Caring for Your Baby’s Teeth

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First, the bad news: over half of eight-year-olds will have experienced at least one cavity. The news is getting any better on this front either: the rate has stayed about the same over the last several years.

There is, however, good news. There are a lot of things you can do to help your child not be in that majority. The potential to avoid cavities, otherwise known as caries, starts during pregnancy and continues during early infancy, which might be long before you see that first tooth pop up. In this blog, we’ll examine some measures you can take to give your little one a great start in the oral health department.

In the Beginning….

There’s so much to think about when looking after yourself and your unborn child during pregnancy, and you can add good dental health to the list. A great summary of the changes affecting the mouths of pregnant women can be found here. Where babies are concerned, we’ve known for a while that Mom’s dental infections contributing to prematurity and low birthweight. More recent evidence has shown that oral bacteria can be inherited, leading to a tendency for affected children to develop caries. Conversely, a healthy mouth for Mom can mean a healthy mouth for her child.

Those First Months

Unless your baby is born with a few teeth, which does happen occasionally, there’s not a lot to do right at birth where oral health is concerned. However, there are some precautions to follow right off the bat.

First off, consider breastfeeding your baby. In addition to all the other known benefits, such as protective antibodies that will help lessen the chance of a variety of infections, there’s evidence that the teeth may ultimately line up better if babies are breastfed. If you do use a bottle, however, it’s important not to put it in the bed with the infant. It’s a setup for something called nursing bottle syndrome, which involves caries in the front teeth. Not only can teeth pop up at any time, but baby habits are hard to break, so resist the urge to start this habit at any age. (If there are any issues soothing the baby, talk to your infant’s provider for fixes, or look here.)

Pacifiers are little more controversial, and it wouldn’t hurt to see how your baby’s provider feels about them. If your baby does use a pacifier, there are some precautions. Don’t dip the pacifier in sweetened liquids. This is especially true of honey, which in addition to affecting any developing teeth can be associated with infant botulism. Also, realize that use of the pacifier beyond infancy may be associated with dental problems. Avoid this by considering limiting it to the crib (i.e., don’t let your older baby crawl or walk around with it), and by checking with your provider regarding the discontinue deadline.

Ready, Set….Teeth!

OK, so those first teeth have erupted. Give your baby’s teeth the best start they can have by considering the following:

  • After feeding, wipe the gums with a clean soft cloth.
  • After teeth have erupted, use a soft toothbrush to brush them. As far as toothpaste goes, professional opinions change; currently the thinking is to use regular “adult” toothpaste—just a tiny smear of it (as opposed to the “pea size” that was formerly recommended).
  • Avoid sweetened foods and liquids. Also avoid juice, which shouldn’t be used until at least one year of age.
  • Talk to your little one’s provider about fluoride, which has been shown to protect teeth against caries. Fluoride is present in many community water supplies, but it’s not always easy to figure out how much babies are getting. In many cases, especially if there is no community fluoridation, a supplement may be recommended when the baby is a little older.
  • Know that the first dental visit is recommended by one year of age of by six months after the eruption of the first tooth. Reality check here: you may live (as I do) in an area where no dentist will see a child that young. For this reason, many pediatricians’ offices will provide fluoride varnish treatments for young children; check to see if this is available.
  • If your child takes a bottle, wean onto a cup as soon as she’s ready. In addition to helping tooth development, it avoids ear infections. Also, children who continue to take a bottle long past infancy tend to fill up on liquids, which dulls their appetites for solid food. (I often hear: “that’s the only way she’ll take her milk (or take anything, for that matter).” Realize that if she can take a cup, and if liquids are only offered that way, she’ll take it. And one could make a case that at least temporarily, it’s better for her health to be off the bottle than to have what’s in it!)

As I write this, we’re in the midst of the holiday season. By all means, indulge in the spirit of giving. And realize that the gift of a healthy mouth will keep on giving long after they’re done with all the other presents!

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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