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Children’s Dental Health Care

The road to a bright smile begins long before the first tooth breaks through the gum. Parents play a big part in helping their children develop healthy teeth. Early monitoring by a pediatrician is important. Regular care by a dental professional, getting enough fluoride, and eating right are all steps to good dental health. By following these steps and teaching them to your children, you can help your children grow up to have healthy teeth and winning smiles.

When do teeth start to form?

Teeth start forming under the gums even before a child is born. During pregnancy, a woman can get their child’s teeth off to a healthy start by following her doctor’s advice and eating a well-balanced diet. A child’s first tooth generally breaks through the gum at about 5 or 6 months of age, but this can vary quite a bit. Some children already have a tooth when they are born. It may be a real tooth or an extra tooth. To find out, your pediatrician may have your child see a pediatric dentist. Other children may not get their first tooth until after 1 year of age.

What can I expect when my child starts teething?

When teething begins, your child’s gum may be swollen in the spot where a tooth is about to break through. To ease the sensation of teething, you can give infants a one-piece teething ring or pacifier to suck on. (Teething rings and pacifiers made up of more than one piece may become unattached and may cause choking.) You should never give infants pacifiers that have been dipped in sweet liquids. Sugar from such liquids stays on the teeth and provides food for bacteria that can cause tooth decay.

When they are several months old, infants begin to produce more saliva than they are able to swallow, which causes them to drool. Also at about the same age they begin to put objects in their mouths and bite or chew on them. Drooling and chewing on objects (or rubbing them against the gum) are a natural part of an infant’s development and may or may not signify teething.

Why are baby teeth important?

Baby teeth, or primary teeth, help children chew food, speak clearly, and retain space for their permanent teeth that start to come in at about 5 or 6 years of age.

It is important to get children into the habit of good dental care at an early age. Children who begin to take care of their teeth at a young age are more likely to have good dental habits as adults.

What is fluoride and why is it important?

Your toothpaste and drinking water may have fluoride in them, but you may not know what fluoride is or why it is important. Fluoride is a natural chemical that can be added to drinking water. It strengthens enamel, the hard outer coating on teeth. Enamel production occursFluoride before teeth break through; so even before teeth actually appear, fluoride helps prevent decay. Fluoride also helps repair early damage to teeth. The fluoride content of local water supplies varies. Water that has low levels of fluoride can be a problem for infants who get very little fluoride from breast milk or formula. Check with your local water department to find out the exact water-fluoride level in your area. Then talk with your pediatrician to see if your child needs additional fluoride. Infants who are not getting enough fluoride should start taking additional amounts at 6 months of age. These children should continue to take additional fluoride until they are at least 16 years old.

When should I start cleaning my child’s teeth?

Brushing Teeth Daily dental cleaning should start as soon as your infant’s first tooth appears. Wipe the teeth with a piece of gauze or a damp cloth. Switch to a toothbrush with a fluoride toothpaste as the child gets older. Fluoride in toothpaste absorbs into the tooth enamel and helps prevent tooth decay. Because children tend to swallow toothpaste, put only a small (pea-sized) amount of fluoride toothpaste on your child’s toothbrush. Ingesting too much fluoride while brushing can result in bright white tooth staining (mottling).

Also check the teeth for early signs of decay. These appear as white, yellow, or brown spots on the teeth. Some children may develop decay in spite of the best preventive efforts. This may be because it runs in their family. Genetic influence also plays a role in a person’s overall dental health.

Does thumb sucking hurt teeth?

Thumb sucking is normal in infants and young children and should cause no permanent problems if not continued past the age of 5. Likewise, it is harmless for infants to use pacifiers. Children who suck their thumbs past the age of 5 may need a referral to a pediatric dentist to determine if problems are developing.

Can putting children in bed with a bottle harm their teeth?

Infants put to bed with a bottle filled with milk or juice have a higherBaby Bottle risk of developing “baby bottle tooth decay” or “nursing bottle decay.” When these infants fall asleep, they can end up with a small pool of liquid in their mouths. The sugar in milk or juice creates a breeding ground for bacteria, which damage their teeth. This process may lead to severe decay. Toddlers who carry around and suck on a bottle filled with milk, juice, or other sugary liquids can also develop baby bottle tooth decay.

There are some steps parents can take to avoid baby bottle tooth decay:

  • Do not put children to bed with a bottle.
  • Do not use a bottle of milk or juice as a pacifier during the day. This means you should not let a child walk around with the bottle.
  • Teach children to drink from a cup as soon as they are old enough to hold one. Most children can do this well before their first birthday.

Are there other eating habits that are bad for a child’s teeth?

Sweets like candy or cookies can lead to tooth decay. Starchy foods such as crackers and sticky foods such as raisins, tend to stay on the teeth long. These foods are also more likely to lead to tooth decay. Sugar from fruits and fruit juices left on the teeth for long periods of time is also not healthy for teeth. Starches and fruits, however, are a necessary part of any child’s diet. To avoid tooth decay, give children these foods only at mealtime (before the teeth have been brushed), not at bedtime. For healthy teeth, offer children a well-balanced diet with a variety of foods.

When should children be seen by a dentist?

Dental VisitBefore the age of 3, your child’s basic dental care can be handled by your pediatrician. During regular well-child visits, your pediatrician will check your child’s teeth and gums to make sure they are healthy. However, if dental problems do arise, your pediatrician may refer your child to a dental professional. A pediatric dentist (pedodontist) specializes in the care of children’s teeth, but some general dentists are interested in treating children’s dental needs and will also see children.
Situations in which a pediatrician may wish to refer a child to a dental professional before age 3 include:

  • If the child chips or injures a tooth or has an injury to the face or mouth.
  • If the teeth show any signs of discoloration. This could be a sign of tooth decay.
  • If a tooth is painful or is sensitive to hot or cold foods or liquids. This could also be a sign of decay.

Most mouth pain in children is not dental in origin. It could be a sign of infection. A pediatrician can rule out medical conditions that are not related to a child’s dental health.


Children should get regular dental checkups after age 3 or when all 20 baby teeth have come in. Parents might prefer to take their children to a pediatric dentist for these regular checkups. As previously noted, some children may need earlier visits to the dentist.

Regular dental checkups, a balanced diet, fluoride, injury prevention, and brushing are all important for healthy teeth. Starting children off with good dental habits now will help them grow up with healthy smiles.