With so many years of dealing with your own teeth, you’d think that caring for your baby’s tiny ones would be no big deal. Yet there’s still a lot of confusion about what to do when teeth start making an appearance around 6 months. This expert advice will answer your questions and dispel some common misconceptions.
FACT: Yes, your baby’s primary teeth are temporary and will eventually fall out. However, they have many functions beyond looking adorable. “Baby teeth are essential for eating and getting proper nutrition, for the structure of the face, and for holding space for the adult teeth to come in properly,” says Homa Amini, D.D.S., chief of pediatric dentistry at Nationwide Children’s Hospital, in Columbus, Ohio. If a tooth is lost too early because of decay, the other teeth could shift so there’s not enough space for the adult tooth to grow in, she says. Another reason those tiny teeth are critical: your baby’s speech development. She’ll need her teeth to be able to eventually produce sounds like l, th, and sh.
FACT: Although you may have heard that teething causes diarrhea, fever, and a whole host of other problems, recent research shows that any symptoms are actually quite mild. Gum irritation, drooling, and irritability are the most common symptoms associated with teething, according to a recent study in Pediatrics; some babies may also experience a slight rise in temperature. However, a true fever (100.4°F or higher) isn’t related to teething, says Jade Miller, D.D.S., president of the American Academy of Pediatric Dentistry (AAPD). If your baby has significant signs of sickness, contact your pediatrician.
FACT: Twice a day is better. “It takes approximately 24 hours for the film of bacteria that causes cavities, commonly referred to as plaque, to build up enough strength to damage the tooth structure,” says Dr. Miller. “It’s unlikely any person—child or adult—will get all of the plaque removed on once-a-day brushing. Therefore, we recommend brushing twice a day, to improve the likelihood of more thorough plaque removal.” Before your baby has any teeth, clean her mouth and gums with a damp washcloth. Once her first tooth sprouts, switch to a small, soft-bristled toothbrush, and use a fluoridated toothpaste sparingly. “A small amount, the size of a grain of rice, is all you need,” Dr. Miller says. Use the same brushing technique you use: Put the toothbrush on your baby’s gum line and brush in small circles, making sure to get the front and back of every tooth. And don’t worry about dental floss yet: You can wait until she has two teeth that touch each other before you floss.
FACT: This was once the thought, but experts now advise using a fluoride toothpaste right from the start. “Fluoride significantly decreases the chances of decay,” Dr. Miller says. The reason fluoride was once delayed is because too much can affect the appearance of a child’s teeth, causing white spots or rough, pitted surfaces, and very young children swallow toothpaste instead of spitting it out. That’s why you should use only a small smear. Parents also often wonder whether they should use a toothpaste with a “baby” label. “If the baby-labeled toothpaste does not have any fluoride, then it does not provide any cavity-prevention benefits,” Dr. Amini says. “Technically, any fluoride toothpaste will have the same concentration of fluoride, but the flavor of kids’ toothpaste may be more pleasant.” You certainly want to avoid adult toothpastes that have additional ingredients for things like whitening or tartar control.
FACT: “If you have a tooth, it can get a cavity,” says Jill Lasky, D.D.S., a pediatric dentist at Lasky Pediatric Dental Group, in Los Angeles. And even though your baby’s teeth will fall out eventually, that doesn’t mean decay is a small or temporary problem. “If left untreated, a cavity in a baby tooth may cause the tooth to become infected or abscessed, which can cause pain and swelling,” Dr. Miller says. In addition, the permanent tooth is forming right at the ends of the root of the baby tooth, so any infection in the baby tooth can damage the permanent tooth, he says. In fact, one study found that children who had cavities in their baby teeth were three times more likely to develop cavities in their adult teeth. In addition to brushing, the most important way to reduce your baby’s likelihood of developing cavities is to avoid putting him to bed with a bottle of formula or juice, or breastfeeding him on and off throughout the night. “The bacteria that cause cavities love sugar and carbohydrates,” says Dr. Miller. “After your baby falls asleep, the sweet liquid pools in his mouth and provides the opportunity for cavities to develop.” Also avoid sharing utensils with him or cleaning his pacifier with your mouth, which can pass on your adult cavity-causing germs to your baby. Contact a pediatric dentist if your baby shows signs of a cavity, which may include a white, dark brownish, or black spot that doesn’t brush or wipe off or a tooth that looks chipped or cracked (when no previous trauma has occurred).
FACT: The American Academy of Pediatrics and the AAPD now both recommend that a baby see a dentist after he gets his first tooth or by his first birthday. “About 60 percent of children in the U.S. have tooth decay by the time they’re 5 years old,” says Dr. Miller, and it’s not uncommon for babies to show signs of early decay. At the first visit, the dentist will do an exam to evaluate your baby’s current cavity risk and talk with you about what you can do to keep her mouth healthy. After the first visit, your baby should have a dental checkup every six months or as recommended by your dentist.