Department of Health
John J. Dreyzehner, MD, MPH, Commissioner

Your infant depends on you for everything, including oral health. Good oral health practices should begin when your child is an infant. As parents, we need to realize that a baby's teeth are at risk for decay as soon as they appear in the mouth (see Early Childhood Caries).

• Teething may make your baby's gums sore and tender. If a fever is present, consult your pediatrician. A teething ring, clean finger, or small cool spoon can provide comfort.
• A baby's first tooth usuallyappears around six months of age. By three years of age, all 20 primary teeth should be visible (see Primary Teeth Eruption Chart).
• Sucking is a natural, soothing reflex for babies. Prolonged use of pacifiers and finger sucking can affect oral development.
• Wean your child from the bottle by the first birthday. Begin by offering liquids from a cup.
• After each feeding, wipe your baby's teeth and gums with a clean, damp cloth or gauze.
• Once the first tooth erupts, begin using a small, soft-bristle toothbrush to clean your child's teeth. Toothpaste is not recommended for cleaning an infant's teeth.

The preschool years are an important time to help your child establish good oral health habits. Tooth decay is the major cause of tooth loss in children (see Preventing Tooth Decay). Since children at this age are unable to clean their own mouths effectively, parents need to provide this care for them.
 

• Be a good role model; allow your child to watch you brush and floss your teeth.
• Brush your child's teeth two times daily after the first tooth appears.
• Use a child-size, soft-bristle toothbrush.
• Use a pea-size amount (or less) of fluoride toothpaste once your child is able to spit.
• Floss your child's teeth daily when all 20 primary teeth are present (see Primary Teeth Eruption Chart).
• Good eating habits and snacking patterns begin during these years (see Nutrition).
• Plan balanced diets using a variety of foods from the five major food groups (see food pyramid).
• Help your child choose sensible snacks that do not promote tooth decay.
• Avoid using sugary snacks as a reward.

Pacifiers and finger sucking, if prolonged, can affect oral development. Usually children stop between the ages of  2 to 4 years of age.  If you are unsuccessful in breaking the habit, consult your dentist.

Yearly dental visits should begin by their first birthday. The dentist will instruct you on proper cleaning techniques, determine if additional fluoride is needed, and address any concerns you have regarding your child's oral health.

During these years, parents need to instruct, monitor, and motivate children to help maintain good oral health practices. Parents continue to be an influential role model for children; therefore, it is important for parents also to practice good oral health habits.

Plaque, a bacterial film that forms on teeth daily, will cause tooth decay and periodontal (gum) disease. Proper daily tooth brushing and flossing are necessary to remove this harmful plaque. For additional information see Preventing Tooth Decay and Preventing Periodontal Disease.

• Most children should be able to brush alone by seven years of age. This should be done twice daily.
• Most children should be able to floss daily, with supervision, by eight years of age.
• Use a pea-size amount (or less) of fluoride toothpaste.

  A well-balanced diet is essential for growth, development, and maintaining a healthy body. The mouth, like the rest of the body, needs a good diet (see Nutrition).

• Encourage your child to eat a variety of foods from the five major food groups (see food pyramid).
• Teach your child the importance of choosing sensible snacks that do not promote tooth decay.
• Avoid using sugary snacks as a reward.

  By six years of age, permanent teeth usuallybegin to erupt (see Permanent Teeth Eruption Chart). The permanent first molars (six-year molars) are often mistaken for primary teeth because they do not replace any primary teeth. These molars are important because they help other teeth come into their proper place.

• Dental sealants are used to protect the chewing surfaces of the (premolars and molars) back teeth.
• Premature loss of a primary tooth may result in malocclusion (crooked teeth) or malalignment (improper bite). Your dentist may recommend the use of a space maintainer to reserve space for the permanent teeth.

Injuries to the mouth occur easily, especially during childhood (see Preventing Oral Injuries). Anyone participating in sports activities that could harm the oral-facial area should wear a mouth guard.

The use of tobacco, in any form, can damage your child's health. Help your child learn about the dangers of tobacco usage.

Regular dental visits play an essential role in maintaining good oral health. During these years, it is important for the dentist to assess the growth of your child's teeth and jaws. Your dentist may refer you to a dental specialist, called an orthodontist, for treatment of malocclusion, if needed.