My baby didn’t seem like such a baby anymore when her first two teeth erupted around age 6 months. Who was this person sitting across from me at the table, gnawing on a piece of toast in a high chair?
The tiny milestone opened a floodgate of questions: What was I supposed to do with those two front teeth? How do I keep them clean and healthy? What dental products are baby-safe? Is fever a sign of teething? When do dentist appointments start?
Not all resources on the internet are consistent when it comes to advice about dental care in the first year of a baby’s life. It’s ideal to talk to a medical expert to determine what’s best for your child, so I spoke with Novant Health pediatrician Dr. Soren Johnson to bring his perspective into the mix.
Get the best care for you and your baby.
Should you wipe your baby’s gums daily before teeth come in?
Some dental resources say you should wipe your child’s gums with a damp cloth a couple of times a day before teeth come in. However, there’s not strong evidence for that being necessary from a medical standpoint. Bacteria naturally exists in the mouth and there’s a balance that’s important, so it’s best if you let it be.
Still, some babies do get a yeast overgrowth in the mouth called "thrush" — it’s a buildup of something called white plaques that won’t go away. This can easily be fixed with an antifungal prescription from your pediatrician.
When do a baby’s first teeth start to show up?
Like most childhood development stages, there’s a range of ages for the appearance of first teeth. While the 6 to 9 months is common, tooth eruption can happen at any time during infancy, from birth all the way to 15 months. The first teeth are typically the two lower front teeth.
Do you have to wait for teeth to start coming in before introducing solid food?
No, introducing solid food is more about helping your child develop oral skills like chewing and spitting, and experiencing different tastes and textures. Gums are hard and can handle many types of foods, working them down to bite-size, swallowable pieces. Also, “solid food” in pediatrics refers to any food that is not breastmilk or formula. We recommend starting with purees as the first solids.
What are signs of teething?
There’s a laundry list of symptoms that people attribute to teething, from drooling and chewing on hands to low-grade fever. But many of these symptoms are common during early development, so it’s hard to confirm that they’re connected to teething and they are not great predictors of when teeth are going to come in. Once you feel a sharp, bony piece in the mouth, that’s when you know the teeth have arrived.
What toothbrush type is best?
Any soft-bristled toothbrush that’s a child-appropriate size.
What toothpaste is best: non-fluoride or fluoride?
Historically, the recommendation was to avoid toothpaste that contains fluoride until a child can spit adequately. Consuming too much fluoride can cause nausea, or over time it can cause “flourosis,” which is the white discoloration of permanent teeth (even before they erupt). But updated guidelines from the American Academy of Pediatrics recommend that it’s safe to use toothpaste with fluoride twice a day as soon as teeth come in, as long as it’s a tiny amount.
Ultimately, fluoride toothpaste is better at preventing cavities. The trick is how much toothpaste you offer, since a baby will swallow whatever you put in their mouth. Try for an amount less than half a grain of rice until your child is reliably spitting.
Why do pediatricians offer a fluoride treatment when your baby’s teeth first come in?
Around the six-month checkup, depending on your baby, your pediatrician may offer a topical, fluoride-based varnish to apply to the new teeth. It’s stickier and more durable than toothpaste and will adhere to dental enamel to protect teeth better than just brushing. It’s often recommended every three to six months. Once your child starts going to a dentist, they can take over those treatments.
What’s a safe approach to relieving teething pain and discomfort?
Babies can enjoy teething toys but never use teething necklaces — these are a choking and strangulation hazard. Generally, it’s best to avoid teething medicines as well, due to health risks. For example, oral gels that contain benzocaine can cause life-threatening complications that are rare but do happen. If your child is truly in pain, it’s fine to try a dose of Tylenol to see if it helps. Check with your pediatrician for the right dosage based on your child’s weight.
Are certain store-bought teethers bad for teeth? Some are silicone, some are harder plastic.
Generally, silicone or rubber are best, since they are resilient materials, are free of harmful chemicals and are not a choking hazard. It’s best to avoid:
- Plastic teethers because they can crack.
- Putting any teethers in the freezer, because they could burn or stick to the gums.
- Teethers that contain liquids or gels, because you don’t want that substance to get into your baby’s mouth if the teether cracks.
When should your child start seeing a dentist?
Generally, you can start making these appointments as soon as your baby has a tooth. But not everyone has access to a pediatric dentist and in these first few years, it’s really all about good dental hygiene at home, brushing at least twice a day with toothpaste. Your pediatrician can be your resource for questions about brushing, toothpaste usage and more. By age 3, it’s good to establish a relationship with a dentist.
Are pacifiers bad for a baby’s jaw and teeth?
There are pros and cons. Some pediatricians may discourage pacifier use after a year because it can restructure the teeth a little bit if a pacifier is in a baby’s mouth around-the-clock. But lots of kids need that soothing habit for emotional regulation. There’s not a one-size-fits-all recommendation, so it’s a good conversation to have with your pediatrician.
