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Caring for your baby's first teeth

True, baby teeth fall out in just a few years. But they have important jobs. They help babies form words and chew food. They also hold space for adult teeth and take a front-and-center role in that heart-melting smile.

Expect to see your baby's first teeth—already formed at birth and hiding under the gums—when your child is around 6 to 12 months old. These primary teeth, also called baby teeth, deserve the best of care. Healthy baby teeth hold space for adult teeth that will arrive in a few years. Decay in baby teeth can cause pain and can lead to infections that may be serious.

Teething tips

Your baby's two bottom front teeth will likely appear first. Next may be the top front teeth. Most babies have 20 primary teeth by the time they are 3 years old.

A baby who is teething may be fussy and drool a lot. He or she may have tender or swollen gums too. And some babies run a low-grade fever.

To help during this time, the American Academy of Pediatrics (AAP) and other experts offer these tips:

  • Gently rub or massage the gums with one of your fingers.
  • Try a teething ring. Look for ones made of firm rubber. Don't use frozen teething rings though. They can do more harm than good.
  • Give your baby a clean, cool, slightly wet cloth to chew on.
  • After checking with your doctor, try liquid acetaminophen or ibuprofen. Never give aspirin to a baby.

It's not necessary to put a teething gel on your baby's gums. According to the AAP, these gels wash out of the mouth in minutes.

One word of caution: If your child seems very uncomfortable or has a temperature over 101 degrees, consult your doctor. It's probably not because of teething.

Taking care of new teeth

As soon as a tooth appears, you should take steps to keep it healthy. The American Dental Association (ADA) offers the following advice:

  • Gently brush your baby's teeth with a child-size toothbrush and a dot of fluoride toothpaste, about the size of a grain of rice. Kids 3 years and older should use just a pea-size dot of toothpaste.
  • As soon as two teeth touch, gently floss between them each day. This removes plaque in places where the toothbrush can't reach.
  • Schedule a well-baby checkup with your dentist by the baby's first birthday—or when the first tooth comes in. Your dentist will look for any signs of early trouble.

In addition, follow these tips to help prevent cavities:

  • Never put your baby to bed with a bottle. Milk, formula and juice can pool around the teeth. This makes cavities more likely.
  • Teach your child to drink from a cup as soon as possible. Cups can't be taken to bed.
  • If your child must have a sippy cup or bottle for a long period (in the car, for instance), offer only water.

Pacifier problems

Sucking on pacifiers, fingers or thumbs can affect the shape of a baby's mouth or how the teeth line up. Problems like these often correct themselves if your child stops by 2 to 4 years old. Children who continue sucking on objects may need orthodontic care later in life.

A word about fluoride

Fluoride helps the teeth produce stronger enamel, according to the AAP. But too much can cause a condition called fluorosis. It's harmless, but it makes the tooth enamel mottled, brown or discolored.

Ask your dentist or doctor about fluoride levels in your local water. If the water has no fluoride, you may want to add fluoride drops. But if you want to limit fluoride intake, you may need fluoride-free bottled water for mixing formula.

If you notice discolored baby teeth, check with your dentist. Correcting the problem right away can help avoid a repeat in the permanent teeth.

Reviewed 1/18/2022

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