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. click here to see the 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 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 DentalWipesTM to clean your baby’s gums has the additional benefit of xylitol which helps reduce the number of decay-causing bacteria.
- If your baby has 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.
To clean teeth, sit your baby or toddler up rather than lying them down. Use a small headed, soft bristled toothbrush or a Dental Wipe. Encourage your baby to chew on Brush-Baby’s Chewable Toothbrush, its designed to help clean teeth and gums as it is chewed and also acts like a teether.
Use a tiny smear of toothpaste for babies and toddlers (0-3years) and for older children (3-6 years) 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 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 – this keeps fluoride in the mouth and next to teeth so it can go on protecting the teeth for some time after brushing.
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, 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.
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 between 1 year and 18 months.
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.
Top Tips for preventing fear of the Dentist - 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. But before you assume that getting your toddler into the dentist’s chair will involve either a tantrum or bribery, remember that your child doesn’t harbour any grudges toward its first dentist — yet. After all, he hasn’t had a close encounter with The Drill. For your child, its first dentist appointment could be as much fun as visiting the park (the chair goes up and down, back and forth!). So keep your own negative feelings in check (if you have any) and let your child enjoy its first dental visit with the same enthusiasm as any other activity. If you are worried take one of their favourite books or toy to make them feel at home.
What will happen. Expect the first dentist appointment to be short and informal — more of a meet and greet for your child and the dentist. Depending on your child’s age and comfort level, you may be asked to hold him while the dentist pokes around his mouth.
As for the business of inspecting your tot’s teeth, the dentist will check for decay and take a look at your child’s gums, jaw, and bite. The dentist or the hygienist may clean your child’s teeth and apply a fluoride preparation (particularly if there is a stain or a high risk of cavities) or he or she may save that for the next visit. Chances are, the dentist will talk to you about good oral-hygiene habits — and give you the chance to ask any questions you may have about toddler teething, thumb sucking, tooth-friendly foods, or anything else that pertains to your toddler’s oral health. You may want to bring a list of your questions to the appointment so that you remember them when you’ve got the dentist’s attention.
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 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.
So how can you help your child stop?
Home remedies such as placing a glove, sock or thumb guard before bedtime, painting the thumb with various foul tasting substances can be successful if combined with positive reinforcement and encouragement; praise your child when they are not sucking their thumb rather than scolding them when they are. Let your child know that placing a sock or thumb guard over his hand at night is not a punishment, just a way to help him remember to avoid sucking.
- Start a progress chart and let him put a sticker up every day that he doesn't suck his thumb. If he makes it through a week without sucking, he gets to choose a prize (trip to the zoo, new set of blocks, etc.) When he has filled up a whole month reward him with something great (new toy); by then the habit should be over. Making your child an active participant in his treatment will increase his willingness to break the habit.
- If you notice your child sucking when anxious, work on alleviating his anxiety rather than focus on the thumb sucking
- Take note of the time your child tends to suck (long car rides, watching films) and create diversions on those occasions
- Explain clearly what might happen to their teeth if thumbsucking continues
Whatever your method, always remember that your child needs your support and understanding during the process of breaking the thumb sucking habit. And as most children suck their thumbs when they are tired or bored, keeping their hands busy helps! Visit your dentist – it’s amazing what a few words from an expert to your child can do! I often get parents call up the next day to say that whatever I said to their child has magically made them break their habit overnight. Most children are unaware how their little thumbs can affect their mouth and teeth and react in a very positive way when this is demonstrated to them.
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 toothpaste 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.
- Always use a toothpaste for the correct age of your baby or child.
- Use a tiny smear of toothpaste for your baby (0-3years) 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. Wait at least 20 minutes after eating to brush teeth, this help preserve the tooth's enamel.
Tooth decay is caused by the presence of decay-causing bacteria such as 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.
Decay causing bacteria 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.
Just in case, we wanted to re-iterate here SUGAR IS BAD FOR 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 and beyond
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 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 savory 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.
In-between meal snack food guidance
Try to avoid the following as in-between meal snacks
Fruit juices especially if given in a bottle and sipped throughout the day, are a major cause of tooth-decay. If you do give juice, offer it in a cup at meals and dilute with water - most babies cannot tell the difference and it will help to keep them hydrated
Rusks although sold specifically for teething babies, they are usually packed with hidden sugar, so best to avoid these
Raisins and dried fruit widely regarded as a healthy snack, but high in sugar and sticky so cling to teeth. Fresh fruit is normally a better choice
Better and healthier snacks for teething babies are:-
Calcium-rich foods like yoghurt, milk and cheese essential for building strong teeth nails and bones. Try popping a stick into one of Plum's no-added-sugar fromage frais and freeze for an hour to make a nice natural soothing ice lolly, a perfect treat for tender gums.
Low sugar teething sticks/biscuits get ones with no added sugar or salt. Sugar-Free teething biscuits are good ones for this
Tap water its FREE and not only is it hydrating and sugar-free, but it also contains fluoride to help strengthen the teeth
Raw, fibre-rich foods like carrot,celery, cucumber and apple these help ease irritation by massaging sore gums and are ultra healthy to boot! Offer them chilled for an extra soothing treat
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 just be irritable for a short time, but some may have a tough time for weeks being bad tempered or irritable/crying more than usual/ trouble sleeping, having pain and drooling or being more dribbly than usual with red, hot cheeks
Teeth do NOT ‘cut’ through the gums
There is a long-held and generally-believed myth that teething pain is caused by babies’ teeth “cutting” through the gums. This is not biologically true. The teeth do not cut through the flesh. Instead, special chemicals are released that cause the cells in the gums to separate, allowing the new teeth to come through. This process of the gums receding to make way for new teeth should not be painful (although there may be some discomfort, which is why toddlers like to chew on the area). It is also often accompanied by lots of dribbling due to increased saliva – which (despite all the extra laundry) is actually a good thing, as this helps to flush the area and keep the gums clean.
What causes the teething pain that some children experience?
Teething can sometimes be 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. But the majority of pain during teething is generally due to inflammation and infection of the gum tissue – not the tooth! This can be caused by bacteria and food getting caught in tiny gum flaps around the emerging tooth. Therefore, the best way to prevent teething pain is to keep baby’s gums and those new emerging teeth as clean as possible.
Soothing teething: What you can try:-
Clean gums This is the no. 1 way to help avoid teething pain altogether. Try using a clean gauze or specially designed Xylitol wipe to wipe you baby's gums see how>>
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 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. You might also consider a teething gel. These contain a mild local anaesthetic to dull the pain. However, the USA Food and Drugs administration has recently come out against "gum numbing" medications as potentially causing harm to babies in some instances, so now recommend gum massage and cleaning baby gums as an alternative.
Try homeopathic remedies. A homeopathic remedy such as chamomilla may help, 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.
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. If you think your baby is teething but seems obviously unwell contact your doctor or dentist.
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.
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!
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. It is important to prevent tooth decay in baby teeth because:-
Baby teeth prepare the way for healthy development of permanent teeth.
Tooth decay in a child can be particularly unpleasant. It causes pain and sleep problems
Decay can affect the way your child looks and what they are able to eat
If a decayed milk tooth has to be taken out, many children will need to have a general anesthetic to treat the damaged teeth – which can be traumatic for the child and carries the complication risks associated.
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 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 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 doing the
1.Avoiding sugary and acidic foods (such as fizzy drinks and sweets) especially in between meals. They should only be allowed these at mealtimes if at all.
2. Reduce the time that any acid food or drink stays in their mouth (i.e used straws for sugary drinks)
3. If your child is sick, rinse their mouth with plain water to prevent acid in the vomit attacking teeth. Do NOT brush their teeth immediately, wait one hour afterwards to protect the tooth enamel
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 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.
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.
It is important that your dentist identifies these white marks as NOT being due to decay. If they are not decay, then they are most likely to be developmental i.e. due to the way the minerals in the tooth have been lain down as it developed. This is the case particularly if these marks where present when the tooth erupted.It is important to keep the teeth clean, paying attention to the white marks, particularly if they are rough as such a surface can collect more plaque. Make sure that you are using a toothpaste with the appropriate amount of fluoride and only use a smear of toothpaste with each brushing. Swallowing to much fluoride at this age can also mark the developing ADULT teeth which will erupt at around age 4-6 years.
The UK Dept of Health recommendsthe following
Age 0-3 years: A SMEAR of more than 1000ppmF. Due to the risk of flurosis at this age only if a smear of toothpaste should be used and do not let children eat toothpaste.
Age 3-6 years: A PEA SIZE amount of 1350ppmF toothpaste. After age 3 years the adult teeth are developed and flurosis is less of a problem.
If your toddler is at high risk of tooth decay, a pea sized amount of more that 1350ppmF is recommended. Ask your dentist.
Losing Baby Teeth
Losing their baby teeth is a big milestone in your child's life. Baby teeth have to fall out to make way for permanent teeth to grow — a process that lasts six or more years from start to finish.
Most kids are excited to feel a tooth wiggle (and perhaps get a visit from the tooth fairy), while some worry about whether it will hurt when it falls out. If your child is a worrier, you can reassure him that he probably won't feel anything.
First in, first out
A child's 20 baby teeth, which typically come in by age 3, usually fall out in the order in which they came in.
That means the lower middle teeth (lower centre incisors) are usually the first to go, around age 5 or 6. The top middle pair is next. A baby tooth typically doesn't loosen until the permanent tooth below pushes it up to take its place.
Some children lose their first tooth as early as 4 or as late as 7. Generally, the younger the child was when the teeth came in, the earlier they fall out.
It's possible for children to lose a baby tooth too early, before the permanent tooth is ready to erupt, because of an accident or dental disease. Sometimes a dentist will put a spacer (a custom-fit plastic placeholder) in the place where a baby tooth fell out too soon until the adult tooth is ready, to prevent future spacing problems. If your child begins to lose teeth before 4, you should consult a dentist to make sure there's no underlying disease.
It's also possible for a child to reach 7 or 8 without losing any baby teeth. In such cases, there's probably nothing wrong, but it's a good idea to consult a dentist for X-rays to assess the situation.
Out with the old
Encourage your child to gently wiggle a wobbler. Some loose teeth can actually be rotated because the root underneath has almost completely disintegrated.
But remind your child not to yank a tooth before it's ready to fall out on its own because it makes the broken root more vulnerable to infection. A loose tooth that refuses to come out may need to be pulled by a dentist, though this is hardly ever necessary.
Losing baby teeth is seldom as painful a process as teething. If your 5- or 6-year-old complains of pain in the back of his mouth, it's probably the 6-year molars coming in. (He has no baby teeth there to fall out first). A topical painkiller like ibuprofen can ease the ache, though it's unlikely to last long.
In with the new
The new teeth may look bigger, especially those first few. That's because they are! Adult teeth also tend to be less white than baby teeth and have pronounced ridges because they haven't been used yet for biting and chewing.
Sometimes, not often, a couple of new teeth come in before the old ones are gone, creating two rows of pearly whites. This is a temporary stage, sometimes called shark's teeth.
Brushing is now more important than ever. You'll probably need to supervise the process until your child is around 7-8, and until then he won't need to use more than a pea sized dot of toothpaste.
Replace toothbrushes every two or three months to reduce harmful bacteria and keep them working at their best. And make sure your child sees a dentist twice a year.
Most children will lose their last baby teeth around age 12 or 13, about the time the 12-year molars appear.