A complete guide
What to do when your baby gets teeth
So, your child is getting their first baby teeth. Now is the best time to get them learning about oral health care and setting up healthy habits that will last a lifetime!
To help you get started, let’s talk about everything you need to know about baby teeth.
In this guide
Here’s a guide to your baby’s milk teeth
So, what teeth do babies get first, when do the rest come in, and when will they start falling out again?
Your baby’s first teeth – erupting
A baby’s milk teeth generally start to erupt at around the six-month mark. You’ll probably see little front incisors start to poke through on the lower jaw. Within a few months, the front upper teeth will come through, too.
The process of teething can last until a child turns around two to three years old, or about 33 months. All totalled, if everything goes normally you’ll see 20 teeth appear – quite a bit fewer than they’ll have as adults, but more than enough to help their development for now.
Teeth farther back in the mouth (i.e. molars) tend to come up later in life than those at the front.
Learn more: “My baby’s teeth are coming in crooked: What should I do?”
Your baby’s first teeth – shedding
After they turn three years old, your child will probably have all of their baby teeth. These will last for a few years more, usually until around six years old, at which point the process of ‘shedding’ typically begins - that is, their baby teeth will start to fall out.
The process of shedding milk teeth works in a similar order to their eruption in the first place. The front teeth (incisors) tend to pop out first, followed by teeth farther back in the mouth.
By the time your child is around 12 years old, they will probably have lost all of their 20 baby teeth, to be replaced by 28 permanent adult teeth. Wisdom teeth usually grow in much later, rounding their total teeth up to 32.
Looking after a teething child
Teething can be an uncomfortable experience, especially for a very young baby. But, there are things you can do as a parent to help soothe this process. Here are some quick tips:
Cold things can be quite soothing on sore, teething gums. You can put chew toys in the fridge to chill them down, or wrap bits of cold fruit in muslin to be chewed on. You could also wrap ice cubes in cloth and hold it to the outside of your baby’s face, but avoid putting ice directly on their gums as this can be painful.
Massage is often also soothing. If your child is uncomfortable, try applying gentle pressure to their gums with a clean finger, or rubbing in a light massage motion.
Your child may experience a variety of symptoms as they teethe, including irritability, drooling, discomfort, not eating or sleeping, and coughing or gagging. Each of these is relatively normal.
Signs that something may be going wrong include fever (37-38° C or higher), diarrhoea, bleeding or swollen gums, or pus on the gums. If you’re ever worried, and especially if your child experiences these latter symptoms, consider seeing a doctor as soon as possible.
Learn more: “Oral health in a teething baby: Everything you need to know”
How to look after baby teeth
Brushing your baby’s teeth properly
When to start brushing baby teeth
Oral health care starts as soon as your baby is born – even before they have their first teeth! You can clean their gums long before teeth erupt by wiping them with a clean cloth (don’t forget the backs).
Then, as they get more and more teeth, you can brush those with the advice we’ve listed below.
How to hold a young infant while brushing their teeth
As your child gets older it’ll be easier to brush their teeth – you can ask them to keep still, and even start teaching them how to brush their own teeth (see below on when to start trying this).
But when they’re very young and especially in those first years, you’ll need to hold and support your child properly so they feel secure enough to let you touch their mouth.
Place your baby on your lap, feet facing away from you.
Hold their body firmly in the nook of your two legs – be careful they don’t fall through the gap.
Lift their head and rest it on your chest.
Now you can brush your baby’s teeth while keeping them secure.
As they get older, you may find it easier to ask them to stand and tilt their head back.
Good brushing techniques to practice
Cupping their chin gently can help keep their head nice and stable.
Brush their teeth twice a day, with one of those times being just before bed.
Brush in soft, circular motions for their teeth, and gentle side to side (vibrating) motions over their gums.
Brush all the surfaces of their teeth, front and back, and try to get in the gaps.
Remember to also brush down to the gumline, holding the toothbrush at a 45° angle to the gums.
Gently clean their tongue, too.
Over time, teach your child to spit their toothpaste out. When they’re too young to spit, wipe excess toothpaste away with a clean cloth.
Don’t rinse their mouth with water. It’s better to let the fluoride (from their toothpaste) sit in their mouth – rinsing will wash it away.
How long to brush a baby’s teeth
After your baby turns one year old, brush their teeth for two minutes at a time. This time includes the front and backs of their teeth, as well as their gums and tongue. This is best practice for oral health at all stages of their life, and you’ll be setting them up with good habits right from the start by beginning now.
Before they turn one, and when they have very few if any teeth, you don’t have to brush for the full two minutes – just make sure each tooth is properly cleaned, and you’ve wiped their gums and tongue too.
Learn more: “How to brush your toddler’s teeth – and tips for when they refuse”
What toothbrush to use on a baby or young child
There are a variety of child-friendly toothbrushes available at most grocery stores, and especially supermarkets. But, here’s the kind of thing to keep an eye out for so you know what you need:
A brush with very soft bristles
Small toothbrush head (it’s going in a child’s mouth, after all)
Some adults like a child’s brush with a long handle
Other important tips about child toothbrushes
Whenever you use your child’s toothbrush, let it air-dry standing upright somewhere. Don’t get it wet and then close it up inside a container of some kind, as this can prevent healthy drying and promote the growth of bacteria.
Replace their toothbrush every three or four months (basically once a season). You might replace it sooner if the bristles get particularly worn or frayed.
If your child has had a cold, flu or other type of infectious disease, you may consider replacing their toothbrush immediately.
Can I use an electric toothbrush on my baby?
Yes, you absolutely can. There are plenty of child-friendly electric brushes on the market, some of which have built-in timers, lights and even songs.
The same rules apply here as they would for a normal brush. You’ll need a small one with soft bristles most of all, and you can replace the head once a season (or when applicable).
Before using an electric toothbrush on your baby, make sure to read the instructions. You’ll also still need to move it in gentle strokes around their mouth (they won’t do all the work for you, despite being electric).
When to teach a child to brush their own teeth
Children usually don’t have the right motor skills developed to brush their own teeth until they’re a bit older - older than the age group we’re discussing in this article, up to that six years’ mark.
After they turn around seven or eight, you can start to let your child brush their own teeth, at first supervising them until you know they can do it correctly, then letting them handle it independently.
Until that point, you’ll need to handle it for them.
But that’s not to say they can’t be involved
Young kids might not be able to do it themselves, but you can still teach them what to do from a young age and keep them involved.
As they get older, explain why you are doing what you’re doing and how it’s meant to be done. You can even let your child give it a go themselves, especially those easier front teeth, so that they start to develop the right skills even before they can do it alone.
What toothpaste to use on a baby or young child
Babies and young children don’t need the same amount of toothpaste we adults do, and you probably won’t want to buy the same type of toothpaste either (there are plenty of child-friendly versions on the market).
So, what should you be thinking about?
For babies and very young children, up to about five or six years old, use only a grain of rice’s worth of toothpaste each time you brush.
As your child gets older, has more teeth and is better at spitting, you can increase this to a pea-sized amount of toothpaste.
Use a toothpaste containing fluoride (see below).
Consider experimenting with different flavours. Some parents find that, if their baby fights them when brushing, it’s because they dislike their toothpaste. There are lots of varieties out there, and another might be more suitable for your child.
What is fluoride toothpaste?
Fluoride is a naturally occurring substance that has dental health properties. For example, it’s known to help fight bacteria in the mouth, repair damaged teeth and prevent decay (see source below).
Most toothpastes will include fluoride and these are the brands to look for for your child.
The Ministry of Health’s guidance for infants on the matter of fluoride is that parents should look for a product with at least 1,000 ppm (parts per million) of fluoride in it. On the box, this may be written as ‘contains 0.221% sodium fluoride’ or ‘contains 0.76% sodium monofluorophosphate’.
These might sound like scary chemicals but they’ve been in use for decades and have the support of major organisations such as the NZ Dental Association and World Health Organisation (WHO).
Learn more:
— Fluoride and oral health (health.govt.nz)
— Busting the myths about fluoride in Northland’s water
Can you use dental floss on a baby or young child?
You absolutely can, and in fact this can be a good habit to get into early as it will teach your child to keep this going their whole life – which is excellent for their oral health!
As your baby gets more of their baby teeth, their teeth will start to fit closer together. At this point you could consider flossing.
Is flossing necessary?
If your baby’s teeth aren’t close together (often baby teeth have a reasonable gap between even their closest neighbour), it’s not strictly necessary, no.
It is more necessary when their teeth are close together, as flossing can help remove any trapped debris and therefore make it harder for bacteria to grow in those hard-to-reach places.
However, even if it’s not necessary it’s always worth considering flossing now if only to teach your child about the habit and help encourage them to do it as they get older.
How to floss a child’s teeth
Unwind a good amount of floss (around 30-40 cm) and wrap most of it around each middle finger, leaving about an inch or so in between your two hands.
Gently slide the floss between your child’s teeth, being careful not to be too rough.
Curve it around one tooth and slide it up and down, then curve it around the neighbour in the same gap and slide it up and down again. Go right down to the gumline.
Their gums may bleed the first few times you do it, but this should stop. If it doesn’t, stop and consider seeing their dentist for advice.
Use a new section of the floss roll every time you move to a new gap.
Some parents find flossing with string hard, and instead use flossing sticks. You may have to experiment to see what works for your needs.
Can you use mouthwash on a baby or young child?
Antibacterial mouthwash is certainly a great tool for keeping a healthy mouth, but it’s usually recommended that children under the age of six not be given it. So, for our purposes today – discussing children who are still developing baby teeth – the short answer is: no.
Until they are older, your kids won’t likely have developed the swallowing or spitting functions they need to safely use mouthwash. It can be dangerous to ingest these products, so for now – consider avoiding it.
Checking your child’s mouth for decay
Keeping your child’s mouth nice and clean, as well as taking them for regular dental checkups (see below), will likely work wonders for preventing serious tooth decay. That said, you can make sure your child’s mouth is off to the best start in life by checking it once a month.
All you have to do is lift their lip and inspect the teeth that have come through. Decay may show up as chalky white spots or lines near their gums, or brown marks or cavities.
If you’re ever unsure, pop in to see your dentist and they can help you understand what you’re looking at.
Learn more: Lift the lip (NZ Dental Association)
Brushing the teeth of a child that is fighting you
It’s all very well having the best intentions, but we all know that children don’t always play along. So, what can you do if your child is fighting you?
Get help
Sometimes it pays to have help. If you have someone who can assist you, one person can distract your child and hold their hands to keep them out of the way while the other person brushes their teeth.
Make it fun
Distraction works wonders for children. So can you make teeth time fun? Playing games, singing songs, speaking in funny voices, or putting on music have all been used by parents around the world to help make this activity more enjoyable.
You could also give them a doll or toy to play with as you brush – and you could even encourage your child to ‘brush’ their doll’s teeth, helping instill these good habits, and the right motor skills, from a young age.
Some electric toothbrushes come in-built with lights and songs, and of course, different toothpaste flavours may also help make this activity better for your child.
When to take your baby to the dentist for the first time
If your baby has teeth, even just one, it’s time to start going to the dentist regularly!
Your baby’s first dental visits are going to set them up for life, and could make the difference between their feeling happy and confident in the dentist’s chair, and feeling anxious.
Plus, by going regularly, your dentist can help you keep an eye out for preventable oral health problems such as tooth decay, and offer advice on how to help the situation.
Learn more: “When to take your baby to the dentist for the first time”
How much will child dental visits cost?
It depends a little on the dentist.
In New Zealand, you can generally get basic dental care for children up to the age of 17 for free. This really will be basic care though, such as check-ups, x-rays, and very basic procedures (i.e. fissure sealants).
For more specific surgeries or to choose a dentist that you like which doesn’t receive funding from the Ministry of Health for children, you may be required to pay a fee.
What if my baby is anxious to see a dentist?
Dental anxiety and phobia happens to many, so it’s absolutely normal if your child feels nervous to visit us. But what can you do?
Knowledge is often power when it comes to certain fears. You can bring your child into the dentist at any point to talk to us and we can organise showing them around a bit, so they know what to expect.
You can also show them what a dental appointment will be like with videos online.
Positive words of affirmation and gentle encouragement go a long way with children.
Start small. Don’t wait until your child needs a major surgery before bringing them in for the first time. Small, simple checkups can help them feel more confident, so if those big surgeries are ever required they already have a bit of certainty in their minds and it’s not a big unknown.
Learn more: Dental phobia
Other oral health tips for a baby’s first milk teeth
Avoid dummies after 12 or so months
Every parent knows the wonders of the dummy/pacifier, but after a certain age these can be not so good for your child’s development even if they’re good for your peace and quiet.
The more a child uses a dummy after that 12-month mark, the more they are at risk of developmental issues in their mouth – namely an ‘open bite’, where their front teeth don’t connect with each other when they close their mouth. Basically, their teeth will have developed differently in order to allow space for the dummy.
This can also impact their speech development.
How to wean a child off a dummy
After they turn six months, start to think about restricting the use of a dummy. For example, only during sleep times.
Look for alternatives to a dummy for an upset toddler. Think of ways to distract them, or if they are genuinely upset, look for the cause and encourage them to express their feelings and explain what’s wrong so you can try to deal with it.
At some point you will have to stop using the dummy entirely. Different parents have had success here in different ways, so there’s no right answer. Some allow their children to self-settle and accept they may have a few sleepless nights as a result. Others try to explain why they are taking the dummy away, or get the ‘dummy fairy’ to do it in the night. These latter suggestions only work on children who can talk.
You can replace their dummy with something else, like a new toy or teddy.
Learn more: “When to wean your child off dummies – for their oral health!”
Avoid putting your child to bed with a bottle
Putting a baby to bed with a bottle is generally something to always avoid. Aside from the risk that your baby may choke as it feeds itself overnight, it’s really not good for their teeth.
Milk is great for babies but bacteria love it too. The longer it’s in their mouth, the more the bacteria around their teeth will be encouraged to grow. So, by putting your baby to bed with a bottle, they will have that liquid in their mouth for longer and, thus, feed the bacteria too.
Try to feed your baby before bed and clean their mouth before they go to sleep, to remove the source of food for bacteria and inhibit their growth.
What if I feed my baby in the middle of the night?
Some parents feed their babies overnight to soothe them and help them sleep again. However, if they are old enough for baby teeth to erupt they probably don’t need to be fed – it’s not necessary, so you don’t have to. You could consider exploring other means to soothe them instead.
If you do feed your child overnight, consider cleaning their mouth immediately afterwards.
What to do if your child is grinding their teeth
Teeth grinding, also known as bruxism, is a relatively common thing and even experts aren’t entirely sure of the explicit cause of the condition. There could be a few, you see, ranging from misaligned teeth to stress, discomfort (i.e. teething pain), and more.
How to spot bruxism in a baby or young child
Look for complaints that they have a sore face or jaw in the morning.
Chipped teeth with no obvious cause.
Grinding noise coming from their mouth as they sleep.
Pain while chewing.
How to treat child bruxism
For the most part, children who grind their teeth at night often grow out of it – especially if the cause of the bruxism is treated (i.e. if the discomfort ends).
Your dentist may prescribe a special night guard to help keep their teeth safe even if your child continues to grind them. You can pop in to talk to us on Maunu Road if you think this is right for your child.
Learn more: Bruxism
Offer your child healthy snacks and avoid sugar
Sugar might be incredibly common in our supermarkets, but it can be hugely damaging to teeth - especially a child’s baby teeth, which are not as resilient as permanent adult teeth.
When it comes to drinks, children really don’t need sugary drinks like chocolate milk or juice. Milk and water is sufficient and healthy, and both can be given in a sippy cup as they get older (from about six months onwards) in order to wean your child off breastfeeding or bottles.
The same goes for food. There are lots of children's products out there containing sugar, and these should be avoided. Check food labels before you buy and see how much sugar is in each product, so you know you’re getting the best for your child.
What if I want to treat my child?
Our advice is to avoid and cut down the use of sugary food and drink, but you can still offer it on occasion as a treat. For example, you may offer juice at a mealtime as a special occasion, but we would recommend diluting the juice (one part juice, 10 parts water).
There are many other ways to reward children, and we would encourage you to explore these as alternatives.
Of course, you’ll need to ask friends and family to follow these rules as well – in case your children get spoiled with chocolate and fizzy drinks at someone else’s house without your knowledge.
Ready to see the dentist? Come in and talk to us
Kowhai Dental is located on Maunu Road in Whangarei, and we’re ready to talk to you about the needs of your child and how we can help.
Making an appointment is easy:
More children’s dental guides:
Oral health in a teething baby: Everything you need to know →
What to do when your baby gets teeth: A complete guide
What to do when your baby’s teeth start to fall out: A guide →