A bright smile begins long before the first tooth appears. Parent and caregiver help is important for children to develop healthy teeth. Read on for information from the American Academy of Pediatrics about caring for your child’s teeth.

Steps to good dental health include

• Regular care by a dentist beginning by 1 year of age
• Enough fluoride (in water, toothpaste, and fluoride varnish)
• Brushing and flossing 2 times each day
• Eating healthy and limiting sugar
• Using a mouth guard during sports participation to prevent injury, if necessary

Fluoride is important because it

• Hardens tooth enamel (the outside coating on teeth)
• Repairs early damage to teeth all day every day

Note: Fluoride is a natural substance that can be added to drinking water, toothpaste, mouthwash, and varnish (dental treatment). During well-child visits (also known as health supervision visits), doctors may recommend drinking more fluoridated water or, for some children, using fluoride tablets or drops. Also, fluoride varnish should be applied to children’s teeth by their doctor or dentist up to 4 times per year.

Here’s how to clean your child’s teeth.

Babies to 3 years of age

• Wipe the gums 2 times each day with a piece of gauze or a damp cloth until the first tooth or teeth arrive.
• Brush the first tooth or teeth with a soft toothbrush 2 times each day. Brush for 2 minutes each time.
• Use “Just a dot, not a lot!” of fluoride toothpaste. The amount of toothpaste should be the size of a small grain of rice for children younger than 3 years.

Children 3 years and older

• Brush your child’s teeth with a soft toothbrush 2 times each day. Brush for 2 minutes each time. Children should learn how to brush their teeth on their own. However, parents should brush their children’s teeth first before handing over the toothbrush to their children until they are 7 years of age.
• Use “Just a dot, not a lot!” of fluoride toothpaste. The amount of toothpaste should be the size of a small pea for children 3 years and older.

All children

• Teach your child to spit out excess toothpaste. Your child may want to swallow the toothpaste because it tastes good. However, swallowing too much toothpaste can result in white spotting of the teeth called fluorosis. Children should not rinse after brushing and spitting out excess toothpaste.
• Floss where any 2 teeth touch each other to prevent a cavity forming between the teeth.
• Check front and back of the teeth for early signs of tooth decay, such as white, yellow, or brown spots or lines on the teeth. Lift up the top lip to get a good look at the front upper teeth.
• Change your child’s toothbrush every 6 months.

Here are other ways to help prevent tooth decay in babies and children.

• Schedule regular dental checkups for each family member.
• Avoid sharing food, drinks, spoons, and forks. If your baby is using a pacifier, avoid licking it to clean it.
• Offer water if your child is thirsty. Also, only offer water in sippy cups between meals and in bedtime bottles. Sipping juices, sports drinks, flavored drinks, lemonade, soft drinks (soda, pop), or flavored teas throughout the day causes acid attacks on teeth.
• Offer healthy snacks such as fruits or vegetables. Avoid offering sweet or sticky snacks, such as raisins, gummy candies, and vitamins, or fruit-flavored snacks/rolls or cookies. There is sugar in foods like crackers and chips too. Reserve these for desserts at the end of meals.
• Be sure to clean teeth after your child drinks milk at bedtime.
• Check front and back of the teeth for early signs of tooth decay—white, yellow, or brown spots or lines on the teeth. Lift your child’s lip to get a better look at the upper front teeth. This should be done about once a month.

Common Questions

Does pacifier use or thumb-sucking hurt teeth?

Sucking on a pacifier, thumb, or fingers may affect the shape of the mouth or how teeth are lining up.

• If the habit stops by 3 years of age, the teeth will usually correct themselves without treatment.
• If the sucking habit continues after “permanent” teeth have come in, orthodontic care may be needed to line the teeth up for disease prevention and appearance.

What should I do when my child falls and loosens a tooth?

• Call your child’s dentist or pediatrician for advice.
• For the next 6 months or so, watch for redness in the gum above the loosened tooth and notify your child’s dentist immediately if it occurs.

What is a pediatric dentist?

Pediatric dentists have special training to provide routine dental care for children and can care for children with complicated oral health problems. They are specialists in the care of children’s teeth and mouth problems, especially when

• Teeth are chipped or injured or there is an injury in the mouth area.
• Teeth show signs of discoloration that could be tooth decay or trauma.
• Children complain of tooth pain or sensitivity to hot or cold foods or liquids. This could also be a sign of decay.
• There is any abnormal growth inside the mouth.
• Children have an unusual bite (in other words, their teeth do not fit together right).

You can find a pediatric dentist in your area on the American Academy of Pediatric Dentistry website at www.aapd.org. Some family dentists are trained to provide care for children without complicated problems. There are also many family dentists who provide preventive care to healthy children.

When should my child begin regular dental checkups?

• All infants should receive oral health risk assessments by 6 months of age at their well-child visit with their medical provider and at every well-child checkup.
• Children with special health care needs should be referred to a dentist as early as 6 months of age, and no later than 12 months of age, to establish their dental home and may be seen more frequently than typical children.
• Every child should have a dental home established by 12 months of age.

Remember

If you have any questions or concerns about your child’s teeth, contact your child’s dentist.

Disclaimer

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2020 American Academy of Pediatrics. All rights reserved.