeze it for 15 to 30 minutes before giving it to the child. You can also gently rub your child’s gum with a cool wet washcloth or feed them cool and soft food if they are eating solids.

When should I start brushing my child’s teeth? How much Fluoride can I safely use?

The American Academy of Pediatric Dentistry (AAPD) recommends starting to brush your child’s teeth as soon as the first tooth erupts. You can also clean the gums before teeth erupt by using a wet washcloth, gauze, or silicone brush. By starting early, you are helping your child build a routine and adapt to this new sensation. At six months of age, it is safely recommended to use a smear layer of fluoridated toothpaste until the child turns three years of age or can spit.

After three years of age, once your child can spit, use a pea-size amount of fluoridated toothpaste. Your child should only spit without rinsing to keep the minerals from the toothpaste on the teeth. Flossing should be introduced once two adjacent teeth are touching, usually around age three, once the molars have erupted. Parents and caregivers need to supervise brushing until a child turns seven or eight years old.

Children tend to dislike brushing their teeth. However, it's essential to establish a habit and be consistent. Even if it’s tempting to skip teeth brushing sometimes, it is important to remember that initiating a routine is challenging, while maintaining it is somewhat easier. 

Remember to change the child’s toothbrush every three months. A child should brush their teeth twice a day for two minutes. To make brushing fun, you can play your child’s favorite song or sing to them. You can also brush your teeth at the same time. Please remind your child how brushing helps in having healthy teeth. Studies have shown that children with unhealthy teeth are three times more likely to miss school.

When should I schedule my child’s first dental visit?

The AAPD recommends that you schedule your child’s first dental visit once their first tooth appears, or no later than their first birthday. It's essential to build a dental home as early as possible. Choose a pediatric dentist to care for your child’s oral health. Pediatric dentists pursue two to three years of training after graduating from dental school and have a strong understanding of child psychology, growth and development, and special healthcare needs.

Once you schedule your child’s dental appointment, remember not to project your dental fears and anxiety on your children. During that visit, the pediatric dentist will perform an exam for the soft and hard tissues (teeth). They will also discuss and evaluate your child’s carious risk (their risk of developing cavities), and develop a prevention plan for the child.

There are several ways to prepare your child for their first dental appointment. Reading dental-themed books to your children like Daniel Tiger goes to the dentist, The Berenstain Bears Visit the Dentist, is a great way to get them excited for the visit. You can also encourage your child to go to their dentist by using simple words and making the visit sounds fun, like “Dr. Carla will count your teeth, and then you will pick a prize from the treasure tower”. 

A dental checkup is recommended every six months. The pediatric dentist might recommend a dental evaluation every three months in certain cases. 

My child falls asleep while drinking milk, what should I do?

When it comes to dietary recommendations, it's highly recommended not to go to bed with a bottle of milk or juice. Children tend to fall asleep while nursing or drinking milk or juice from their bottles. It's important to brush their teeth and gums afterward. Milk and juice are high in sugar, and having them sit on the teeth for several hours while the child is asleep makes the teeth more prone to developing cavities. Juice should not be introduced before age one unless recommended by the pediatrician. It can be enjoyed with meals occasionally after that age.

Remember, the pediatric dentist is your guide during your child’s dental journey. Having a dental home and establishing good oral hygiene at an early age is tremendously helpful for your child.

Let’s help our kids have healthy smiles!

Dr. Carla Stephan

Dr. Carla Stephan practices in Sterling, VA. She attended dental school at Saint Joseph University Beirut, Lebanon, she then graduated with a master's degree in pediatric dentistry. Dr. Stephan later moved to the United States and pursued a two-year pediatric dental specialty at the University of Maryland College of Dentistry, Baltimore.