Baby dental hygiene

New recommendations from the Academy of Pediatrics suggest that you find a dentist for your baby by the age of one. Previously, the group had recommended that children first see a dentist at age three, with the thought that little could be done for those tiny little baby teeth. At either one or three, the dentist certainly will not have a cooperative patient unless the baby is extremely mellow, or the dentist is good at winning over wee ones.

But baby teeth do need attention. Babies start cutting teeth—usually the lower incisors come first—at the age of four months, on average, but there is tremendous variation. I have seen babies go as long as fifteen months before cutting the first tooth. Dentists tell me that they want to see a baby that has not cut a tooth by the age of fifteen months. If there is no sign that a tooth will be poking through soon, they would then do an x-ray to be sure that teeth are present. These very late bloomers are rare.

As soon as your baby has teeth, you should start to clean them to remove plaque and any sugar residues. Lactose is the sugar in milk products (unless the milk is lactose free) and should not sit on the tooth enamel for long periods of time. A simple piece of gauze wrapped around your finger is a good way to clean these early teeth. In the second year, your baby may let you brush his teeth with water or baby toothpaste. Do not use adult toothpaste, as babies do not spit out the excess paste and can ingest too much fluoride.

Fluoride is a mineral that helps prevent tooth decay. It is found in adult toothpastes, and it is added to most public water supplies. It is even added to some bottled water. If you are on well water, if you only use fluoride-free bottled water, or if your baby does not get any water, consult your pediatrician or dentist to see if your baby should take fluoride supplements. Luride drops are the usual way to give fluoride supplementation. It also comes as a tablet, for when your child is older and can swallow pills. Some dentists have seen staining of the teeth from too much fluoride, so get approval from a medical source before giving supplements to be sure your baby is getting the right amount of fluoride. Remember, too, that fluoride can be found in many foods as well.

Ideally, your baby should have his teeth brushed at least twice a day. It is helpful to establish a routine so that tooth hygiene is not neglected in the chaos of evening bedtime preparations or morning rush hour.

Some babies are born with stains or defective enamel. It is not clear if this is a genetic problem or comes from a mishap that occurred during pregnancy. There is also a condition called milk-bottle caries that causes black decayed teeth. “Caries” is the medical term for cavities. It was thought that cavities arose because babies went to bed with a bottle, and the lactose sugar would sit on the enamel and cause bacterial feasts, leading to decay. However, it is not clear that this condition is caused by baby bottles at night, as many babies who get nighttime bottles do not get this condition. However, it is a good idea to clean the baby teeth after feeding.

What do you do to keep your baby’s teeth healthy? What does your dentist recommend?

Wishing you all a Happy Holiday Season!

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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