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Oral health for children in the early years (aged 1-5)

Why is it important to brush milk teeth?

Caring for your baby’s teeth is a very important job. They help with smiling, eating and speaking, but also act as placeholders, helping to align a child’s permanent teeth when they are ready to come through. Looking after milk teeth, from when they first begin to come through, can prevent tooth decay.

Baby finger in the mouth
baby smile

When do first teeth begin to appear?

Usually, a baby’s teeth will begin to come through at four to eight months of age. Children are expected to have 20 milk teeth (also known as baby teeth) by the time they are two or three years old. Milk teeth need daily care to make sure they are healthy.

How can I help my baby with teething?

When children’s gum become sore from their milk teeth coming through, this is called teething. A teething child’s cheeks may look red, they may dribble or chew on things more than usual and become more upset both in the day and at night from the pain.

Often teething symptoms can be relieved by offering children something to chew on, like a teething ring or gently rubbing their gums with a clean finger. You can give your child some sugar free paracetamol or ibuprofen if they are 3 months of age or older.

If your child looks to be in significant distress, and is unwell with symptoms such as diarrhoea, it is best to seek medical attention.

How should I brush my child’s teeth?

If they are 0-3 years old:

It is important parents brush their children’s teeth until they are 2 years old. After this, children should be supported to brush their teeth until they are 7. A top tip is to sit your child on your knee, with their head resting against your chest. This way will make it easier to access their mouth and to stop them moving too much.

Children under 3 should use only a smear of toothpaste.

A smear of toothpaste on a toothbrushThere are lots of child friendly toothpastes which make sure children’s teeth are protected but also are in child-friendly flavours. Children under 3 years old should use toothpaste containing no less than 1000 ppm fluoride. Fluoride in toothpaste helps to prevent and control tooth decay.

It is advised to change your babies toothbrush approximately every 3 months, this is because children are likely to chew the bristles, making them less effective.

Young children will be unable to spit out the toothpaste, so it is important to wipe away any excess once finishing brushing.

If they are 3 to 6 years old:

At the age of 3, children should have a complete set of milk teeth. It is important to keep the milk teeth has healthy as possible in preparation for the permanent ones to appear. Brushing teeth removes plaque. Plaque contains bacteria which covers the gums and teeth. Brushing plaque- a white sticky film- away, helps to keep teeth and gums healthy.

Parents should still supervise tooth brushing until their child is at least 7 years old to make sure they are cleaned correctly.

Children aged between 3 and 6 years should be using toothpaste that contains more than 1000 ppm fluoride. You can see the amount of fluoride in a toothpaste written on the side of the tube.

Children of this age should be using a pea-sized amount of toothpaste. It is important to not let a child lick or eat the toothpaste out of the tube.

a pea-sized toothpaste on a toothbrush

Show your child that they need to brush their teeth in small circular movements, making sure that each tooth is covered. Ask them to spit the toothpaste out afterwards. There is no need for them to rinse their mouths with water as this will wash away the fluoride in the toothpaste.

It is important to get your child to brush their teeth twice a day. One time should be just before bed so the fluoride can continue working while your child is asleep. The other can be on another occasion throughout the day,

There are many different children’s toothbrushes on the market, designed to fit in a smaller hand and with soft, nylon bristles. There are often bright and colourful to make tooth brushing more fun.

For more information about our local toothbrushing scheme, please visit Dudley’s Community toothbrush scheme.

Dudley's community toothbrush scheme

Healthy Teeth For Children on Vimeo produced by University Hospitals Birmingham NHS Foundation Trust

Healthy teeth for children

What tips are there for if I am struggling to brush my child’s teeth?

  1. Try not to worry- there are lots of children who do not enjoy tooth brushing. The important thing is to try to make it part of their routine from as early as their milk teeth come through- even if they only brush for a short while at first.
  2. For babies, sit them on your knee with their head rested on your chest. As they get older, try standing behind them and tilting their head back.
  3. Show your child you brushing your own teeth. When they are a toddler, they can then copy you and have a try at brushing their teeth themselves.
  4. Try to make toothbrushing fun, perhaps making it into game or song. Here are some apps and online videos that can help with this:

When should I first take my child to the dentist?

Booking an appointment at the dentist when your baby’s first tooth comes through, can help get your child used to having regular check-ups.

Dental check-ups are important for children because tooth decay can happen faster with milk teeth. Check-ups make sure teeth are growing as they should and can help spot any issues early.

In preparation for your child’s first visit to the dentist, it can be helpful to talk them through what will happen there. There are lots of online videos, tv shows and books that explore this topic so going to the dentist can be seen as a positive experience. It can also be beneficial to play a game of ‘going to the dentist’ at home. Children can then get used to opening their mouths and having their teeth checked but in a fun setting.

How much will it cost to take my child to the dentist?

Dental treatment is free on the NHS for children under 18, or under 19 and in full-time education. It is also free if you are pregnant or have had a baby in the last 12 months. It is important your child sees a dentist regularly. It is advised the time between appointments is no more than 12 months whilst your child is under 18.

If you don’t have a dentist, you can use the Find a Dentist website.

If anyone in your family needs to see a dentist urgently, please contact a local NHS dentist or call NHS 111.

dentist and a baby
baby, toddler drink with a cup

What should my child be drinking?

The only drink or food a baby should be having for the first 6 months of their lives is breast milk, or formula as a substitute.

More solid foods can be introduced at six months old, but breastfeeding or formula should still be given alongside, until babies are at least one year old.

Children can drink water after your child is 6 months old, in between meals to help reduce tooth decay.

Cows’ milk as a drink can be introduced from 12 months.

Sugar or honey should not be added to weaning foods or drinks.

Fizzy drinks should be avoided. Fruit juice and smoothies contain sugar and should be drunk very little, ideally diluted with water especially for children under 5 years.

Offer a drink with meals and in between, more will be need in hot weather or after exercise.

From six months old, babies can be given a free-flow cup to drink from.

Using a free-flow cup has lots of benefits including:

  • Helping a child’s teeth and jaw development
  • Protects milk teeth from tooth decay
  • Improves speech development
  • Supports a healthy lifestyle

For more information about using a free-flow cup, please go to: Have confidence to pick up a cup

Pick up a cup branding

Healthy eating:

Encouraging your child to eat a balanced and healthy diet with lots of vegetables, fruit, protein, dairy and carbohydrates, but low in fats, sugar and salt, can help to lower your child’s risk of having tooth decay.

Some food naturally contain sugar such as fruits and milk. These foods do not need to be limited with the guidelines below.

Instead, food and drinks that contain ‘free sugars’- sugars that have been added and are not natural- should be limited to less than 5% of our calorie intake.

It is particularly important to avoid children having sugary food and drink before bedtime and to only give sweeter foods at mealtimes.

What tooth friendly snacks would we recommend?

  • Fresh fruit, such as an appleFruit and vegetables
  • Raw vegetables
  • Pieces of cheese
  • Breadsticks
  • Pitta breads or crumpets
  • Plain popcorn
  • Sandwiches filled with cheese, ham, chicken, houmous or cream cheese and cucumber

For more information please visit NHS children’s oral health.