Teething is an exciting time in your baby’s development, but it can also be a challenging time for you and your baby. This brochure has been developed to help you understand what to expect, as well as provide some helpful advice on how to care for your baby’s new teeth. If you have any concerns, be sure to speak to your dentist or healthcare professional.
Your baby’s teeth will be forming in their jawbone before they are born, but it’s not until about 6 months old that most babies will actually get their first tooth. Teething ages and patterns vary between children, depending on genetics and external environment. Most children have their full set of 20 primary teeth by about age 3. At this time, the second or permanent set of teeth are already forming in the jaw, and these will erupt between the ages of 6 and 16 years.
Baby teeth, also known as milk teeth or deciduous teeth, are precious and are just as important as permanent teeth. They help:
- Reserve spaces in the child’s gums for theirpermanent teeth to erupt.
- When a baby tooth is lost too early, the permanent teeth can drift into the space where the absent tooth was, creating problems with correct alignment.
- Speech development and the ability to chew food.
- Enhance a child’s appearance and, in turn, their self esteem.
Many babies experience some degree of discomfort when they are teething, but some do not. Teething symptoms are unique to every baby, and there is a wide variation in normal teething behaviour.
Symptoms of teething may include:
- sore, red or swollen gums
- teething blisters (eruption cyst), which can look like a blood blister or bruise on the gum; treatment is usually not needed
- irritability and crankiness
- a low-grade fever
- red cheeks
- changes in appetite i.e. not wanting to feed as often or as much
- changes in bowel motions
- a need to chew and gnaw on toys
- pulling at their ears, often on the same side as the erupting tooth.
Here are some tips that might help:
- With clean hands, and using the pad of your thumb, gently rub your baby’s gums with your finger.
- Give your baby a teething ring or a wet washer to bite down on.
- Offer non-sweetened teething rusks to chew on.
- Give extra feeds, cuddles and comfort.
- Speak with your doctor or pharmacist before giving your baby pain relief medication or teething gels or powders.
- Always follow the manufacturer’s instructions regarding dose and frequency of medications.
If you are worried about your baby or feel that their symptoms may not be due to teething, it is important to have them examined by a doctor.
What is it?
Tooth decay is damage that occurs when bacteria in the mouth slowly weakens a tooth, eventually leading to a cavity or hole (also known as caries). It can cause pain, infection and even loss of the tooth, if left untreated.
What causes it?
Plaque, the sticky substance that forms on your teeth after eating, contains bacteria. This bacteria feeds on sugars in the food you eat and produce acid, which causes calcium and phosphate to be lost from the tooth enamel (hard, outer surface of the tooth). If this process continues over time, the enamel is weakened and destroyed, causing decay. Brushing teeth is effective in preventing decay because it disrupts the build-up of bacteria on the teeth.
Ditch the bottle!
Baby feeding bottles can lead to a unique form of infant tooth decay known as bottle caries, early childhood caries (ECC), or baby bottle tooth decay. It most commonly effects the upper front teeth but can effect other teeth as well.
Milk contains a form of sugar, known as lactose, so infant teeth can decay when they are in prolonged contact with milk. That is why bottles should only be used for feeding, not for pacifying. It is important to avoid putting your baby to bed when they are sucking on a bottle. Instead, wait for them to finish drinking their bottle before putting them to bed.
Ideally, encourage your baby to drink from a cup from about 6 months of age, and try to stop all bottles from the age of 12 months.
Did you know?
Baby teeth are more prone to decay than adult teeth because they have a thinner enamel coating.
How is it treated?
Early tooth decay can be corrected by a dentist scraping the teeth and removing the plaque. More advanced decay requires drilling the decayed portion of the tooth and filling it. Toothache in children is almost always caused by dental decay. If your child complains of toothache, it is important that you take them to a dentist as quickly as possible.
On the next few pages is some important advice to help you take care of your child’s teeth and prevent decay, from newborn to toddler and beyond.
1) Be careful with your own oral hygiene.
The bacteria that causes tooth decay is highly contagious, and it is easy for parents who have active tooth decay to pass this on to their baby, even in the newborn period.
- Don’t share eating utensils with your child.
- Don’t taste food to check its temperature before offering it to your baby.
- Don’t put your baby’s dummy in your own mouth.
- Don’t share a toothbrush with your child.
2) Don’t fill your baby’s bottle with any fluid other than milk or water.
3) Clean your baby’s gums before they even have any teeth. This can help them become used to the sensation.
4) Start cleaning your baby’s teeth as soon as their first tooth erupts.
- Using a clean washer or a finger wrapped in clean gauze, wipe all the surfaces of each little tooth. Doing this twice a day will help to remove plaque from building up.
- Once your baby is about 1 year old (or younger, if they are cooperative), start using a soft, small headed children’s toothbrush to clean their teeth.
5) Ensure your child is eating a healthy diet that is low in sugar.
- Foods that help to support the formation of tooth enamel contain calcium, phosphorus, vitamin A and magnesium. These foods include milk and dairy foods, meat, eggs, fish, bananas, wholemeal bread and dark leafy vegetables.
- Fruit juices, muesli and fruit bars, lollies and carbonated soft drinks are all high in sugar, which may lead to tooth decay.
- Encourage your child to eat hard cheeses, which have been shown to provide preventative benefits when eaten after a meal.
6) Teach your child how to look after their teeth, including brushing twice a day.
- Help brush your child’s teeth until they have the manual dexterity to do a thorough job themselves (at about 8–9 years old).
7) Start flossing your child’s teeth when they are about 2½ years old.
- Aim to do this at least twice a week, especially where teeth are touching each other. This helps to remove plaque and food debris building up between the teeth and along the gums.
- Preventative dental sealants (a thin layer of plastic liquid) are also very effective in reducing the risk of decay occurring.
8) Watch your child’s teeth for any signs of early decay.
- Lift their upper lip gently so that you can see the whole tooth, including the gums.
- White lines along the gum line can indicate early decay. Brown or damaged spots on the teeth can also mean decay is present.
- The majority of decay occurs either in the grooves on the chewing surfaces of the primary molars, or between the two back teeth.
9) Take your child to the dentist every 6 months.
When is my baby ready for their first visit to the dentist?
The Australian Dental Association recommends that a child’s first visit to the dentist should be within 6 months of when their first tooth erupts, or by their first birthday.
You may wish to consider taking your child to a paedodontist, which is a dentist who has had additional training and qualifications to specialise in children’s dentistry.
Alternatively, many parents find that taking their child to the dentist during their own regular check-ups helps to build confidence and familiarity. Positive parental role modelling helps to support good oral care in children.
A step-by-step guide to brushing your child’s teeth
- Until your toddler is 18 months old, use onlywater on the toothbrush; from the ages of 18 months to 6 years, use a pea-sized smear of fluoridated, children’s toothpaste.
- Position your child where you can see their mouth clearly – either sitting on your lap with their head tilted back, or facing away from you while resting the back of their head on your chest (for a similar brushing action to when you brush your own teeth).
- Brush every surface of each tooth. Brush the grinding and biting surfaces of the large back molars with a firm backwards and forwards motion.
- Aim for a total brushing time of 2 minutes, twice a day. You may need to build up to this if your child isn’t cooperative.
- Encourage your child to spit out the toothpaste after brushing and not to swallow.
Did you know?
Children’s toothpaste has a different flavour and concentration of fluoride. The tubes are also smaller to avoid overdosing if the toothpaste is swallowed.
- Replace your child’s toothbrush every 3 months or when the bristles are frayed.
- An electric or battery-operated toothbrush may be more acceptable to your child. Most have a timer attachment that helps to monitor the correct length of brushing time.
- Encourage your child to look in a mirror or at a story book while you are brushing their teeth.
- Praise your child when you are finished.
- Let your child have a turn brushing their own teeth, but always follow this up by doing it yourself as well.
- Consider using plaque disclosing tablets. These help to determine if your tooth brushing technique is effective at removing plaque.
What should I do if my child complains when I clean their teeth?
It’s not uncommon for infants and young children to complain when having their teeth cleaned. This is often due to the need to stay still when they would rather be busy. Because of this, some parents avoid brushing their child’s teeth, or just get their child to do it and hope it will be enough.
But teeth cleaning is such an important part of overall health management that it is worthwhile persevering and finding ways for your child to become more cooperative. Aim for tooth brushing to be fun, and offer a reward for allowing 2 minutes of brushing time.
Many babies suck their thumb, but most outgrow this natural soothing behaviour between 2–4 years of age. If a child is still thumb or finger sucking when their permanent teeth emerge, they can have problems with the alignment of their teeth.
Dummy sucking, just like thumb sucking, provides a means of infant soothing. Some parents feel that their child sucking on a dummy is preferable to using their thumb; however, both pose potential dental problems.
If you are concerned about the shape or position of your child’s teeth, a review by your dentist would be useful. Early assessment by an orthodontist may be necessary in order to monitor the eruption and position of the permanent teeth.
If your child uses a dummy, avoid:
- Putting sweet substances such as sugar, glycerine, honey or jam on it.
- Sucking on the dummy yourself before putting it in your baby’s mouth.
- Using a dummy that has been in another child’s mouth or has dropped on the floor and not been washed.
- Using a dummy which is damaged or has perished; dummies should be replaced regularly.
- Using a dummy beyond your child’s first birthday.
There are many old wives’ tales when it comes to teething in babies. Although some may sound convincing, they may not be supported by scientific evidence. Here we ‘bust’ some common myths you may have heard about teething.
Amber bead necklaces help with teething discomfort
Fact: There is no evidence that teething pain is relieved when a child wears an amber bead necklace. They may even pose a risk of choking.
Rubbing alcohol on a child’s gums helps to relieve teething pain
Fact: Children should not be exposed to alcohol, either through ingestion (drinking) or topical application on their gums.
Teeth move up and down in a child’s gums
Fact: Localised gum swelling can disguise the crowning tooth. As the swelling settles, more of the new tooth can be seen.
Early teething is a sign of intelligence
Fact: Teething is highly individual and unique to each child. The ages when children’s teeth erupt are not a marker for intelligence or developmental advancement.
Baby teeth don’t matter because they are going to fall out anyway
Fact: Baby teeth are very important and need to be looked after, because otherwise they may be the start of dental problems when the child grows older.
Once a tooth is knocked out, it cannot be reimplanted
Fact: A knocked out tooth can be saved by placing it in milk and getting immediate first aid dental care.
If you are worried about any aspect of your child’s oral health, consult with your dentist. Alternatively, your child may qualify for free dental care under the Child Dental Benefits Schedule or your local public hospital. Remember, if problems do exist, early assessment and treatment lead to the best outcomes.
One of the best ways to care for your baby’s teeth is to look after your own. Setting a good example for oral care teaches children that teeth are important and worth looking after. Below is some advice on how to care for your own teeth.
- Take extra care of your teeth during pregnancy, when you may be more prone to gum disease.
- Left untreated, inflammation and gingivitis can develop into a gum infection known as periodontitis. Research has shown a link between periodontitis and premature birth, including babies with low birth weight.
- Have regular dental checks – the Australian Dental Association recommends a dental review every 6 months.
- Brush your teeth twice each day with fluoridated toothpaste.
- Brush your tongue with a clean toothbrush or a tongue scraper, to remove bacteria.
- Floss your teeth daily, and consider a dental check-up if your gums bleed.
- Drink fluoridated tap water, as most bottled water does not contain fluoride. If you are unsure if your drinking water supply is fluoridated, check with your local council.
- Wear a mouthguard if you play contact sports, or at night if you grind your teeth during sleep. This helps to avoid damage caused by undue force on your teeth.
- Avoid foods and drinks that contain a lot of sugar.
- Drink water and/or chew sugarless gum if you cannot clean your teeth after meals.
Breastfeeding is the normal method of infant feeding, and is best for babies. It has benefits for the infant, such as reducing infection risk, and for the mother. It is important to have a healthy balanced diet in preparation for, and during breastfeeding. Infant formula is designed to replace breast milk when an infant is not breastfed. Breastfeeding can be negatively affected by introducing partial bottle-feeding, and reversing a decision not to breastfeed is difficult. Infant formula must be prepared and used as directed. Unnecessary or improper use of infant formula, such as not properly boiling water or sterilising feeding equipment, may make your baby ill. Social and financial implications, including preparation time and the cost of formula, should be considered when selecting a method of infant feeding.