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What busy parents need to know about caring for baby’s first tooth

By Dr. Erika Rowe

Yesterday you were just wiping gums at bedtime but after a week of drooling and chewing on everything, your baby’s first tooth has arrived! What now? Here’s what a busy parent needs to know about caring for them?

The American Dental Association and the American Academy of Pediatric Dentistry recommend that your child’s first dental visit occurs within six months after their first tooth erupts. Even if they haven’t had a tooth erupt, you still want to take them in for a visit no later than their first birthday.  Tooth decay can begin as soon as that first little tooth has come through. “Happy Visits”, where a quick visual inspection is done with the child on a parent’s or caregiver’s lap, are a great way to get started with a positive experience at the dentist.

If you’re reading this and have yet to take your 3-year-old to the dentist, don’t worry! Simply call and make an appointment now. The sooner you can get in, the better! No parent shaming here. Your child’s first dental visit is likely to involve a simple meet-and-greet, along with a quick check of their teeth. The dentist or hygienist may also do a simple cleaning if the child is willing.

When it comes to the health of our kiddos, no question is ever too silly! Always feel free to ask your dental team about any questions or concerns you may have. Starting early will give your child a great foundation for a lifetime of healthy teeth! Here are some of the most common questions we get asked.

At what age can we begin using toothpaste?

For a very long time the American Dental Association (ADA) suggested parents wait until children reached the age of three before using fluoridated toothpaste to care for the little ones’ teeth. That recommendation changed in February of 2014, with the new best practice being that parents begin using what the ADA calls a “smear” of toothpaste as soon as children’s teeth begin to emerge.

A “smear” is about the size of a grain of rice for children younger than 3 years old, and a pea-size amount is recommended for children 3 to 6 years to help prevent cavities. The toothpaste needs to be spit or drooled out. In the toddler years, independent practice brushing is a great way to start learning to brush on their own, but a parent should then go in and brush the child’s teeth as well.

Does milk or formula cause tooth decay?

Whether your baby is nursing or bottle feeding, the frequency of intake and ability to cleanse are the two most important things to consider in reducing the risk of tooth decay. Cavities happen when the bacteria that live in our mouths eat what we ingest and produce acid that breaks down our teeth.

On-demand feeding, where a baby is eating small amounts and starting and stopping, allows the pH of their mouth to change many more times than scheduled and complete feedings. Another factor that can make a baby more susceptible to cavities over time is tongue and lip ties. When the tongue cannot reach all over the mouth to cleanse, or the lip cannot be lifted all the way, milk can get stuck in the vestibule,–the space between the cheeks and teeth. This is why gently wiping down a baby’s gums even before teeth erupt is so important.

Can pacifiers negatively affect my baby’s teeth?

Yes, pacifiers can affect your child’s teeth and the way they occlude or come together. But most experts say that if you curb the habit by the age of 2, and the pacifier is used with moderation and not all day, any dental malocclusion will resolve itself as the child grows. Overuse can lead to an anterior open bite, a crossbite, an unusually narrow palate (roof of the mouth), or a wider-than-normal upper arch. Thumb sucking can lead to these same challenges.

Is teeth grinding in little kids a concern?

For many years the dental community thought as children grew and teeth erupted that grinding was normal and no big deal. We know better now and when a child is grinding it can indicate a much larger problem called sleep-disordered breathing. If your child is sleeping with their mouth open, grinding, or sucking on their thumb during sleep hours, it may mean they are not able to seal their tongue to the roof of their mouth and may not be getting enough oxygen when they are sleeping. Many things like tongue ties can contribute to this, but the good news is it can be resolved. There is a great resource on thehealthystart.com/quiz to see if your child is exhibiting signs of Sleep Disordered Breathing (SDB).


Drs. Kurt and Erika Rowe, parents to Kole (12) and Lilly (9) received their DMD from University of Pennsylvania School of Dental Medicine in Philadelphia, PA. Their practice Rowe Family Dentistry is in Paradise Valley, AZ. rowefamilydentist.com 

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