Oral care can begin before eruption of the first tooth which is generally around six months of age but can have wide variability. Unfortunately, dental decay can begin as soon as the first tooth erupts and the major cause is extended periods of breast and bottle feeding. The gums and early erupting teeth can be cleaned with a wet washcloth after feedings and parents should try to avoid putting babies to bed with a bottle containing anything other than water. A soft bristled infant toothbrush or finger brush can be used to brush the teeth and massage the gums. Toothpaste is not necessary for infants but if used, a training toothpaste that does not contain fluoride is recommended to avoid swallowing.

Teething

Babies can appear very fussy during periods of teething and may drool more than normal, have sensitive gums, and even have a low grade fever or diarrhea. To comfort babies during this time an age appropriate dose of Tylenol or Motrin is recommended especially overnight. Additionally, massaging the gums and cold foods such as frozen pancakes or waffles can be very soothing.

Thumb and Digit Sucking

Thumb and digit sucking as well as pacifier use are very normal in infants and toddlers and may stop naturally between two and four years of age. Parents should try to help the child extinguish these behaviors before the eruption of the permanent front teeth to avoid problems with jaw growth and tooth alignment. Gentle reminders, reward charts, distraction, and even physical barriers such as bandages or socks are often helpful.

The First Dental Visit

The first dental visit should occur within six months of the eruption of the first tooth. This usually coincides with your child’s first birthday. This first appointment will introduce the child to the dental environment, allow the parent to become familiar with how to care for their child’s teeth, and allow the dentist to provide anticipatory guidance for the child’s dental development.