Healthy Teeth for Children

Good dental habits start well before the first tooth appears.

From birth to 12 months

• Wipe your baby's gums with a soft, clean, damp cloth twice a day.
• As soon as the first teeth appear, clean them at least once a day (usually at bedtime) with a soft-bristle toothbrush designed for babies, laying your baby on a flat surface or cradled in your lap.
• Avoid leaving your baby in bed with a bottle.
• After 6 months, introduce a sippy cup and avoid juice — if offered, limit it to 125–175 mL (4–6 oz) per day, in a cup rather than a bottle, and only as part of a meal or snack. If a bottle is needed at nap time, offer water instead of milk or juice. If you breastfeed before naptime, clean your child's teeth before he goes to sleep.
• Never sweeten a soother, and don't put a soother or bottle nipple in your own mouth — bacteria (including those causing tooth decay), viruses and yeast infections can pass between you and your child this way.

From 1 to 2 years

• Take your child for a first dental visit at 12 months.
• Brush your child's teeth daily with non-fluoridated toothpaste.
• Check for signs of early childhood tooth decay once a month — lift the upper lip and look for chalky-white or brown spots along the gum line, and see a dentist promptly if you spot any. Your dentist may suggest starting a rice-grain-sized amount of fluoridated toothpaste.
• Switch to a regular cup for all drinks between 12 and 15 months, and limit soother use to nap and bedtime.

From 3 to 4 years old

• Teach "2 for 2" — brushing twice a day for 2 minutes each time.
• Start using a pea-sized amount of fluoride toothpaste, and teach her to spit rather than swallow — supervise brushing.
• Encourage her to do some brushing herself, with you completing the job so all surfaces get cleaned.
• Be a role model by brushing your own teeth at the same time.

If your child continues to suck her thumb as permanent teeth begin to appear, talk to your doctor or dentist.

For all ages

• Wash your hands before and after brushing teeth.
• Rinse toothbrushes thoroughly and let them dry without touching others.
• Replace toothbrushes every few months, once bristles flatten with use.
• Between meals, quench thirst with water rather than candy, dried fruit (including raisins), or sugared drinks and juices.
• Take your child for regular dental visits (every 6 months, unless your dentist advises otherwise).

How can I help my teething baby?

When your child is getting her teeth, her gums may be swollen and tender. Rub the gums with a clean finger, or offer something to chew on — a wet facecloth frozen for 30 minutes, or a firm rubber teething ring, both work well. Avoid gels that can be rubbed on the gums (your child may swallow it) and teething biscuits (which may contain sugar). Don't dismiss a fever as a normal teething symptom — getting new teeth doesn't make babies sick or give them a fever; if your baby is younger than 6 months, call a doctor.

What is fluoride, and how does it help?

Fluoride is a natural mineral found in soil, water and various foods, and is necessary for tooth mineralisation — a process that hardens and protects teeth. Many communities add fluoride to the local water supply to help prevent decay, and it's also found in many toothpastes, mouthwashes and dental varnishes. Children who start using fluoride products from an early age have fewer cavities than those who don't. Fluoride works by coming into direct contact with tooth enamel and promoting mineralisation, and by being absorbed into the bloodstream and becoming part of the enamel from the inside.

What is fluorosis?

Too much fluoride in the early years can damage teeth as they're forming, leading to fluorosis — white spots or blotches on teeth (though white spots can also signal early cavities; a dentist needs to check). In more severe cases, spots can stain or darken, and teeth can become brittle, chipped or pitted. Fluorosis is quite rare, and most cases are mild.

How much fluoride does my child need?

The right amount prevents cavities without causing fluorosis. About 0.7 parts per million (ppm) in drinking water is the target level — check with your local municipality to find out how much fluoride is in your supply, or have well or spring water tested. If the level is 0.3 ppm or less, ask your dentist or doctor whether a supplement is needed; children younger than 3 should not drink water with fluoride levels much above 0.7 ppm. Start brushing with a pea-sized amount of fluoridated toothpaste by age 3; for children under 3 at risk of early tooth decay, ask your dentist about a rice-grain-sized amount. Fluoride drops or lozenges are only needed if your dentist or doctor specifically recommends them — dilute drops with water per the package instructions and make sure your child doesn't swallow them.