Your baby’s teeth developed before it was born. Baby teeth begin to form about 6 weeks after a baby is conceived. So by the time your baby was born, all its 20 baby teeth will have been present in the jawbones but still hidden in the gums.

All babies are different. In general, you can expect your baby’s first tooth to appear between 6 to 10 months, but some babies have no teeth until they are 12 months old or more.

Baby teeth usually come through in pairs - one on the right and one on the left side of the mouth. The lower two front teeth usually come through first, followed by the upper ones. Below is a table to show you when to expect different baby teeth.

Your baby will have about eight teeth by their first birthday. By the time they are 2 1/2 to 3 years old all their 20 baby teeth will have come through.

Very occasionally, a baby is born with one or more teeth or has a tooth emerge within the first few weeks of life. These early teeth are usually lost soon after birth and are not usually a cause for concern unless they are loose or if they interfere with your baby’s feeding. If you have any questions it's a good idea to talk to your dentist.

Daily dental care should begin even before your baby's first tooth emerges.

Cleaning gums

Cleaning toothless gums will help to prevent the build up of bacteria and establish a healthy environment for your baby’s new baby teeth.

• Wipe your baby's gums with gauze or a soft damp cloth after feeding.
• If your baby has a only afew baby teeth continue to clean the toothless gum areas twice a day. You can do this at the same time you brush their new baby teeth.
• Allowing your baby to chew on Brush-Baby will help to clean gums 

Brushing baby teeth

You can start cleaning your baby’s teeth as soon as its first tooth appears.

Clean your baby's teeth twice a day, after breakfast and last thing at night. Allowing your baby to chew on Brush-Baby will also help to keep teeth clean.

Initially clean your baby’s teeth with water or use a tiny smear of toothpaste, for older children use a pea-sized amount. Always use toothpaste with the correct amount of fluoride for your baby's or child's age (see Fluoride: choosing the correct toothpaste).

Remember when brushing with a fluoride toothpaste:

• Spit out toothpaste after use - this prevents your child from swallowing it
• Don't eat or swallow toothpaste - this could give your child too much fluoride
• Don't rinse - fluoride can go on protecting the teeth for some time after brushing if the toothpaste is not rinsed out of the mouth.

Always keep toothpaste tubes out of the reach of children.

Dummies

If possible try to avoid using a dummy after 6 months of age. This is because if used for long periods dummies can affect tooth development. If you feel that your baby needs a dummy try to use an orthodontic type and only use it when absolutely necessary.

Never, dip the dummy to fruit syrups, honey, fruit juices or anything containing sugars, particularly at bedtime. This exposes your baby's teeth to harmful acids, which can attack the newly formed teeth and cause tooth decay.

Thumb sucking

Thumb sucking is normal. Most babies suck on things including their own thumbs. Thumb sucking in infants and young children has a soothing effect and does little harm and most children will stop by the time they are about 4 years old. If they do continue to suck their thumb beyond this age it is important to tell your dentist who will check to see if it is affecting your child’s teeth.

Newly erupted baby teeth have not yet fully developed the toughened outer enamel surface to protect them and are more prone to decay and erosion. Avoiding sugary foods is very important especially from six months as the new baby teeth start to erupt.  

Sugar can harm baby teeth. Bacteria in the mouth react with sugar to produce acid. This acid then attacks the enamel of teeth and causes tooth decay.

Some foods and drinks, such as fizzy drinks and natural fruit juices, contain acid already. Even milk contains sugar.

The main things to remember are:

• Sugary and acidic food and drinks are bad for teeth
• If these stay in the mouth for a long time close to teeth it can lead to tooth decay

Here are some simple things you can do to protect your child's teeth from sugars

When bottle feeding

Avoid giving your baby a bottle of formula, milk or fruit juice to go to sleep with or to suck on for a long time during the day. Try to use your baby’s bottle for only feeding and not as a pacifier.

Use only milk or water in your baby’s bottle. Don’t be tempted to put fruit-juices in the bottle as the acid can attack your baby’s teeth.

Try to get your baby to drink from a special cup by the time they are six months old, or when they are able to sit up and hold things on their own.

Breastfeeding

Breastfeeding will not harm your baby’s teeth. However, if your baby has teeth and breastfeeds continuously or frequently at night they may also have sugars that stay in their mouth for a long time; this can lead to tooth decay.

Encourage savory tastes

Babies will enjoy foods and drinks without sugar so try to encourage savoury tastes and try to encourage friends and relatives to offer healthy alternatives instead of sugary foods or drinks.

Avoid giving children sugary foods and drinks, particularly between meals

Children do need snacks between meals so try to give foods such as such as fresh fruit or raw vegetables. Water is the best drink between meals, save milk and diluted fruit juice for meal times.  Never put anything sweet on your baby’s dummy.

If you do give sugary treats try to limit these to mealtimes. In between meals try to ensure that sweet treats are all eaten (or drunk) at the same time.

Use sugar free medicines

You can check with your GP or pharmacist. Sugar should be listed on the ingredients label of the medicine. Other names for sugar are: glucose, sucrose, dextrose, maltose, fructose, honey, hydrolysed starch, or syrup.

Teething blisters

Sometimes as a baby’s teeth start to come through, a little bleeding may happen under the skin. This causes a small blood blister or bruise to appear on their gum. No treatment is usually necessary as it will disappear when the tooth comes through.

However, if your baby gets a teething blister and it is still present after a month and the tooth has still not come through you should take your baby to see your dentist.

Never prick teething blisters if they are present as this may cause an infection.

Teeth grinding

Some babies rub their gums together or "grind their teeth" as new teeth are growing and starting to come through.

Rubbing the gums or teeth together relieves some of the discomfort caused by teething. It is also a baby’s way of feeling the changes that are occurring in its mouth, especially as the molars emerge. In general, teeth grinding is normal teething babies and should stop when all the teeth have come through.

If your baby does start to grind its teeth or rub its gums and you are worried contact your dentist.

Always remember – tooth decay and erosion are preventable!

Tooth decay  

Taking care of your child’s teeth from when they are babies helps to prevent tooth decay.

Tooth decay can start as a small white spot on the tooth, which is hard to see. It causes serious damage to teeth and is important in baby teeth because baby teeth prepare the way for healthy development of permanent teeth.

Tooth decay in your child can be particularly unpleasant. It causes pain and sleep problems and can affect the way your child looks and what they are able to eat.

A decayed tooth may have to be taken out. This can mean that your child has a lasting bad impression of going to the dentist.  Many children who have serious decay need to have a general anaesthetic to treat the damaged teeth - nearly half of the general anaesthetics given to children in the UK are to remove decayed teeth.

If your child has missing teeth their remaining teeth can move across to fill the gap and this leaves less room for their adult teeth to come through. Your child may then need more dental treatment and possibly expensive and lengthy orthodontic treatment to correct any misalignment of their adult teeth.

If your child has any sign of decay, see a dentist as soon as possible.

Tooth erosion

Tooth erosion happens when acids damage and dissolve the layers of enamel that cover the tooth. This can cause permanent damage to the tooth.

Acids can come from

• What your child eats and drinks – fizzy drinks contain acid.
• Medicines - such as Vitamin C tablets that are chewed in the mouth.
• Stomach acids from persistent reflux  - this is when children ‘burp’ up the contents of their stomach which is very acidic.

Try to lessen the amount of harm that acid can do to your child’s teeth by:

• Avoiding sugary and acidic foods.
• Reducing the time that any acid food or drink stays in their mouth.
• Using a fluoride toothpaste.

If you think your child suffers from persistent reflux:

• Make sure you avoid giving them acidic foods
• Keep your child’s teeth clean – brush with a fluoride toothpaste
• Get your child to rinse their mouths out with water to remove the acid (and the taste!) after they burp up their food
• Take them to see you dentist. If reflux really is a problem your dentist can help to protect your child’s teeth from erosion.

Your NHS dental treatment is free while you are pregnant and for the first year after your baby is born. All you need to do is show your dentist your MatB1 certificate or NHS Prescription Maternity Exemption Certificate. You can get these forms from your GP or from a registered midwife via form FW8.

Children are treated free under the NHS. To find an NHS dentist in your area, go www.bda-findadentist.org.uk, or ring NHS Direct on 0845 4647

However, NHS dentists are beginning to become hard to find and many are fully booked. This is a very good reason to start looking after your baby’s teeth from an early age to help prevent costly dental treatment.

If baby teeth are knocked out they should not be put back into the tooth's socket !

Unlike permanent teeth which can be put back into the tooth's socket baby teeth that are pushed back into the jaw can get stuck, blocking the way for the adult (permanent) teeth as they come through.

If baby (milk or deciduous) teeth are knocked out always see your dentist to check that no other damage has been done. An X-ray may be necessary to check that the bone around the tooth isn’t cracked.

Other injuries: If a young child damages a tooth or hurts their mouth and the bleeding doesn't stop or if they fall and drive a tooth back up into their gum take the child to see a dentist.