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.

Teeth are some of our children’s most important possessions and baby (milk or deciduous) teeth are just as important as adult (permanent) teeth.

Baby teeth help your child to bite and chew its food, to form words and sounds when learning to speak and to help your child smile. Baby teeth also affect the way your child’s jaw grows, they provide space for the adult teeth to grow and guide them into place.

Establishing good oral hygiene habits early on in your child’s life will pave the way for good healthy adult teeth. It is also important for your child’s overall health both now and in the future; some diseases in adulthood have been linked to tooth decay including heart disease, strokes, diabetes and low birth weight babies.

Unhealthy baby teeth and gums not only cause pain and distress to your child but can also affect their developing adult teeth. Here are some hard facts!

• 50% of the under fives in the UK have tooth decay
• Young children cannot co-ordinate a toothbrush properly to clean their own teeth yet 1 in 5 children under 5 years old in the UK are left to brush their own teeth.
• Tooth decay can cause pain for your child
• Removal of teeth for tooth decay is the main reason why children in the UK have a general anaesthetic
• Missing teeth can cause misalignment of adult teeth
• Misalignment of teeth can mean lengthy and expensive orthodontic treatment later on.
• Visiting the dentist is important to protect baby teeth but an early bad experience at the dentist, because of tooth decay, can deter your child from wanting to go in the future
• Tooth decay is preventable!

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.
• Using Brush-Baby DentalWipes™ to clean you baby’s gums has the additional benefit of xylitol which helps combat decay causing bacteria.
• If your baby has a only a few 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 the Brush-Baby Chewable Toothbrush will also 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’s Chewable Toothbrush will also help to keep teeth clean.

Clean your baby’s teeth with 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.

It is important that brushing and flossing their own teeth becomes part of your child’s daily routine so that they will continue the habit as they get older.

However, while infants and young children love to do things for themselves they do not have the co-ordination to brush their own teeth well enough until they are about 4-6 years old. Dentists recommend that you should brush your child’s teeth until they are 3 or 4 years old and then supervise brushing and toothpaste until they are 6 to 8 years old.

So, always supervise all your child’s tooth brushing and once they have brushed their own teeth, including using Brush-Baby, inspect your child’s teeth and go over them yourself for good measure.

One of the best things you can do is to set a good example: your child will learn about good oral hygiene just by watching you brush and floss your own teeth.

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.

Choosing the right toothpaste for your child’s baby teeth is mainly about choosing the right amount of fluoride in the toothpaste.

Fluoride is found naturally in food and water. The amount of fluoride differs depending on where you live.

Fluoride helps to prevent tooth decay by hardening the enamel on the tooth’s surface. Only 10% of the UK’s water supply is naturally fluorinated and for this reason it is added to most toothpastes in the UK. However, eating or drinking too much fluoride can cause permanent stains on the developing adult teeth.

Young children tend to swallow and not spilt out toothpaste and because too much fluoride could stain their developing adult teeth the amount of fluoride in their toothpaste is particularly important.

Remember:

• Always use a toothpaste for the correct age of your baby or child.
• Use a tiny smear of toothpaste for your baby and a pea-sized amount for children aged 3-6 years.
• Put the toothpaste on yourself until your child can do it properly.
• Keep all toothpastes out of reach of children.
• Spit out toothpaste after use.
• Don’t eat or swallow toothpaste. This could give your child too much fluoride.
• Don’t rinse. The fluoride in toothpaste goes on protecting teeth after brushing if not rinsed out of the mouth.

Check with your family dentist if in doubt of which toothpaste to choose.

If your child drinks water that isn’t fluoridated, he or she may need to receive fluoride treatments or take fluoride supplements. Your dentist will decide if this is necessary. Always consult with your dentist before using fluoride supplements.

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.

Tooth decay is caused by the presence of bacteria called Streptococcus Mutans in the mouth. These bacteria produce acids which destroy the tooth’s enamel. Once there is a hole in the tooth’s enamel bacteria can enter the tooth and destroy the soft pulp inside.

Streptococcus Mutans can be passed from adults to babies particularly around the age of 6-31 months. This period is called the “window of infectivity.”

Keeping your own mouth healthy and decay-free and not sharing eating utensils, toothbrushes or cleaning dummies with your own mouth can help to reduce the spread of these bacteria.

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.

What is teething?

Teething is the emergence of the baby (milk or deciduous) teeth through your baby’s gums.  It usually starts when your baby is between 6 to 10 months and continues until the age of 3 years when all the 20 baby teeth have come through.

Teething is different for each baby. For some babies teething is painless, others may be irritable for a short time and some may have a tough time for weeks.

Why teething is uncomfortable

Teething is uncomfortable because there is a lot of movement and change in the jawbone. This should stop as soon as the tooth appears. The molars (back teeth) can be especially uncomfortable because they are larger teeth.

Signs and symptoms of teething

The common signs and symptoms of teething that you may notice in your baby are:

• being bad tempered or irritable
• crying more than usual
• having trouble sleeping
• having problems feeding, changing what they want to eat or not wanting to eat
• wanting to chew on things e.g.  toys, fingers etc
• drooling or being more dribbly than usual
• having swollen gums
• having red, hot cheeks
• having pain

Teething does not make your baby unwell

Research shows that teething doesn’t make a baby unwell. The signs and symptoms that you may notice occur partly because teething begins at the same time that your baby’s immune system is changing. At this time many babies will have lost most of their protective antibodies passed from their mothers. This can make them more susceptible to infections and illness until their own antibodies increase.

Health problems not likely to be caused by teething include:

• waking a lot at night
• being restless and irritable in the daytime
• colds or other infections
• a temperature (fever)
• a rash, especially a nappy rash diarrhoea.

Remember, you know your baby best and if your baby seems unwell, see your doctor.

Soothing teething: What you can try

Here are some things that you can try to help relieve the discomfort for your teething baby:

Cuddles.  Give your baby lots of extra comfort; whatever your baby needs!

Wipe your baby’s face and use a barrier cream to prevent rashes from developing. Petroleum jelly or aqueous cream will help to protect the skin especially around the chin.

Give your baby something firm to chew on. Make sure whatever you give is big enough so that your baby can’t swallow it and that it can’t break into small pieces. Teethers are good. Cooling teethers in the fridge can give relief to aching gums.

Change the type of food you give your baby. Some babies prefer mushy food for a while because it needs less chewing, while others like something firm to chew on.

Use a mild pain killer or teething gel. If there is a lot of pain and discomfort you can try a mild pain reliever such as infant liquid paracetamol or ibuprofen (e.g. Calpol). Always use the correct dosage. Your dentist may recommend a teething gel. These contain a mild local anaesthetic to dull the pain. Rub the recommended amount of infant teething gel onto the affected gum area with a clean finger. Always use the correct dosage.

Try homeopathic remedies. A homeopathic remedy such as chamomilla may help. Remedies for teething are available from pharmacies, supermarkets and health food stores.

Never place an aspirin against the tooth or rub whiskey or lemon juice on your baby’s gums.

Never prick teething blisters if they are present.

Remember you know your baby best. If you think your baby is teething but seems obviously unwell contact your doctor or dentist.

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.

Some children who suffer with asthma need to use an inhaler. However, many of the powers in puffers are acidic and can erode tooth enamel.

If your child uses an inhaler teach them to rinse with water after using each use. This will help to prevent problems with their teeth. Cleaning their teeth with suitable fluoride toothpaste will also help to protect their teeth because the fluoride strengthens the enamel on the tooth.

Tell your dentist if your child uses and inhaler and have your child’s teeth checked as often as your dentist recommends.

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.

There are lots of toothbrushes for all age groups available.

For babies and young children try to use a toothbrush with a small head and soft bristles. Brush-Baby is new type of chewable toothbrush with a novel design that is particularly suited for babies and young children.

Toothbrushes can spread infection especially to and from young children. To avoid this:

• don’t share toothbrushes
• store them a clean, dry, airy place so that they can dry out between uses
• don’t let toothbrushes touch each other.
• replace toothbrushes after any illness such as colds and flu or after mouth infections.

So that toothbrushes and Brush-Baby work properly you will need to change them regularly particularly when they become 'shaggy', worn or clogged with toothpaste.

Remember, that babies and toddlers cannot co-ordinate to use a toothbrush properly and brushing needs to be done for them. Brush-Baby can help because it uses chewing action, which comes naturally to babies and toddlers and helps to keep their gums and baby teeth clean.

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.

Dentists recommend taking your baby to the dentist about six months after their first tooth appears. For most children this means that they should be seen when they turn one year old.

Thereafter, you can take them as often as your dentist recommends (usually between every 3-12 months). During these visits your dentist will check your child's mouth and teeth and will diagnose any problems which may exist.

Getting your child used to going to the dentist regularly will help them to feel relaxed and prepare them for future visits. Take your child to the dentist as early and as often as possible for example, when you have a check-up. This will help them to get used to the sights, smells and sounds of the dental practice and to feel more comfortable about going to the dentist.

Try not to take your child just when there is a problem, a bad experience could make them frightened of going to the dentist.

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.