Baby Teeth, Teething and Oral Health

Cultivating good oral health and hygiene starts from young. Here's how to make sure your baby has healthy teeth.

When Do Babies Start Teething?

Your baby is drooling so much that you have to change his bib frequently. He is also putting everything into his mouth to ‘chew’. He has swollen, and red gums, flushed cheeks and his sleeping pattern seems disrupted. Nothing you do seems to help. He is grouchy, irritable and restless. These are common signs of teething.

A baby’s first tooth usually appears from about 6 months of age, though for some babies, this may be earlier or later. The two lower front teeth (incisors) are the first to appear. The complete set of baby teeth is usually visible in the mouth by the time he is about 3 years old.

How To Ease Teething Discomfort

A tooth pushing its way out of the gums can be uncomfortable. Here are what you can do to make it less unpleasant for him:

Rub or massage his gums with clean fingers or a cold towel. This will help soothe the discomfort.
Cuddle and play with him to provide him with assurance and comfort and distract him from the uncomfortable feeling.
Give your baby cool food to help numb the discomfort. Foods like chilled yoghurt, blended peaches, and apple sauce can be more appetising than warm or room-temperature foods and may ease uncomfortable gums.
If your baby cannot be soothed, consult your doctor for some pain-relief medication.
Food and Drug Administration (FDA) advises against the topical application of teething gels as they may contain agents harmful to children under 2 years old.
Symptoms like fever and diarrhoea are not often associated with teething. If your baby has the conditions mentioned above for prolonged periods, please take him/her to a doctor.

Cultivating Good Oral Health Habits From Young

Milk teeth or baby teeth are important. They help your child to chew and speak properly. They also create space for the permanent teeth to erupt in the mouth. Healthy looking teeth are a tremendous boost to a child’s self-confidence and self-esteem.

Start your baby on good oral habits and dental care early. Begin by cleaning your baby’s gums daily from birth with a small piece of clean wet muslin cloth or a piece of gauze. This will help your baby get used to the daily routine of cleaning his teeth later on.

Brush your baby’s teeth as soon as they appear. Use a soft-bristled toothbrush that is specially designed for babies. Remember to wipe the surface of his tongue as well.

Fluoride in toothpaste protects your child's teeth from tooth decay by strengthening it. Fluoridated toothpaste containing at least 1000ppm fluoride prevents tooth decay. However, children can get fluorosis on permanent teeth from swallowing too much fluoride toothpaste. Fluorosis results in a change in colour or texture of the teeth.

To prevent fluorosis, ensure that an appropriate amount of toothpaste according to your child's age is dispensed and that your child does not swallow the toothpaste.

By the time your child turns 1, bring him to visit a dentist who can advise you on the appropriate use of toothpaste.

Due to the concern for dental fluorosis, the recommendation for use of a smear amount (size of a rice grain) of 1000ppm fluoride (F) toothpaste for children below 3 years old should be limited to those at high-risk for dental caries. At the first dental visit, the dentist can determine your child's caries risk and make the appropriate recommendation for toothpaste use.

For children 3 years old and above, who are less likely to swallow toothpaste, use a pea-sized amount of fluoridated toothpaste.

It is important to cultivate the habit of brushing your baby’s teeth twice a day from a young age, once in the morning and once at night before sleeping. Having good oral hygiene practices from a young age will go a long way in keeping his teeth healthy in adulthood too.

Early Childhood Caries

Some parents give their babies a bottle of milk or sweetened beverage to drink while putting them to sleep. The milk or sweetened drink will pool around their teeth and when not brushed off before bed, it stays on teeth overnight and can cause tooth decay. This is called early childhood caries.

How To Prevent Early Childhood Caries in Baby Teeth:

Do not put your child to bed with a bottle of formula milk. The sugary liquid will pool in the mouth, and can create a breeding ground for bacteria.
Brush after drinking milk, just before bed.
By the time your child turns 1 year old, attempt to wean off the milk bottle for a night feed. Teach your child to drink from a cup as soon as he can hold one.
Transit your child to full cream milk by the time he turns 1 year old. Full cream milk is not as sweet as formula milk. Frequent consumption of sweetened beverage (e.g., formula milk, juice) in a milk bottle can cause severe tooth decay.
When your child turns 1 and wakes up frequently at night for milk, try to give your child plain water in a milk bottle or dilute the milk to make it less sweet.
Regularly lift your child's upper lip to check for white or brown spots, which are early signs of tooth decay.
Bring your child for early dental checks, as early as 1 year old. A child-friendly dentist can advise you on your child's risk of developing tooth decay and the appropriate use of toothpaste.
Frequent consumption of sweetened foods (ie biscuits, candies and chocolates) and beverages such as juice can cause tooth decay. Do not give children easy access to decay-causing foods and beverages.

Related: Steps to Healthy Smile (PDF with simple oral health tips for preschoolers)

Related: Visual Screening Guide for early tooth decay detection in children

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