57442254Your baby’s dental health

When your baby is born, their primary teeth (more commonly referred to as the ‘milk’ or ‘first’ teeth) are not visible because they are buried below the surface of the baby’s gums for the first six to 12 months. However, around 1 in 2000 babies are born with visible teeth, called ‘congenital teeth’. These teeth tend to be lower jaw incisors and can be quite soft and flexible because the teeth are still immature and have not yet calcified (hardened). Where congenital teeth are supernumerary or loose, the paediatrician (baby doctor) will usually recommend their removal to avoid any risk of your baby inhaling/choking on them.  Should you have any queries or concerns about congenital teeth, you can discuss these with the paediatrician when they undertake the first examination of your newborn baby. For additional information read our article on ‘Examination of the Newborn’.


Keeping your baby’s teeth healthy

From the moment they are born, it is important that you care for your baby’s gums and teeth. A recent study has highlighted that parents need to pay attention to their baby’s oral health and hygiene before their baby starts teething. This is because the bacteria, which are linked with early childhood caries (cavities) is present in the saliva of young infants. Caring for your baby’s oral health will include your choice of preferred method of infant feeding as well as, the foods and drinks you offer your baby when you first begin introducing solid foods. There has been some inconclusive research evidence that has linked breastfeeding in children with the development of dental caries in primary teeth (milk). However, the British Dental Association (BDA) has released a statement in support of the Department of Health’s recommendation that children should be exclusively breastfed for the first six months and then weaned onto solid foods. The BDA also stresses the importance of good oral hygiene routines (brushing teeth) and regular visits to the dentist as well as, limiting children’s intake of sugary foods and drinks.

The BDA also advises that during weaning, on-demand night time feeding should be avoided because milk is left in the child’s mouth while they are asleep; this can lead to acid build up which causes tooth decay. However, this advice can be quite confusing particularly for breastfeeding mothers because night time feeds are very important in maintaining a good milk supply and breastfeeding is very much baby-led. It may help if we differentiate between the different sucking techniques used when bottle or breastfeeding, which are very different from each other. When your baby breastfeeds, the nipple and areola are drawn to the very back of the baby’s mouth (their ‘soft palate’); and the milk flows to the back of the mouth avoiding the teeth, whereas, sucking on a bottle teat is just like sucking on your thumb and so, the milk tends to have more contact with the surface of the baby’s teeth at the front of the mouth. If you are concerned, you can also speak with your health visitor, GP and/or family dentist.

Healthy teeth and a healthy diet go hand-in-hand so it’s important that your baby experiences a well-balanced diet from an early age, which includes a range of both savoury and sweet foods. Try to avoid carbonated (fizzy) drinks and foods that have high sugar content. It is always nice to treat your children and reward them for their good behaviour etc. but it is best to offer sweets as treats after a meal, rather than before or as a between meal snack – this is much healthier for your child’s teeth too! Chocolate is the best sweet to offer as it is easily dispersed in the mouth and less likely to stick to the surface of the teeth.


Cleaning your baby’s teeth

As previously mentioned, your baby’s teeth will start to emerge when they are around six to 12 months of age; this process is more commonly referred to as ‘teething’. Your family dentist will be able to give you advice on caring for your baby’s gums and teeth during this phase of their development. It is good to get your little one into a routine of brushing/cleaning their teeth at an early age, so that this becomes a familiar part of early morning and bedtime routines.

As soon as your baby starts teething, you can sit them on your lap and, using a cotton bud and pre-boiled water gently clean the teeth in the front of the mouth. By doing this, you are introducing your baby to the routine of brushing/cleaning their teeth early on. As they grow older, they can be supported in learning to brush their own teeth using a baby toothbrush initially and then progressing on to a child’s size toothbrush as they get older.


Introducing your little one to toothpaste

When your child is young, it is best to use a children’s toothpaste to clean their teeth. However, it is important that you only use a very small amount of toothpaste on their toothbrush to avoid the possibility of your baby swallowing and/or choking on the toothpaste. It is therefore recommended that only a tiny quantity of toothpaste – around the size of a garden pea, is used with children below the age of seven years. Similarly, young children should always be supervised whilst brushing their teeth.

Always use toothpaste that contains fluoride as this actively helps to strengthen the enamel surface of the teeth, and combats the acid from food and drinks that can attack the teeth and cause dental decay. Ensure that you start with a baby/children’s toothpaste which are suitable for use with children aged 0 – 5 years of age. These toothpastes contain less fluoride than adult toothpastes and are designed specifically for cleaning and protecting the primary teeth.


Visits to the dentist

It can be helpful to take your baby to the dentist with you whenever you go for a routine check-up. Your baby can sit on your lap and become familiar with the surroundings and sounds of the dental surgery, including the way that the dentist’s examination chair moves and reclines. Dentists will often use this time to undertake little practice examinations as a ‘game’ encouraging your child to open their mouth, rather like a hippo, to get used to the process of being examined. At the same time, your dentist can quickly glance to see if the primary/milk teeth are coming through as they should. Children also love to copy their parents!

It is recommended that your child’s first visit to the dentist for their own dental check-up takes place when they are around two to three years of age. This is because your child will have most of their primary teeth by this time. Where your baby has accompanied you to the dentist before, this can make their first check up a lot easier and less stressful. However, if this hasn’t been possible, then your dentist may recommend that you prepare your child in the weeks beforehand by playing a fun game called ‘the dentist looking in my mouth’. This helps your little one to get used to opening their mouth wide and having someone look inside at their teeth and gums. Similarly, your baby/toddler will probably feel happier sitting on your lap for the first few visits, after which time, they may well feel more confident and happy to sit in the dental chair on their own. Your dentist will also be very mindful about making your child’s visit to the dentist a fun experience and colourful wall posters and stickers are often used to help this process.

It is important to remember that babies and children are all very individual, so while some will take visits to the dentist in their stride, others will feel less at ease and can take longer to adapt. Indeed, some children may not be ready until they are at pre-school age (four or five years of age). Try not to worry though; you can still safeguard the health of your child’s teeth and gums by making sure they brush their teeth at least twice a day with fluoride toothpaste and by limiting sugary foods and drinks.

British Dental Association (2010). Infant caries. London: BDA. 1 page.

British Dental Association (2002). Tell me about dental care for mother and baby. Rugby: British Dental Health Foundation. 7 pages.

Cephas KD et al (2011). Comparative analysis of salivary bacterial microbiome diversity in edentulous infants and their mothers or primary care givers using pyrosequencing. PLoS ONE 6(8):10 August 2011, e23503.