Baby oral health care

Healthy teeth are important - even baby teeth. Children need healthy teeth to help them chew and to speak clearly. Teaching your child good oral hygiene habits early can lead to a lifelong healthy smile, but did you know that just because babies don’t have any visible teeth, doesn’t mean they can’t get cavities? A baby’s 20 primary teeth are already present in the jaws at birth. And those baby teeth that begin coming through the gums around 6 months, help set the stage for future smiles by keeping space in the jaw for adult teeth.

Here are some guidelines on how to care for your baby’s teeth:


What are the symptoms of teething and how can I treat it?

  • Teething symptoms: red swollen gums, red flushed cheeks, drooling, sleepless at night, not feeding well, irritable fever and diarrhoea.
  • Gentle rubbing with a finger, cool spoon, or a clean solid silicone-based teething ring (kept cold in fridge) will help relieve symptoms. Use of topical anaesthetics is discouraged due to potential toxicity.
  • You can give your baby infant paracetamol. If your baby seems unwell, or has a fever, check with a doctor first because ear infections may be mistaken for teething.


At what age should I start cleaning my baby’s mouth/teeth?

  • Start cleaning your baby’s mouth during first few days after birth.
  • Start brushing teeth as soon as they are out.
  • For baby’s younger than 2 years - brush with fluoride free toothpaste.
  • For 2 - 5 year old – brush with fluoride toothpaste smear size of grain of rice 2x per day, do not swallow.
  • For 3 – 6 years - pea size fluoride toothpaste supervised brushing 2 x per day. Do not swallow.


Regular dental visits are important. When should be the first visit?

  • The first dental visit should be when the first tooth appears.
  • Not later than his/her first birthday.
  • Remember: A morning appointment is best; talk to you child about visiting the dentist; keep anxiety or concerns to yourself; never bribe your child; never use a dental visit as a punishment or a threat.


At what age should I start giving fluoride tablets?

  • Optimal exposure to fluoride is important, safe and effective!
  • It helps making enamel resistant to decay and repairs weakened enamel.
  • Fluoride supplements (drops or tablets) – for all children that carry a risk & who drink fluoride deficient water (<0.6ppm).
  • 3 - 5 years: 1 tablet (or 4 drops) per day.
  • 6 – 14 years: 1 tablet (or 4 drops) in morning & 1 tablet (or 4 drops) in the evening.


Can pacifiers cause harm? At what age should I wean my child off a pacifier? Is it safe?

  • The need for early sucking is important.
  • For babies younger than 6 months, sucking on a pacifier is linked to a lower risk of Sudden Infant Death Syndrome (SIDS) - although it's not clear why.
  • Don’t dip pacifiers in sugar – it will cause tooth decay.
  • Don’t secure a pacifier to your baby with a cord -- it’s a strangling hazard.
  • Don’t suck them to clean them – saliva bacteria are transmissible. Cavity and gum bacteria will pass on from you to the baby!
  • Do use a pacifier brand that is bisphenol-A (BPA-free).
  • Do pick a pacifier with ventilation holes in the shield –it allows air to the skin and prevents rashes from constant moisture.
  • Do get the right one. Pacifiers are sized based on your baby’s age to make sure they fit his/her mouth. Make sure it's a one piece only with the nipple firmly attached to the base. It must be resistant to boiling or safe for dishwasher cleaning. Rounded or flat pacifiers don’t matter. Go with what works.
  • The best time for weaning from the pacifier is after 6 months old, when a baby's risk of SIDS drops.
  • The American Academy of Pediatrics and American Academy of Family Physicians recommend limiting or stopping pacifier use after your baby is 6 months old to reduce the risk of ear infections. After that, using a pacifier is linked to increased ear infections, especially among 2- and 3-year-olds.
  • Long-term pacifier use can cause your child's upper teeth to tip forward toward the lip, leading to dental (bite) problems.


Early childhood caries (ECC) in infants and very young children is often referred to as baby bottle tooth decay. What feeding habits should I avoid that can cause dental problems?

  • Human breast milk is uniquely superior in providing the best possible nutrition to infants up to age of 6 months.
  • Breastfeeding more than 7 times daily after 12 months of age is associated with increased risk of ECC.
  • Frequent night-time bottle-feeding with milk is implicated in ECC.
  • Pacifiers frequently dipped in sugar or syrup increases the risk for ECC.
  • Night-time bottle (or no-spill cups) feeding with sugar containing juices or repeated in-between meal consumption of sugar-containing snacks or beverages, also increase the risk of ECC.


Any concerns should be discussed with your dentist, but note the following general guidelines:

  • A knocked out baby tooth cannot be re-implanted like a permanent tooth.
  • Thumb sucking - most children can safely suck their thumb without damaging the alignment of their teeth or jaws. Thumb sucking usually stops at the age of four. After that, it can cause problems with tooth alignment.
  • Early loss of teeth - baby teeth keeps space for the permanent teeth - ask your dentist about space maintainers.

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Source: Dr Johan Hartshorne, Dentist, Intercare Tyger Valley


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