Dental health in babies is a challenging area for any new parent. New parents tend to have tons of queries about what to expect, common problems and how to keep dental issues at bay when it comes to their little ones’ teeth.

Tips to ensure good dental health in babies

Teething

Apart from seeing the teeth coming through, you should look out for symptoms such as puffy gums, excessive drooling, an urge to gnaw, fussiness (especially at night), trouble sleeping and a change in eating habits or refusal to eat.

Give your baby something to chew on, like a teething device. Remember to clean it thoroughly. You can also try rubbing a clean finger firmly but gently on the baby’s sore gums. This will help ease the pain temporarily.

If your baby is old enough to eat solid foods, cold foods such as yogurt or applesauce can help. Gnawing on unsweetened teething biscuits can also help relieve some pain.

Feeding & Brushing

Remember to gently clean your baby’s teeth and gums with a soft cloth after every feeding session.

You can start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste.

Parents should also keep a watchful eye on the foods their babies eat - hard, sugary, chewy foods should be strictly avoided.

Don't worry if you don't manage to brush much at first. The important thing is to get your baby used to brushing their teeth as part of their daily routine. You can help by letting them see you brushing yours.

Sleeping

If your baby is drinking milk from a bottle, do not let them sleep with the bottle in their mouth. Continuous nursing or letting your baby sleep with a bottle in the mouth can cause cavities.

Thumb sucking

If you notice it, it is best to break the habit early on, as it can lead to protruded teeth in future.

Water supply

If possible, connect to a public water supply that contains fluoride – this protects teeth from decay.

Calcium

Encourage your child to eat calcium-rich foods such as milk and cheese. Calcium helps build strong teeth.

Injuries to baby teeth

Falls or injuries can loosen, break, knock out or push a baby tooth up into the gum, which can damage the developing adult teeth. If your child injures a tooth in a fall or accident, take them to a dentist to have their mouth and teeth checked.

Baby tooth brushing tips

• Use a tiny smear of toothpaste for babies and toddlers up to 3 years old, and a pea-sized amount for children aged 3 to 6 years.
• Gradually start brushing your child's teeth more thoroughly, covering all the surfaces of the teeth, at least twice a day: just before bed and at another time that fits in with your regular routine.
• Not all children like having their teeth brushed, so you may have to keep trying. Make it into a game or brush your own teeth at the same time.
• The easiest way to brush a baby's teeth is to sit them on your knee, with their head resting against your chest. With an older child, stand behind them and tilt their head backwards.
• Brush the teeth in small circles, covering all the surfaces, and encourage your child to spit the toothpaste out afterwards. There's no need to rinse with water, as this will wash away the fluoride.
• Supervise brushing to make sure your child gets the right amount of toothpaste and are not eating or licking toothpaste from the tube.
• Carry on helping your child brush their teeth until you're sure they can do it well enough themselves. This will normally be until they're at least 7.

Sugar and tooth decay

Sugar causes tooth decay. It's not just about the amount of sugar in sweet food and drinks, but how long and how often the teeth are in contact with sugar.

Lollipops and sweet drinks in a formula bottle are particularly damaging, because they bathe the teeth in sugar for long periods of time. The acid in fruit juice and squash can also harm teeth.

The sugars found naturally in whole fruit and milk are less likely to cause decay, so you don't need to cut down on these types of sugars.

How to cut down sugar in your child's diet

• Avoid sugar-sweetened drinks – the best drinks for young children are their usual milk and water
• From 6 months old, you can offer babies drinks in a non-valved free-flowing cup
• When your baby starts eating solid foods, encourage savoury food and drinks with no sugar. Check if there's sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks.
• If you choose to give your child sweet foods or fruit juice, only give them at mealtimes. Remember to dilute 1 part juice to 10 parts water. Your child should have no more than 1 drink of fruit juice (150ml) in any 1 day as part of their 5 A Day.
• Don't give your child biscuits or sweets – ask family and friends to do the same. Offer things like stickers, hair slides, crayons, colouring books and bubbles instead.
• At bedtime or during the night, only give your child breast milk, formula or cooled boiled water.
• If your child needs medicine, ask your pharmacist or GP for a sugar-free option.  
• Be aware of your whole family's sugar intake – sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch are all sugars. Invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado sugar and concentrated fruit juices are also sugars.

Baby & toddler teeth tips

Despite the fact that baby teeth will eventually fall out, the importance of them cannot be overstated. A good primary dentition helps your child to establish strong biting and chewing patterns, develop speech and hold healthy space in the jaws for permanent teeth.

Baby teeth are just as prone to cavities as permanent or ‘adult’ teeth. When a baby tooth falls out prematurely or is lost to decay, other teeth can tilt into the empty spaces and it can cause delay in eruption. Teaching children to look after their baby teeth from an early age will also help pave the way for healthy adult teeth.

1. Getting started

As the first baby teeth arrive at approximately 6 months, it is often a good idea to introduce the concept of oral hygiene at this time.

Parents often find it challenging to introduce brushing and establish a good oral hygiene regime at this early stage. Try to introduce a kids’ toothbrush at bath time, allowing your toddler to place the brush in their mouths and get used to the idea of brushing.

2. Visiting the dentist

A good time to bring your child to the dentist is before the age of two, and preferably when the first tooth arrives. This gives you an opportunity to ask dietary and hygiene questions and seek professional advice on best maintenance.

It also allows your dentist to establish a baseline record of your child’s dental health and development, further safe-guarding the establishment of good dental health and preventing the premature loss of baby teeth through decay.

3. Establishing a brushing routine

For 0-2 year olds, brushing with a toothbrush and water is best.

From 2-7 years, children should brush twice a day with a pea-sized amount of fluoride toothpaste. Parents will still need to help and supervise brushing, whilst at the same time encouraging children to manage their own brushing.

4. Reducing bottle feeding

Most babies will be able to use a cup from approximately six months, and to avoid tooth decay, bottle feeding should ideally be decreased from 12 months old. Parents should also avoid giving fizzy drinks in a bottle. Cooled boiled water and milk are the ideal fluids for development and growth.

5. Baby teeth and soothers

Using dummies after 12 months can cause an open bite, which is when teeth move to make space for the dummy. They may also affect your child's speech development.

If choosing a soother, however, opt for an orthodontic one, available in most Pharmacies. Avoid dipping a soother in sugar or any sugary snacks.

How many teeth?

Every baby is born with 20 baby teeth under their gums. By about 6 to 7 months old, your child's first teeth begin to appear. By about 2 and a half years old, your child will have the full set of 10 teeth on the top and 10 teeth on the bottom gum.

The baby teeth usually start to fall out from about 6 years of age. The first permanent molar teeth are the first permanent teeth to arrive and replace them, quickly followed by the permanent incisor teeth.

This pattern of loss and replacement continues up to around the age of 11 or 12.

Information adapted from NHS, Health Journal, Patient Info & HSE