Most parents don’t realize tooth care should start before the first tooth appears, but experts breaks down each stage of baby dental care with clear timelines, practical tips, and answers to common questions about building healthy habits early.
Here's something nobody tells you at the baby shower: dental care starts way before you ever see a tooth.
You're probably running on four hours of sleep, covered in some mystery substance, and wondering whether you need to worry about brushing gums that don't even have teeth yet. The short answer is yes, and the longer answer involves a timeline that most parents only discover after their pediatrician asks about oral care at a checkup.
Around 40% of children have cavities by the time they reach kindergarten, which is a statistic that catches a lot of parents off guard. After all, baby teeth fall out anyway, right? But those tiny teeth play a bigger role than most people realize, and the habits you build now stick around long after the tooth fairy has made her last visit.
Let's break down exactly when to start, what to use, and how to make brushing something your child tolerates instead of fights against.
It's tempting to think of baby teeth as practice teeth or temporary placeholders, but they serve real purposes that affect your child's development in significant ways.
Baby teeth guide permanent teeth into position, and when a baby tooth falls out too early from decay or damage, the adult tooth underneath can drift into the wrong spot. That means potential alignment issues, speech problems, and expensive orthodontic work down the road.
They also help your child learn to chew and speak properly, so try saying "tooth" without your front teeth touching—it's harder than it sounds.
The bacteria that cause cavities don't wait for permanent teeth to show up; they're happy to set up shop on baby teeth, and once decay starts, it can spread quickly in those small mouths.
Your baby doesn't have teeth yet, but their mouth still needs attention. After feedings, take a clean, damp washcloth or a piece of soft gauze and gently wipe their gums to remove milk residue and bacteria while getting your baby accustomed to having their mouth touched.
Think of it as laying groundwork, since babies who experience gentle oral care early tend to accept toothbrushes more easily later. You're building familiarity, not perfection.
This is also when teething signs might start appearing, and increased drooling, chewing on everything in sight, and some fussiness around four to six months often signal that teeth are preparing to make their debut.
That first tooth changes everything, with the lower front teeth usually appearing first followed by the upper pair. As soon as you spot one poking through, it's time to upgrade from washcloth to toothbrush.
Use a soft-bristled infant toothbrush with a rice-grain-sized smear of fluoride toothpaste, and yes, fluoride is safe at this age in tiny amounts. Brush twice daily, morning and night, using gentle circular motions.
Your baby will probably squirm, and they might clamp their mouth shut or try to grab the brush, but this is completely normal. Sing a silly song, make funny faces, let them hold a second toothbrush while you work—whatever gets the job done.
Pediatric dental experts recommend scheduling your child's first dental appointment by their first birthday or within six months of the first tooth appearing, and this early visit is mostly about prevention and education rather than treatment.
By age three, most children have all twenty baby teeth, and brushing becomes more of a production as your toddler will likely insist on doing it themselves.
Let them try, then do it again properly afterward.
Toddlers don't have the fine motor control to brush effectively on their own, so they'll miss spots, use too much pressure in some areas and none in others, and probably spend most of their time chewing on the brush. Your job is to follow up with a thorough brushing while making them feel involved in the process.
Some strategies that work:
This is also when dietary habits start mattering more, so limit sugary drinks and sticky snacks since water is always the best choice between meals. If your child still uses a bottle, work on transitioning away from it, especially at bedtime.
Somewhere between ages five and seven, baby teeth start falling out and permanent teeth begin coming in, which is an exciting milestone for kids, though some find the wiggly teeth unsettling.
Let loose teeth fall out naturally by encouraging gentle wiggling, but don't force it. The new teeth coming in need extra attention since they're especially prone to cavities right after erupting.
At this age, children can take on more responsibility for brushing, but they still need supervision and help until around age seven or eight, so focus on reaching those back molars which are easy to miss and prone to decay.
If thumb-sucking or pacifier use continues past age four, it might be time to start phasing it out, since extended sucking habits can affect tooth alignment and bite development.
Even well-meaning parents sometimes miss the mark on baby tooth care, and there are a few things to watch out for.
Skipping bedtime brushing. Nighttime is when bacteria do their worst work because saliva production drops while your child sleeps, giving cavity-causing bacteria free reign. Never skip the bedtime brush, even if your toddler is already half asleep.
Using too much toothpaste. A rice-grain size for babies and a pea-size for children over three is the rule. Swallowing excess fluoride toothpaste can cause issues.
Letting juice sit on teeth. Even 100% fruit juice contains sugars that feed bacteria, so if your child drinks juice, keep it to mealtimes only and limit the quantity.
Putting babies to bed with bottles. Milk and formula contain sugars that pool around teeth while your baby sleeps, and this leads to decay, particularly on the upper front teeth.
The goal isn't perfection—it's consistency.
Children learn by watching you, so brush your own teeth while they brush theirs and make it a family activity rather than a chore you impose on them. Talk about why you're doing it without turning it into a lecture.
Some days will be easier than others, and there will be mornings when your toddler clamps their jaw shut and refuses to cooperate. There will be nights when you're so exhausted that you consider skipping it just once, and that's parenting.
What matters is returning to the routine, since over time brushing becomes automatic and something your child does without thinking twice.
Common teething signs include increased drooling, chewing on hands or toys, mild fussiness, and sometimes disrupted sleep, and you might notice red or swollen gums where a tooth is about to emerge. Not all babies show the same symptoms, and some teeth come in with barely any fuss at all.
Yes, in appropriate amounts, and the American Academy of Pediatric Dentistry recommends using fluoride toothpaste as soon as the first tooth appears. Use a rice-grain-sized smear for children under three and a pea-sized amount for children over three, since these small quantities are safe even if swallowed.
Resistance is common, especially with toddlers, so try different positions like lying them across your lap or standing behind them in front of a mirror. Let them choose their own toothbrush and use distraction techniques like songs or videos, but most importantly, stay calm and consistent since fighting about it makes the experience worse for everyone.
Hurst Pediatric Dentistry has created a detailed resource that walks parents through each developmental stage, and you can access it here to help you build your child's healthy habits from the start.
