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Do you have teeth questions at your appointments with the pediatrician? Are you trying to prevent early childhood cavities in your family? Or, are there dental questions you wished you had asked? You’re not alone. Today, I’m going to cover the most frequently asked questions about kids’ teeth, from a pediatrician’s perspective.

When does my child need to see a dentist?

Both the American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) recommend babies see a dentist as soon as they start getting teeth, and no later than age 1 year. In other words, all kids should have had a routine visit by their first birthday. This may not be possible in all communities, so I would advise any parents to make sure they mention teeth at their child’s one-year-old check up with their pediatrician.

Also, in my anecdotal and personal experience, it’s worth it to see a pediatric dentist if possible. Yes, there are wonderful general dentists too. However, there is something special and different about an office where every interaction and staff member is equipped and excited to work with children.

These first visits are gentle and informative. It’s the perfect time to get established with a dentist, ideally before there’s any emergent need. Some families appreciate already knowing who to call if their little one has a tooth injury.

When do babies start teething?

On average, babies get their first tooth at around age 7 months. Some babies are born with teeth. Some don’t get their first tooth until after age 12 months. It’s a wide range of “normal.”. As soon as a baby has teeth, dental hygiene must begin in earnest (more on that below).

When should I start brushing my baby’s teeth in order to prevent early childhood cavities?

Before they have teeth, it’s reasonable to wipe their gums and tongue regularly with a clean wet wash cloth. As mentioned earlier, tooth brushing needs to start as soon as that first tooth pops through the gums. This means using a soft-bristled brush and brushing with fluoride-containing toothpaste. Fluoride helps prevent cavities. Ideally, they’ll brush after breakfast and at night after their last solid food.

For children under age 3 years, the AAP recommends a smear of toothpaste smaller than a grain of rice. At these young ages, toddlers and babies will probably swallow the toothpaste. The amount is considered safe for twice daily brushing. A big benefit of the fluoride in toothpaste comes when it actually touches the teeth. So, gently brushing on all exposed teeth will help. Please note that this is general information. Many cities have fluoridated water. Some kids take vitamins with fluoride. Some dentists and pediatricians apply fluoride directly to teeth during appointments. Because there are a few variables, it’s a great conversation to have with your child’s pediatrician or dentist.

Over age 3, or when a child can reliably spit, the amount of toothpaste can increase to about the size of a pea. Kids should then spit out the excess toothpaste.

Is my baby teething right now?

This is a really common question! As I told many parents, sometimes the first sign of teething is . . . a tooth! Some kids don’t show many symptoms. And, some have all the classic signs of chewing on things more, fussiness and swollen gums. Here are things I would love for all families to know:

First, many babies at around age 3-4 months start to look more “drooly.” You might see more strings of saliva than before. They shouldn’t have any trouble breathing or swallowing, but rather just a bit more drippy. By about 6 months, they’ve been putting their hands (and toys) in their mouths more too. Both things can happen even if they’re not teething.

Second, a fever (more than 100.4 F) is not due to teething. Ever. If a child has a fever, please address it like a “real” fever and don’t ignore it by just thinking it’s teething.

(If you think your child is uncomfortable due to teething, please chat with your pediatrician or dentist about the best approach. Many times chewing or sucking on a cold wet towel provides as much relief as anything else. It’s like a little cool massage. And, there’s no evidence behind amber beads for teething).

Do childhood cavities really matter? They’re just baby teeth.

Yes. Aside from the obvious pain and discomfort for kids with tooth decay, there are bigger risks too. Let’s pause a moment, though. Pain and discomfort are real issues that we should try to prevent. Tooth pain can lead to missed school, poor sleep, and a restricted diet, just to name a few things.

Early childhood cavities can affect a person’s health overall. This means, if a child has cavities, they usually need to be addressed (I’ll leave it to my dentist colleagues for details of when and how). For many children, dental procedures happen under anesthesia. While often done safely, it’s an added risk that can be avoided with good dental care.

Do I need to stop breastfeeding once my baby has teeth?

No, you do not need to stop. If a baby has latched properly, they can safely breastfeed without any issues. With a proper latch, their teeth don’t come into contact with the nipple. (Biting just before or after feeds is another issue entirely. Kellymom.com has a helpful article on the topic).

For information on preventing cavities in babies who breastfeed at night, see this post.

What else can I do to keep my kids’ teeth healthy?

Okay, full disclosure here. Few people ever asked me this question. So, I’ll offer the following unsolicited:

Children and babies do not need to drink juice or soda. By simply removing sugary drinks from their diets, we’ll go a long way in preventing tooth decay. If a child needs to drink juice for a specific reason (constipation for example), they can drink it in one sitting. Sipping on sugar all day is not good for teeth. Cavities come from bacteria plus sugar. So, if we eliminate extra sugar? It makes a big difference. After age 1 year, water is enough. As a reminder, babies should not drink plain water before solids are introduced.

For a final answer: Yes, we can prevent early childhood cavities.

Most kids can have healthy teeth with just a few steps at home. It helps to brush with fluoridated toothpaste twice a day and avoid extra sugar. Children should also establish care with a dentist by age one year.

(If you’re interested in more baby FAQ, please check out my newborn booklet, available on Amazon):

Note: This post may contain affiliate links. As an Amazon Associate I may earn a small commission on qualifying purchases at no additional cost to you.

Photo by amirhosein esmaeili on Unsplash.

Maya M. Mahmood, D.O., FAAP is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.

Disclaimer:

This is for information only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.