Dental Care in the First Three Years
Your child needs dental care long before they can brush on their own. The first years set up everything that follows.
Bring your child in by their first birthday, or within six months of the first tooth appearing. Whichever comes first is the right time.
Most parents wait far longer than that. The early visit is not about treatment, and in most cases nothing needs doing at all.
Why the First Visit Is So Early
Decay can start as soon as a tooth appears. It moves faster in baby teeth, because the enamel is thinner than on adult teeth.
The early visit lets your dentist spot the first signs while they are still reversible. It also lets your child meet a dentist while nothing hurts.
That second reason matters more than parents expect. A child whose first visit is an emergency learns to fear the chair.
What Happens at the Visit
Very young children are usually examined on your lap, knee to knee with the dentist. There is no need for them to sit alone.
- A look at the teeth, gums, tongue and bite.
- A check for early decay, especially on the upper front teeth.
- Advice on brushing, feeding and dummy use.
- A fluoride varnish if your dentist thinks it is needed.
- A plan for how often to come back.
The whole appointment is short. Most of it is spent talking to you rather than working on your child.
Teething
The first tooth usually appears between six and ten months. The bottom front teeth almost always come through first.
Sore gums, dribbling, chewing on everything and broken sleep are all normal. A chilled teething ring and gentle gum pressure help.
Teething does not cause a high fever, diarrhoea or a rash. If your child has those, they are ill with something else and need a doctor.
Cleaning Baby Teeth
Before the first tooth
Wipe the gums with a clean damp cloth once a day. This clears milk residue and gets your baby used to the routine.
From the first tooth
Start brushing twice a day with a soft baby brush. Use a smear of fluoride toothpaste, about the size of a grain of rice.
From about age three
Move up to a pea-sized amount. Encourage your child to spit it out, and do not rinse with water afterwards.
Brush their teeth for them until they are around seven. Before that, their hands are not steady enough to clean properly.
Bottle and Sippy Cup Decay
This is the most common serious problem we see in toddlers. It affects the upper front teeth first, as brown or white marks near the gum.
It happens when sweetened liquid sits on the teeth for long periods. Juice, cordial, flavoured milk and sweetened formula all do it.
- Do not put your child to bed with a bottle of anything but water.
- Move from bottle to open cup from about twelve months.
- Keep juice to mealtimes, and dilute it well.
- Never dip a dummy in honey or anything sweet.
Saliva flow drops during sleep, so anything sweet at bedtime stays on the teeth for hours.
Why Baby Teeth Matter
Baby teeth are often treated as temporary, so parents assume problems can wait. They cannot.
Each baby tooth holds space for the adult tooth forming underneath. Losing one too early lets the neighbours drift into the gap.
The adult tooth then has nowhere straight to come through. That is one of the common reasons for crooked teeth later.
Baby teeth also matter for chewing, speech and confidence. Toothache in a small child affects sleeping and eating quickly.
When to Come In Sooner
- White, brown or black marks on any tooth.
- Bleeding or swollen gums.
- A knocked or chipped tooth after a fall.
- Your child avoiding cold food or chewing on one side.
- Any pain, or a face that looks swollen.
Do not try to reinsert a knocked-out baby tooth. Putting it back can damage the adult tooth developing above it.
Related Reading
- Early interceptive treatment, from about age seven
- Pulpectomies for badly decayed baby teeth
- Pit and fissure sealants
- Polishing and fluoride