Most babies get their first milk tooth at around six months, usually in the front and at the bottom. But all babies are different.
Some are born with a tooth already, and others have no teeth when they’re one year old. Most will have all their milk (or primary) teeth by about two and a half. There are 20 primary teeth: 10 in the top row and 10 at the bottom. The first permanent ‘second’ teeth grow at the back at around the age of six.
Some teeth grow with no pain or discomfort at all. At other times you may notice that the gum is sore and red where the tooth is coming through, or that one cheek is flushed. Your baby may dribble, gnaw and chew a lot, or just be fretful.
Teething tips
It can help to give your baby something hard to chew on, such as a teething ring, a crust of bread or breadstick, or a peeled carrot. (Stay nearby in case of choking.)
Don't give them rusks, because almost all brands contain some sugar. Constant chewing and sucking on sugary things can cause tooth decay even if your baby has only one or two teeth.
For babies over four months old, you can rub sugar-free teething gel on their gums. You can get this from your local pharmacy. For younger babies, talk to your GP or health visitor.
You could also give them some sugar-free baby paracetamol or ibuprofen. Follow the instructions on the bottle for your child’s age, or check with your pharmacist, GP or health visitor.
Caring for your child’s teeth
As soon as your baby’s teeth start to come through, you can start brushing them. Use a baby toothbrush with a tiny smear of fluoride toothpaste.
Don’t worry if you don’t manage to brush much at first. The important thing is to get your baby used to teeth-brushing as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.
Brushing tips
- Use a tiny smear of toothpaste for babies and a pea-sized amount for children.
- Gradually start brushing your child’s teeth more thoroughly, covering all the surfaces of the teeth. Do it twice a day: just before bed, and at another time that fits in with your routine.
- Not all children like having their teeth brushed, so you may have to keep trying. Don't let it turn into a battle. Instead, make it into a game, or brush your own teeth at the same time and then help your child finish their own.
- The easiest way to brush a baby’s teeth is to sit them on your knee with their head resting against your chest. With an older child, stand behind them and tilt their head upwards.
- Brush the teeth in small circles covering all the surfaces and let your child spit the toothpaste out afterwards. Rinsing with water has been found to reduce the benefit of fluoride.
- You can also clean your baby’s teeth by wrapping a piece of damp gauze with a tiny amount of fluoride toothpaste on it over your finger and rubbing this over their teeth.
- Carry on helping your child brush their teeth until you’re sure that they can do it well enough themselves. This will normally be until they’re at least seven.
Taking your child to the dentist
NHS dental treatment for children is free. Take your child with you when you go for your own dental appointments, so they get used to the idea. To find a dentist you can use our services search, ask at your local clinic, contact your local primary care trust (the address and phone number will be in the phone book) or call NHS Direct on 0845 4647.
Prevent tooth decay by cutting down on sugar
Sugar causes tooth decay. Children who eat sweets every day have nearly twice as much decay as children who eat sweets less often.
This is caused not only by the amount of sugar in sweet food and drinks, but by how often the teeth are in contact with the sugar. This means sweet drinks in a bottle or feeder cup and lollipops are particularly damaging because they bathe the teeth in sugar for long periods of time. Acidic drinks such as fruit juice and squash can harm teeth too. This is why it’s better to give them at mealtimes, not in between.
The following measures will help you reduce the amount of sugar in your child’s diet and prevent tooth decay.
- From the time your baby is weaned, encourage them to eat savoury food. Check if there's sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks, especially fizzy drinks, squash and syrups.
- Only give sweet foods and fruit juice at mealtimes.
- Don't give biscuits or sweets as treats. Ask relatives and friends to do the same. Use items such as stickers, badges, hair slides, crayons, small books, notebooks, colouring books, soap and bubble baths. They may be more expensive than sweets but they last longer.
- If children are having sweets or chocolate, it’s less harmful for their teeth if they eat the sweets all at once and at the end of a meal rather than eating them little by little and/or between meals.
- At bedtime or during the night, give your baby milk or water rather than baby juices or sugar-sweetened drinks.
- If your child needs medicine, ask your pharmacist or GP if there’s a sugar-free option.
- Don't give drinks containing artificial sweeteners, such as saccharin or aspartame. If you do, dilute them with at least 10 parts water to one part concentrate.
- It’s OK to use bottles for expressed breast milk, infant formula or cooled boiled water. However, using them for juices or sugary drinks can increase tooth decay. It’s best to put these drinks in a cup and keep drinking times short.
- Between six months and one year, you can offer drinks in a non-valved free-flowing cup.
- Check your whole family’s sugar intake, and look for ways of cutting down.
Sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch are all sugars. Invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado and concentrated fruit juices are all sugars. Maltodextrin is not a sugar, but can still cause tooth decay.
Further information
