Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2004;70(11):2121-2122

When will my baby’s teeth appear?

Every baby is different, but teeth normally start appearing when a baby is about six months old, although your baby may be drooling more at four months. When teeth start to come in, they can cause pain and fussiness.

Healthy teeth are important to your child’s overall health. Teeth help your child chew food and form words and sounds when speaking. They also affect the way your child’s jaw grows.

What can I do to help my teething child?

Giving your child a cold teething ring or a cold washcloth to chew and suck on may help. Teething gels should be used carefully because too much is not good for your child.

Teething does not cause a fever. If your baby has a fever, you should talk to your doctor.

What are cavities?

Cavities are holes in the teeth that can cause pain and bad infections. Cavities happen when bacteria (germs) in the mouth use the sugar in food to make acid. This acid eats away at the teeth. Cavities are the most common disease in children. Good tooth care can keep cavities from happening in your child.

Is my child at risk for cavities?

Your child might be at risk for cavities if he or she eats a lot of sugary foods (such as raisins, cookies, and candy) and drinks a lot of sweet liquids (such as fruit juice and punch, soda, milk, and sweetened drinks). Your child also might be at risk if he or she has any of the following risk factors:

  • Was born early (prematurely) or weighed very little at birth (low birth weight)

  • Has ongoing special health care needs

  • Has white spots or brown areas on any teeth

  • Does not go to the dentist very often

In addition, children from families who eat a lot of sugary foods and drink sweet liquids, who have a lot of cavities, and who do not go to the dentist very often are at risk for cavities.

How can I help stop cavities?

The first thing is that everyone in your family has to take good care of their teeth. Family members with lots of cavities can pass the cavity-causing bacteria to babies and children.

Teeth should be brushed twice a day and adults should floss once a day. Everyone should see the dentist twice a year. Have your doctor or dentist show you the right way to brush your child’s teeth.

Limit sweet snacks and drinks between and after meals. Have meals and snacks at regular times. Too much snacking between meals can cause cavities. Teeth-friendly snacks include fresh fruits and vegetables, and cheese and crackers.

What about breastfeeding, bottles, and sippy cups?

Breastfeeding is good for your baby’s teeth. If you give your baby a bottle, always hold the baby when you feed him or her. Do not leave a bottle in the crib. Do not put juice in a bottle.

Your baby can start using a sippy cup when he or she is six months old. Stop giving your baby a bottle when he or she is a year old. Do not let your child walk around with a sippy cup unless it has only water in it. Do not give your child a sippy cup of juice or milk in the crib.

After your child is one year old, give only water or plain milk between meals instead of other drinks. If you give your child juice or flavored milk (like sweetened milk products), only give it with meals. Juice and flavored milk have a lot of sugar in them.

When should I start brushing my baby’s teeth?

Start brushing your baby’s teeth twice a day when the first tooth appears. The most important time to brush is just before bedtime. Use a soft baby toothbrush. Put a dab of toothpaste on the brush. The dab should be the size of a rice grain. Ask your doctor or dentist what kind of toothpaste you should use for your baby. He or she may suggest that you use toothpaste with fluoride (say: floor-ide) in it. Fluoride helps stop cavities.

Some toothpastes made for babies do not have fluoride. If you use this kind, be sure to switch to toothpaste with fluoride in it when your child reaches age two. Your child will need help with tooth brushing until about age eight.

Does my child need extra fluoride?

Some cities put fluoride in the drinking water. If you do not have fluoride in your drinking water, your child may need to use liquid fluoride or chewable fluoride tablets starting at six months of age. You can call your water company and find out how much fluoride is in the water. If you have well water, have it checked for fluoride before you give your child extra fluoride. Too much fluoride can cause spots on your child’s teeth. Spots also happen when children use too much toothpaste. Your child may need the extra fluoride supplements until age 16.

When should I take my child to the dentist?

Your baby should see a dentist by his or her first birthday, especially if the child is at high risk for cavities or has any problems with his or her teeth. It is better for your child to meet the dentist and see the office before he or she has a tooth problem. If you wait until your child is two or three years old before seeing a dentist, be sure to follow all of the advice in this handout in the meantime.

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