Your child’s first dentist visit and daily care for baby teeth

Three habits help protect baby teeth: brushing twice a day with fluoride toothpaste from the first tooth, having sugary food and drinks as rarely as possible, and regular check-ups, starting with your child’s first dentist visit in their first year. Decay in baby teeth often starts without pain, so early check-ups help to catch problems in time.

This is general guidance, not a substitute for a dentist’s assessment.

When do babies’ first teeth come through?

Babies are born with all 20 baby (milk) teeth hidden in their jaws. According to the UK’s NHS, most babies get their first tooth at around 6 months, some before 4 months and others after their first birthday. The bottom teeth often come through before the top ones.

The approximate order:

Most children have all their baby teeth by the age of 2 or 3.

Teething: what can help

While a tooth is coming through, the gum can be red and sore. Your baby may dribble more than usual, chew on everything, have one flushed cheek or a rash on their face, and not sleep very well. Some teeth cause no trouble at all.

The NHS tips for teething babies suggest:

• a teething ring; some can be cooled in the fridge, but never in the freezer;
• gently rubbing the gums with a clean finger, cuddles and play;
• from 6 months, once your baby has started solid food, raw fruit and vegetables to chew on, always supervised;
• a children’s pain-relief syrup with no sugar: paracetamol from 2 months or ibuprofen from 3 months, exactly as directed.

Never tie a teething ring around your baby’s neck, as they could choke. Do not give aspirin to children under 16.

There is not enough evidence that teething gels work, and ordinary oral pain-relief gels are not suitable for children. Homeopathic remedies are not recommended.

Teething can cause a slightly raised temperature, below 38 °C, but there is no evidence that it causes diarrhoea. For a temperature of 38 °C or above, diarrhoea or anything else that worries you, contact your child’s doctor.

Your child’s first dentist visit: when to go and what to expect

The NHS and the American Dental Association (ADA) advise taking your child to the dentist when their first baby teeth come through, and by their first birthday at the latest. Do not wait for toothache: an early check-up is about prevention.

The first visit is mainly a chance to get to know each other. Your child usually sits on your lap while the dentist checks that the teeth, gums, jaw and bite are developing as they should, and may gently clean off any plaque.

Much of the visit is a conversation about brushing, how much toothpaste to use, what your child eats and drinks, and whether they use a dummy or suck their thumb.

The check-up can be done by your child’s chosen dentist (izbran stomatolog) under the Health Insurance Fund (FZO) or by a children’s (paediatric) dentist. The dentist will tell you how often to come back.

How to prepare your baby or toddler for their first dentist appointment

• Choose a time when your child is rested and happy, not their usual nap time.
• Give them a light meal beforehand and brush their teeth.
• Practise ‘open wide’ at home as a game.
• Talk about the visit calmly and positively. Crying or wriggling is normal when something is new.

Baby teeth care: when to start brushing and how much toothpaste to use

Before the first tooth comes through, gently wipe your baby’s gums after feeds with clean, damp gauze or a soft cloth. Start brushing as soon as it does. The NHS advice for each age:

• Brush twice a day for about two minutes, including last thing at night.
• Children’s toothbrush: small and soft-bristled, suited to your child’s age.
• Under 3: just a thin smear of toothpaste, the size of a grain of rice, with at least 1,000 ppm fluoride. You do the brushing.
• Ages 3 to 6: a pea-sized amount with 1,350–1,500 ppm fluoride (a child without tooth decay can also use a lower-strength children’s toothpaste with at least 1,000 ppm). Your child brushes; you help and supervise.
• Age 7 and over: toothpaste with 1,350–1,500 ppm fluoride. Most children brush on their own, but keep an eye on them.
• After brushing, your child should spit the toothpaste out, not rinse with water: rinsing makes the fluoride less effective.

The fluoride level (ppm) is printed on the pack. With fluoride toothpaste for babies and young children, the amount matters: too much fluoride in childhood can leave white spots on the adult teeth (Cleveland Clinic). So measure the toothpaste, but do not avoid it: fluoride is an important defence against decay.

When two teeth start to touch, floss between them too. Our guide on how to brush and clean between your teeth explains the technique.

How to prevent tooth decay in children

With tooth decay, how often your child has sugar matters, not just how much. The UK government’s prevention toolkit Delivering better oral health includes this advice for parents:

• Only put breast milk, formula or cooled boiled water in the bottle.
• From 6 months, teach your baby to drink from an open cup rather than a non-spill cup with a valve.
• After their first birthday, gradually phase out the bottle.
• Do not add sugar to your baby’s or toddler’s food and drinks.
• Offer sugary food and drinks as rarely as possible and in small amounts, and not before bed: there is less saliva at night to protect the teeth.
• Where possible, choose medicines that contain no sugar.

Fluoride varnish and fissure sealants

Your child’s dentist may recommend fluoride varnish, which helps protect teeth against decay. According to the NHS, it is applied at least twice a year from age 3, and earlier if the dentist thinks it is needed.

Fissure sealants are a thin protective coating that seals the grooves (fissures) on the chewing surfaces of the adult back teeth, where food easily gets trapped. They are applied when the first permanent molars (six-year molars) come through, at around 6 or 7, and again when the other permanent molars come through, between 11 and 14. The NHS says a sealant can last up to 4 years.

Do baby teeth need treating if they fall out anyway?

Yes. Baby teeth are temporary, but they matter. They help your child chew, learn to speak clearly and smile with confidence, and they hold the space for the adult teeth, which start coming through at around 6. According to the ADA, baby teeth lost to decay can put the adult teeth at risk.

Tooth decay is more common in children and often starts without pain. According to Cleveland Clinic, the first sign is white, chalky spots on the enamel. At this early stage, fluoride and better care can sometimes stop it.

Later, the spots darken and a hole (cavity) forms. Once decay reaches the nerve, it can cause pain and, if left untreated, an infection (abscess).

Treatment depends on how damaged the tooth is: fluoride and more frequent check-ups, a filling, nerve treatment or, in more severe cases, taking the tooth out. The dentist will explain the options, with their benefits and limitations, before you decide.

When to take your child to the dentist sooner

Do not wait for the next routine check-up if you notice:

• white, chalky spots along the gumline, or brown or black spots on the teeth;
• a hole in a tooth, or pain when your child eats or has something hot or cold;
• bleeding gums, or bad breath that does not go away;
• a tooth that has turned grey or dark after a knock.

Facial swelling or a temperature alongside toothache can mean an infection, so your child should see a dentist the same day. If the swelling spreads towards the eye or neck, or your child finds it hard to breathe or swallow, call 194 (ambulance) or 112 (European emergency number), or go to hospital straight away.

For what to do until you can see a dentist, read our guide to toothache. For a knocked or knocked-out tooth, see our frequently asked questions.

For a child under 14, please do not send an appointment request through the website. Call us instead, and we will tell you whether and when we can see your child.

Do not forget your own teeth either. If your last visit was a while ago, a dental check-up with a scale and polish (teeth cleaning) is a good place to start.

Common questions about baby teeth

For your own check-up, book an appointment or call us on +389 78 218 457.