Dental Care for Your Infant and Toddler

HealthLinkBC File Number: 
19
Last Updated: 
July 2016

Beginning dental care early is important for your child's health and to keep teeth healthy for a lifetime. Healthy baby teeth help children eat and speak clearly. Baby teeth guide permanent adult teeth into the proper position. Some baby teeth are not replaced by permanent teeth until the age of 12 or 13. Dental care includes cleaning your baby's gums even before the teeth come into the mouth. Keeping your child's teeth and gums clean is the easiest way to keep them healthy.

What is early childhood tooth decay (cavities)?

Early childhood tooth decay refers to the development of cavities in children from 6 months to 6 years of age. Once your child has teeth, they are at risk for tooth decay. Tooth decay is caused by many factors including the bacteria that normally reside in the mouth. Without treatment, decay can spread deeper into the tooth, causing pain and infection, and even damage to the underlying adult tooth. The baby tooth or teeth may need to be removed.

What can contribute to tooth decay?

The following factors may contribute to early childhood tooth decay:

  • frequent snacking (especially sticky or sugary foods);
  • constant use of a baby bottle or sippy cup filled with sugary beverages such as milk, juice or formula (especially at bedtime); and
  • not brushing your child's teeth.

According to the Canadian Dental Association, the damage that sugar does to teeth depends on how much sugar goes into the mouth and how long it stays in the mouth. When your child eats or drinks sugars, the germs (bacteria) in your child’s mouth mix with the sugars to make a mild acid. This acid attacks the hard outer layer of teeth (also called enamel) to form cavities.

If your child is always sipping juice or snacking on sticky, sugary snacks between meals, the teeth are being coated in sugars over and over again. Tooth decay can also develop when a child is put to bed with a bottle of milk or juice as the liquid stays in the mouth, bathing the teeth in sugar for a long time.

Transferring bacteria from your mouth to your baby’'s: Bacteria can also be passed to your child by family members through the saliva. You can reduce the chance of passing cavity-causing bacteria to your baby – avoid sharing toothbrushes, licking soothers to clean them or feeding your baby with a spoon that has been in your mouth.

This risk of transferring cavity causing bacteria, combined with poor dental hygiene and poor eating habits, can increase the risk of your child developing early childhood cavities.

How can tooth decay be prevented?

Practice good dental care

Good dental care includes cleaning and checking your child's teeth and mouth every day. Lift the lip so you can see along the gum line when cleaning and look for white or brown spots which may be early signs of tooth decay.

Gently clean your baby's mouth using a soft baby toothbrush or wet face cloth. When teeth start to come in, use a toothbrush with a smear (size of a grain of rice) of fluoride toothpaste. Brush your child's teeth in the morning and especially at bedtime. Once your child turns 3, brush your child’s teeth using a "pea-sized" amount of fluoride toothpaste on a soft child's toothbrush. Fluoride toothpaste used in these amounts is considered safe and effective against tooth decay.

Offer water to drink between feedings

Water is the best choice between regular feeding times and for thirst. Introduce your baby to using a lidless cup between 6 and 9 months of age.

Give up the bottle or sippy cup at bedtime

For tips on how to help your child give up a bottle or sippy cup at bedtime, visit the Canadian Dental Association – Early Childhood Tooth Decay www.cda-adc.ca/en/oral_health/cfyt/dental_care_children/tooth_decay.asp.

When will my child get teeth?

Children have their own schedule for teething. Most children begin teething at about 6 months of age. Your child should have all of their first set of teeth, or "baby" teeth, by 3 years of age. The bottom front teeth usually appear first, followed by the top front teeth. In total, 20 teeth should appear – 10 in the top jaw and 10 in the bottom jaw.

For more information about when teeth come in, visit Your Dental Health – Importance of Baby Teeth www.bcdental.org/YourDentalHealth/YourDentalHealth.aspx?id=9969.

How can I comfort my baby when they are teething?

Teething may cause some discomfort, making your baby fussy. Your baby may feel better if allowed to chew on a clean, chilled teething ring, teething toy, or clean wet face cloth. Teething cookies or biscuits are not a good choice because these can stick to your baby's teeth and cause tooth decay.

Check with your doctor, dentist or health care provider before using teething ointments, gels or tablets, or any other teething items.

Teething does not cause fevers. If your baby has a fever or diarrhea while teething, treat it as you would at any other time. If you have any questions or concerns about your baby's fever or diarrhea, call 8-1-1 to speak with a registered nurse, or contact your health care provider.

What about soothers or pacifiers?

Soothers or pacifiers are sometimes given to babies during rest, sleep or other times. If you choose to give your baby a soother, here are a few tips:

  • ensure that breastfeeding is well established;
  • choose the right size soother for your baby's mouth;
  • check the soother nipple often – throw it away if it is sticky, cracked or torn;
  • keep the soother clean;
  • avoid dipping the soother in honey or other sweet substances that can cause tooth decay; and
  • by age 1 or 2, if a soother is used, limit use to nap time or bedtime.

Soothers or pacifiers are not recommended once all baby teeth have grown in, usually when your child is about 3 years old. After this age, regular use of a soother may affect the child's speech development.

Can fluoride help stop tooth decay?

The Canadian Dental and Medical Associations and the dental professionals of British Columbia recommend fluoride for preventing tooth decay for people of all ages.

Fluoride is a proven, effective, and low-cost way to prevent cavities. Using the recommended amount of fluoride toothpaste twice a day helps make tooth enamel stronger and better able to resist tooth decay. Some toothpastes do not have fluoride. Always check the label.

Your dentist or dental professional may also apply fluoride at regular dental visits.

In B.C., there is little natural fluoride and few cities add fluoride to the drinking water. If you are unsure if your water supply contains fluoride, call your local public health unit. For more information on water fluoridation, see HealthLinkBC File #28 Water Fluoridation Facts.

When should my child go to the dentist?

The Canadian Dental Association recommends regular dental visits starting 6 months after your child's first tooth appears or when they are about 1 year old. Your child's first dental visit is a good time to discuss daily dental care, fluoride, and eating habits. If you have a concern about your infant's or toddler's oral health, make an appointment to see your dentist or a dental professional.

For More Information

Children in families who receive income assistance or MSP premium assistance are eligible for basic dental care through the Healthy Kids Program. For more information, call 1-866-866-0800 or visit www.mhr.gov.bc.ca/factsheets/2005/healthy_kids.htm

For more information on dental care, please contact the dental program at your public health unit, your dentist or dental hygienist.

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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