Oral Health for babies

Why is it important to brush milk teeth?

Caring for your baby’s teeth is a very important job. Not only do they help with smiling, eating and speaking, milk teeth hold the jaw in place whilst under the gums, adult teeth form. They are known as placeholders, helping to align a child’s permanent teeth when they are ready to come through.

The most common oral health disease affecting children in the UK is dental decay. Looking after milk teeth, from when they first begin to come through, can help to make dental decay largely preventable.

When do first teeth begin to appear?

Usually, a baby’s teeth will begin to come through at four to eight months of age. Milk teeth need daily care to make sure they are healthy.

Incisors are the name of the bottom front teeth. These usually are the teeth that appear first, followed by the top teeth. After the incisors come through, usually then do the first molars, canines and second molars. Children are expected to have 20 baby teeth by the time they are two or three years old.

Permanent teeth usually start to come through at the age of around 6 years. It is expected that they will come have come through between the ages of 12 and 14.

How can I help my baby with teething?

For some children, when their milk teeth begin to come through, their gums can get sore. This is called teething. You may notice that their cheeks look red, they are dribbling more than usual, chewing on things more and getting distressed both in the day and at night. These symptoms can show you that your child is in discomfort with teething issues.

Often teething symptoms can be relieved by offering children something to chew on, like a teething ring, gently rubbing their gums with a clean finger of offering them some sugar free paracetamol or ibuprofen if they are 3 months of age or older. Make sure if you choose to use a teething gel that it is sugar free.

If your child looks to be in significant distress, and seems unwell with symptoms such as diarrhoea, it is best to seek medical attention to rule out other issues, such as an ear infection.

How should I brush my child’s teeth?

If they are 0-3 years old:

Decay can appear as soon as a child’s teeth come through, so this is when it is time to begin brushing them.

It is important parents brush their children’s teeth until they are 2 years old, after this, children should be supported to brush their teeth until they are 7. A top tip is to sit your child on your knee, with their head resting against your chest. This way will make it easier to access their mouth and to stop them moving too much.

Children under 3 should use only a smear of toothpaste. There are lots of child friendly toothpastes which make sure children’s teeth are protected but also are in child-friendly flavours. Children under 3 years old should use toothpaste containing no less than 1000 ppm fluoride. Fluoride in toothpaste helps to prevent and control tooth decay.

It is a advised to change your babies toothbrush approximately every 3 months, this is because they have a tendency to chew the bristles making them less effective.

Young children will be unable to spit out the toothpaste, so it is important to wipe away any excess once finishing brushing. It is important children do not swallow toothpaste. It can cause a stomach upset or fluorosis, which is when white spots appear on a baby’s teeth because there is too much fluoride from the toothpaste in their bodies.

What tips are there for if I am struggling to brush my baby’s teeth?

1. Try not to worry- there are lots of babies who do not enjoy tooth brushing. The important thing is to try to make it part of their routine from as early as their milk teeth come through- even if they only brush for a short while at first.
2. For babies, sit them on your knee with their head rested on your chest. As they get older, try standing behind them and tilting their head back.
3. Try to make toothbrushing fun, perhaps making it into game or song. There are many apps and online videos that can help with this. Here are a few for inspiration:

• Timer song and game
• Brush DJ app
• CBeebies Hey Duggee brushing badge
• The Brush Bus

When should I first take my child to the dentist?

Booking an appointment at the dentist when your baby’s first tooth comes through can help with getting your child used to having regular check-ups.

Dental check-ups are important for children because tooth decay can happen faster with milk teeth. Check-ups make sure teeth are growing as they should and can help spot any issues early.

In preparation for your child’s first visit to the dentist., it can be helpful to talk them through what will happen there. There are lots of online videos, tv shows and books that explore this topic so going to the dentist can be seen as a positive experience. It can also be beneficial to play a game of ‘going to the dentist’ at home. Children can then get used to opening their mouths and having their teeth checked but in a fun setting.

A first check-up usually includes a parent sitting on the dental chair with their child in their lap. The dentist will check for decay, how your child’s teeth and jaw are developing and clean their teeth. It is important this check-up is seen as positive experience for your child, so if you are particularly anxious yourself about the dentist, it can be helpful to get another adult to go with you also.

Dental treatment is free for children under 18, or under 19 and in full-time education, It is also free if you are pregnant or have had a baby in the last 12 months. It is important your child sees a dentist regularly. It is advised the time between appointments is no more than 12 months whilst your child is under 18.

If you don’t have a dentist, you can use the Find a Dentist website

If anyone in your family needs to see a dentist urgently, please contact a local NHS dentist or call NHS111.

How can sugar in food and drinks affect tooth decay?

The biggest cause of tooth decay is sugar consumption. When we eat or drink sugary items, plaque in our mouths, feed on it and makes acid. This acid easily erodes the enamel on a child’s teeth because it is so thin.

Not only is it important for the number of sugary foods or drinks eaten to be reduced, but also for teeth to be cleaned twice a day so that the time teeth are exposed to sugar is reduced.

As a child gets older it can be more difficult to control what they eat or drink, so educating them the early years is important to instil healthy habits.

What should my baby be drinking?

The only drink or food a baby should be having for the first 6 months of their lives is breast milk, or formula as a substitute.

More solid foods can be introduced at this time, but breastfeeding or formula should still be given alongside, until they’re at least one year old.

Children should drink water in between meals to help reduce tooth decay.

Cows’ milk as a drink can be introduced from 12 months.

Sugar or honey should not be added to weaning foods or drinks.

From six months old, babies can be given a free-flow cup to drink from.

Using a free-flow cup has lots of benefits including:

• Helping a child’s teeth and jaw development
• Protects milk teeth from tooth decay
• Improves speech development
• Supports a healthy lifestyle

For more information about using a free-flow cup, please go to: Have confidence to pick up a cup

Healthy eating:

Encouraging your child to eat a balanced and healthy diet with lots of vegetables, fruit, protein, dairy and carbohydrates, but low in fats, sugar and salt can help to lower your child’s risk of having tooth decay.

Some food naturally contain sugar such as fruits and milk. These foods do not need to be limited with the guidelines below.

Instead, food and drinks that contain ‘free sugars’- sugars that have been added and are not natural- should be limited to less than 5% of our calorie intake.

Food packaging can be confusing because sugar is written in a lot of different ways. These could include glucose, fructose, sucrose, dextrose, maltose, honey or syrups to name a few. Even if products are advertised as natural sugars, they can still be harmful to teeth.

For 4–6-year-olds the recommended maximum intake of free sugars is no more than 19g per day. This is equal to 5 sugar cubes.

For 6–10-year-olds the recommended maximum intake of free sugars is no more than 24g per day, which is equal to 6 sugar cubes.

For children 11 years over, the recommended maximum intake of free sugars is no more than 30g per day, which is equal to 7 sugar cubes.

It is important to avoid children having sugary food and drink before bedtime and to only give fruit juice or sweet foods at mealtimes. Although fruit juices count as one of your child’s 5 a day, even unsweetened fruit juice is sugary, so it is advised that consumption should be limited to no more than 150 mls a day.

What tooth friendly snacks would we recommend?

• Fresh fruit, such as an apple
• Raw vegetables
• Pieces of cheese
• Breadsticks
• Pitta breads or crumpets
• Plain popcorn
• Sandwiches filled with cheese, ham, chicken, houmous or cream cheese and cucumber