Children’s Teeth

Oral hygiene starts in infancy

A child's first teeth might be soon replaced by a second set - but 'milk' teeth can be as important as permanent teeth and need the same level of care to prevent decay. These first teeth are essential for chewing, speech development, and the successful eruption of adult teeth.² It can even arise that if a baby's first teeth are removed because of dental decay, it may cause overcrowding later on.

What causes tooth decay?

Tooth decay (dental caries) is caused by acid produced by bacteria in the mouth - this acid attacks the teeth, causing decay. Sugary and starchy foods encourage bacteria to produce acid ^3,4. Decay-causing bacteria can also be passed on to babies and children by parents and other carers - that's why it's a good idea not to put a baby's spoon, dummy or bottle in your own mouth.⁵

How can I assist in preventing tooth decay in my child?

• Limit sugary drinks and snacks. This includes so-called 'healthy' snacks such as fruit juices, fruit bars and muesli bars. Instead, encourage your child to eat fruit and vegetables and to drink water instead of soft drinks and juice.^3,4
• Brush your child's first teeth. To get them used to brushing their teeth, clean your child's first teeth and permanent teeth twice a day - morning and night.  Starchy foods such as bread, pasta, crackers and milk products can encourage acid production, so regular cleaning is vital.^4,5
• Don't put your child's cutlery in your mouth. Sharing items with your baby can transfer decay causing bacteria from your mouth to your child.⁵
• Lead by example. Children tend to imitate their parents' behaviour. Let your child watch you brush your teeth and teach them how to brush their own.⁵
• Offer your child water before bed. Tooth decay can be caused by frequent, long term exposure of a child's teeth to liquids containing sugars. Milk contains natural milk sugar (lactose).  If a child falls asleep with a bottle containing milk, formula or other sugary drink, their teeth are bathing in a pool of sugar which will eventually lead to decay.⁶
• Encourage your child to drink from a cup. From six months old, introduce your child to a feeding cup, and in most cases they won't need a bottle by 12 months.^4,6
• Have regular preventative dental check-ups. The Australian Dental Association recommends children visit a dentist within six months, and no later than 12 months, of their first tooth appearing.² Regular checks at least once a year are recommended to help early diagnosis of any problems and prevent dental disease.⁴

When should I start brushing my child's teeth?

Once the first teeth appear, the Australia Dental Association recommends that parents use a soft infant tooth brush to clean their baby's teeth twice a day.⁵ From around the age of four to five they can begin to brush their own teeth, but will need your help until around eight years of age.⁷

When should my child use fluoride toothpaste?

Until your child is 18 months old, clean their teeth with water, not toothpaste ^3,4. This is largely because toothpaste contains fluoride. While fluoride is essential for building strong teeth, babies can ingest and absorb too much, causing fluorosis - a build up of white marks on their teeth. The Australian Dental Association recommends using low-fluoride children's toothpaste from the age of 18 months.³ Apply just a smear of toothpaste and make sure your child spits it out after brushing.

If you live in an area where fluoride is not added to the water, ask your dentist for advice.

Good hygiene for toothbrushes

These steps may help prevent transferring decay-causing bacteria from person to person:

• Ensure your child's toothbrush is rinsed thoroughly before being put away.
• Air-dry your child's toothbrush - bacteria grow on wet toothbrushes.
• Store toothbrushes in such a way that they are not touching each other.
• Don't share a toothbrush with your child.^4,7

Should I floss my child's teeth?

You can start flossing your child's teeth at around two and a half years of age.⁵ This helps remove decay-causing bacteria from between the teeth.

• Gently slide the floss between your child's teeth and work it up and down; be careful not to let the floss cut into the gum.
• After flossing, have your child rinse their mouth out with water.
• Ideally, you should floss your child's teeth at least twice a week. If you find flossing difficult, ask your dentist to show you how.

Tips for making brushing and flossing fun

Making brushing and flossing as enjoyable as possible encourages toddlers to co-operate. The Australian Dental Association suggests:

• considering a battery-powered brush which adds novelty value.
• singing nursery rhymes or playing favourite songs while you brush your child's teeth.
• offering a reward (not sweets!) each time your child lets you brush for two minutes.⁵

Further information

• Australian Dental Association
  www.ada.org.au

Sources

1. Australian Institute of Health and Welfare. A Picture of Australia's Children, 2009 (online). (Accessed 24 Nov 2010) Available from: http://www.aihw.gov.au/publications/index.cfm/title/10704  
2. Australian Dental Association. Tooth Development in Babies and Toddlers (online). (accessed 24 Nov 2010) Available from: http://www.ada.org.au/app_cmslib/media/lib/0711/m102967_v1_tooth%20dev_factsheet.pdf
3. Australian Dental Association. Healthy eating equals healthy teeth (online). (accessed 24 Nov 2010) Available from: http://www.ada.org.au/app_cmslib/media/lib/0711/m102959_v1_healthyeating_factsheet.pdf
4. Department of Human Services. Oral Health Promotion: A Practical Guide for Children's Services (online). (accessed 24 Nov 2010) Available from: http://www.dhs.vic.gov.au/health/dentistry/downloads/oralhealth_childrenservices.pdf
5. Australian Dental Association. Oral Hygiene for Babies and Toddlers (online). (accessed 24 Nov 2010) Available from: http://www.ada.org.au/app_cmslib/media/lib/0805/m128283_v1_oral%20hygiene_factsheet_.pdf
6. Australian Dental Association. Caring for Teeth for Life (online). (accessed 24 Nov 2010) Available from: http://www.ada.org.au/app_cmslib/media/lib/0711/m102734_v1_media_release_babies_%20toddlers.pdf
7. Raising Children Network. Baby dental care (online). (accessed 24 Nov 2010) Available from:  http://raisingchildren.net.au/articles/dental_care_babies.html?highlight=teeth

Last published: 2 December 2010

Disclaimer
This information has been developed and reviewed for Bupa by health professionals and to the best of their knowledge is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice. Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the recommendations or assessments and is not liable for any loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.