August 3, 2016

Do I need to clean my baby's gums before his teeth come in?

Yes. Even before your baby sports his first tooth, it's a good idea to get into the habit of wiping his gums with gauze or a soft wet washcloth during bath time. You don't need to use any toothpaste yet. Simply wrap the cloth or gauze around your index finger and rub it gently over his gums.

Bacteria in the mouth usually can't harm the gums before the teeth emerge, but it can be hard to tell when the teeth are starting to push through, so you'll want to start early. Getting your baby used to having his mouth cleaned as part of his daily routine should make it easier to transition into toothbrushing later on, too.

What's the best way to brush my baby's teeth after they start coming in?

As your child's teeth start to appear (generally around 6 months), look for a baby toothbrush with a small head and grip suitable for your hand. (If your child is healthy and still hasn't gotten her first tooth by the end of her first year, don't worry – some children don't start getting teeth until 15 to 18 months.)

• Brush twice a day. Brush in the morning and right before bedtime.
• Use a tiny amount of fluoride toothpaste. To avoid giving your child too much fluoride, use a thin smear of toothpaste or a dot the size of a grain of rice.
• Brush gently on the inside and outside of each of your baby's teeth, as well as her tongue (if she'll let you), to dislodge bacteria that can cause bad breath. Since you're using such a small amount of toothpaste, there's no need to rinse.
• Replace the toothbrush as soon as the bristles start to look worn or splayed.

For now, your baby's teeth are probably far enough apart that you don't have to worry about flossing. In fact, there's no evidence that flossing baby teeth makes a difference. Most dentists recommend starting to floss when tooth surfaces touch and you can't clean them with a toothbrush.

How can I tell if my baby is getting the right amount of fluoride?

Your baby's developing teeth can benefit from a little fluoride. (The amount recommended for children under 3 is .25 milligrams per day.) This mineral helps prevent tooth decay by strengthening tooth enamel and making it more resistant to acids and harmful bacteria.

Your baby can get fluoride from toothpaste, water, supplements (if necessary), and a fluoride varnish that his primary healthcare provider or dentist can apply to his teeth.

Note: In general, it's not a good idea to give your baby water until he's about 6 months old. Until then, he'll get all the hydration he needs from breast milk or formula, even in hot weather. Read more about giving water to your baby.

If the water you use to make your baby's formula contains fluoride, he'll get fluoride from his bottle feedings. Most municipal water supplies are fortified with adequate fluoride. (Call your local water authority to find out about yours). Read more about what kind of water to use to prepare baby formula.

If your municipal water supply isn't fluoridated or you get your water from a well, you might consider buying a test kit from your local health department, a hardware store, or a pharmacy.

If the fluoride content is less than .3 parts per million, ask your child's doctor or dentist whether you should give your child a fluoride supplement. The doctor can prescribe fluoride in the form of drops that you can add to your baby's bottle or cereal once a day. Experts don't recommend fluoride supplements for babies under 6 months old.

Bottled water and fruit juices may contain fluoride, although the amount isn't always listed on the label.

Keep in mind that while a little fluoride is a good thing for your baby's teeth, too much of it can lead to a condition called fluorosis, which causes white spots to show up on your child's adult teeth. This is why it's important to use only the tiniest amount of toothpaste until your child is old enough to rinse and spit it out.

When should I start taking my baby to the dentist?

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend that you take your child to the dentist within six months after her first tooth erupts, or by her first birthday, whichever comes first.

In the meantime, at every well-baby visit, your baby's primary healthcare provider should take a look at your baby's teeth (if she has any) and apply fluoride varnish every three to six months, depending on your baby's risk of cavities. Risk factors include a family history of cavities and poor dental health in the mother during pregnancy.

When you do take your child to the dentist, be sure to communicate what fluoride treatments your baby has already received at the doctor's office.

If you can't afford dental care for your baby, consider getting in touch with your local health department to ask about resources.

Do certain foods cause tooth decay in babies?

Certain foods can contribute to cavities. Sweet foods like these are a common culprit:

• fruit
• dried fruit
• juice
• peanut butter and jelly

Starches can also contribute to cavities:

• breads
• crackers
• pasta
• pretzels

Serve these foods at mealtime rather than as snacks so they're more likely to get dislodged and won't sit on the teeth too long. Serving them with water is also helpful.

Don't put your baby to bed with a bottle of milk, formula, juice, or sweetened liquid. These liquids feed bacteria in the mouth that cause tooth decay.

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