Dental: Teeth and Gum Care for Infants and Toddlers

Everyone knows dental care is important for children and adults, but what about baby teeth? Dentists tell us that teeth and gum care should begin even before the first baby tooth appears.

Why Healthy Baby Teeth Are Important

baby's first tooth appears by 6 months of age

It's important to keep baby teeth clean and healthy because:

  • Baby teeth hold spaces open for the permanent teeth to come in. 

Baby teeth help to:

Form the shape of your child's face.

  • Make it easier for your child to talk more clearly.
  • Make chewing and eating easier.
  • Tooth decay can result when baby teeth are not cared for. Tooth decay causes:
  • Pain and discomfort.
  • Infections that can affect the child's total health.
  • Need for costly dental care.
  • Damage to the underlying permanent teeth.
  • Missing school or needing emergency care.
  • Loss of the space needed for permanent teeth to come in.

How Many Teeth and When?

  • The first teeth are already present inside your child's jaws at birth.
  • Usually by 6 months, the first tooth will appear in the mouth (Picture 1).
  • Your child has 20 teeth by the time he or she is 2 1/2 to 3 years of age.
  • The front teeth fall out between 6 and 7 years of age. The back teeth (those used for chewing) don't fall out until the child is 10 or 12 years of age.
  • To keep the teeth healthy, it's very important to care for the baby's gums and teeth even before they appear in the mouth.

How to Clean Your Child's Mouth

clean child's teeth at least once a day

Even before the teeth begin to come in, you should clean baby's mouth at least once a day with a clean gauze pad or soft cloth. This should become a regular habit. To clean the child's teeth and gums:

  1. Sit on a sofa or chair with your child's head in your lap (Picture 2). Or if someone is helping you, place the child's head in your lap with his feet toward your helper. It is important your child is comfortable and you can see easily into his mouth.
  2. Place a clean gauze pad or soft cloth over your finger. Dip the gauze in water so that it's damp, but not soaking wet. Wipe your child's teeth and gums gently.
  3. When your child's teeth start coming in, begin to use a small, soft toothbrush to brush his teeth. Be sure to brush all surfaces of the teeth, including the gums.
  4. It is not necessary to use toothpaste, but if you do, use a small amount of fluoride toothpaste (about the size of a small pea).
  5. Children should be able to brush their teeth totally unsupervised by age 11. Until then, parents should watch or help, based on their child’s abilities.

Things You Can Do to Prevent Tooth Decay

Tooth decay is caused by bacteria in the plaque (plak) that forms on teeth. When your child eats food or takes medicine that has sugar in it, the bacteria produce acids. These acids destroy the teeth. To prevent tooth decay:

  • Clean the baby's teeth with gauze or a soft cloth after each feeding. When the child is older, you may use a toothbrush.
  • A young child is not able to brush every tooth surface in his mouth and does not know how important it is to brush the teeth well. This is why an adult should brush or clean the child's teeth at least once a day until the child is about 7 or 8 years of age.
  • Don't give the child large amounts of sugary foods or liquids such as juice, Kool-Aid® and soda pop. Offer sweets only as dessert.
  • When you start using toothpaste to clean the child's teeth, be sure it contains fluoride (but use only a small amount - the size of a small pea).

How Fluoride Helps

wean your child to a cup by 12 months

  • Fluoride is one of the best ways to prevent tooth decay. It makes teeth stronger so they can resist the acid and bacteria that cause tooth decay.
  • Fluoride should be provided in either the drinking water or as a supplement in the form of drops or tablets, with or without vitamins. Ask your child’s dentist or doctor about providing your child with fluoride if you don't have fluoride in your water.
  • When your child is about 2 years of age, fluoride treatments should begin. Your dentist or dental hygienist applies a fluoride solution on the surface of the child's teeth to give the teeth added protection.

Baby Bottle Tooth Decay

Severe tooth decay can occur when your baby is allowed to use either the bottle or the breast as a pacifier. When a baby goes to sleep with a sweetened liquid in his mouth (such as cow's milk, formula, breast milk, soda pop or apple juice), the acid that is formed breaks down the tooth enamel very quickly. Instead of being swallowed and washed away by saliva, the liquid stays around the teeth and causes damage.

  • To prevent “baby bottle tooth decay”:
  • Avoid bedtime and nap time feedings.
  • Avoid long or frequent feedings.
  • Wipe your child's teeth off after feeding.
  • Don't put your baby to bed with a bottle.
  • Give baby a small amount of water at the end of the feeding.
  • Use the bottle at feeding time only and not as a pacifier.
  • Wean the infant from the bottle or breast to a cup by 12 months of age (Picture 3).


  • As teeth appear in the mouth, your baby may have some discomfort. Your baby's gums will be sore and he may get cranky or fussy.
  • It often helps if you gently rub the baby's gums with a clean finger. Sometimes it's helpful to give baby a clean, cold object to chew on. Try giving a teething ring that you've kept in the refrigerator or a non-sweetened teething biscuit.
  • Teething doesn't make a child ill, just uncomfortable. Often it seems a cold or mild fever goes along with the drooling and chewing. If your child seems ill, call your doctor. Something other than teething may be causing the problem.

Thumb-sucking and Using a Pacifier

It's natural for all babies to want and need to suck. Usually there's no damage to the teeth from thumb-sucking or using a natural-shaped pacifier unless this continues beyond 5 years of age. After age 5 the habit could affect the permanent teeth as they come in.

Early Dental Visits

Your child should be seen by a dentist before he or she is 2 years old. After that, he or she should have regular "happy teeth" check-ups to make sure the teeth stay healthy. If you have any questions, be sure to ask your child’s dentist, dental hygienist, or doctor, or call the Dental Clinic at (614) 722-5650 or ___________________.

Dental: Teeth and Gum Care for Infants and Toddlers (PDF)

HH-IV-29 5/89, Rev. 7/10 Copyright 1989-2010, Nationwide Children’s Hospital