Not without My Binky! A Parent’s Primer to Infant Oral Care

infant oral care

Did you know that more than 40 percent of children have tooth decay by the time they reach kindergarten? The time to start taking care of your baby’s teeth begins before the first tooth comes in. 

Even though primary teeth will only be around for a short time, they are essential to the healthy development of a growing jaw and permanent teeth. 

  1. Start Before Baby’s Teeth Come In

Even before any teeth have arrived, it’s important to keep baby’s mouth clean. Use a warm, wet washcloth or gauze to gently wipe your child’s gums after every meal. Use a rubber or silicone fingertip brush to clean and stimulate baby’s gums every day. This will remove bacteria and sugar from the mouth.

Once the teeth begin coming in, start taking care of them right away. Many parents think baby teeth aren’t important because they’re eventually replaced by permanent ones. But these first teeth preserve the spacing for the permanent ones and help baby chew and talk. If they’re not cared for properly they can decay, leading to a gum infection called gingivitis, which can affect the spacing of permanent teeth.

2. Follow the 2 x 2 Rule

Teeth are candidates for tooth decay from the moment they appear. Most babies have their first teeth come in at around month six. (When they do, you can graduate to using a toothbrush.) Brush for two minutes, two times per day. 

Of course, parents should brush children’s teeth until they are able to do it themselves. We highly encourage allowing your children to tackle this ritual; however, you should still assist them to make sure their teeth are cleaned properly. Most children have developed enough by age six to brush correctly and rinse/spit unsupervised. 

3. Schedule Their First Dental Visit

When should infants have their first dental examination? We recommend having the first dental visit by their first birthday or within 6 months of the first tooth coming in. This visit helps your child feel comfortable with me, and we’ll make sure everything is developing properly. If needed, your child may also have a gentle cleaning. This includes polishing teeth and removing any plaque, tartar, and stains. We can help you with the finer points of brushing and flossing baby teeth and advise you of any other special considerations that may be in order. 

4. Beware of Baby Bottles

Many parents are unaware that baby bottles can be a significant cause of early childhood caries. Putting the baby to bed with a bottle of milk or juice is notorious for causing cavities. These contain sugar, and the long exposure means that those young teeth are being attacked by bacteria-produced acids all night long. 

Don’t leave your infant with a bottle for long periods of time, especially if you notice he’s no longer feeding and is just using the bottle for comfort. If your child is old enough to have water, always give that as a nighttime thirst quencher rather than juice or milk.

5. Wean them off of pacifiers and thumb-sucking

From infancy, children use sucking behaviors to calm themselves. In fact, plenty of parents rely on pacifiers, teething toys, and other items designed for children to suck on in order to encourage emotional regulation. Prolonged use of a pacifier (or thumb-sucking) can increase the risk of cavities and interfere with the normal development of the jaws and teeth. 

The most serious permanent side effect of thumb-sucking is malocclusion. Malocclusion is a categorical term that describes tooth misalignment that is visible when the mouth is closed. Two of the most common types of malocclusion caused by thumb-sucking are open bite (when the front upper and lower teeth don’t touch when the child bites down) and overbite (when the front upper teeth stick out too far beyond the lower teeth).

6. Use Fluoride Toothpaste

Fluoride is a great defense against cavities. It reduces the ability of plaque-forming bacteria to produce damaging acids from sugar consumption, and it attracts calcium and phosphate, helping teeth remineralize. The thing to remember about brushing young kids’ teeth with fluoride toothpaste is to use small amounts.

As we want to minimize the amount of toothpaste that your baby might swallow, use only a rice grain–sized smear of toothpaste, carefully brushing it onto their teeth. As your baby grows into a toddler and is able to assist by spitting, you can use a pea-sized dab of fluoride toothpaste. 

A Foundation of Dental Health

As tooth decay is nearly 100 percent preventable, these fundamentals will help parents establish a foundation for dental health. Remember, the earlier you create healthy habits, the healthier your children will be and the easier their upcoming dental visits will be.


~Dr. Debra Duffy

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