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The Do’s and Don’ts of Proper Oral Care for Infants and Young Children

Tuesday, January 14, 2020 9:45 AM

By: Lauren McRae

Proper oral hygiene is an integral part of a child’s overall health and development, and parents should be aware of the do’s and don’ts of taking care of their child’s teeth. Remember, it’s important to establish proper dental care and a routine at an early age. Parents should be aware of general information about baby teeth and how to properly care for them, to proper techniques when feeding, tooth brushing and flossing.

The American Academy of Pediatrics, the American Academy of Pediatric Dentistry, the American Dental Association all recommend a dental visit for children by 1 year of age.

Diana Maniev, M.D., NorthShore Department of Pediatrics, offers these guidelines:

Tooth Facts and Primary Teeth:

By age 3, there are usually 20 primary teeth, also called baby teeth. You may notice gapping between each of the teeth, which is normal and important because it allows enough room for the bigger, permanent teeth. When a child loses their baby teeth, it’s normal for their permanent teeth to have wavy edges when they erupt, which smooth out with normal wear and tear.

Parents should start brushing teeth twice a day upon the first tooth eruption, which is usually between 4 and 15 months of age. Premature and low birth weight babies can have delayed primary tooth eruption and enamel defects, putting them at a higher risk for decay.


If you’re breastfeeding, it’s important to implement oral hygiene following feedings. Although breast milk alone is not cariogenic, it can become cariogenic when combined with other carbohydrate sources. Make sure to stop night feedings when teeth erupt. If you’re bottle-feeding, bottles should only be used with formula, breast milk or water.

Once the infant can sit unsupported (around 6 months of age,) introduce a sippy cup. Try to eliminate the bottle by 1 year of age. Like the bottle, other sugar-containing drinks should be avoided. Also, don’t put a baby to bed with a bottle at bedtime, and bottles should not be propped with infants in cribs or car seats. Infants should be held when bottle-fed. Children who drink bottles while lying down may be more prone to ear infections.

Oral Care Children

Tooth brushing:

Up until the age of 6, parents should help children brush their teeth twice daily with a toothpaste containing fluoride. Before age 3, use an amount similar to a grain of rice. After age 3, a pea-sized amount is appropriate. Always supervise and use a soft toothbrush.

Advice to Parents:

  • Clean or brush a young child’s teeth twice daily.
  • Begin wiping the gums of even a very small infant with a soft washcloth or soft toothbrush, even before tooth eruption, to establish a daily oral hygiene routine.
  • Toothbrushes for infants and toddlers should be soft with a small head and a large handle.
  • Tooth brushing should be supervised until the child can reliably rinse and spit out excess toothpaste (usually 6 years of age). Younger children do not have the hand coordination necessary for independent tooth brushing before that age.
  • Electric toothbrushes are especially useful in situations of limited movement. They do the work for you, they position well, and the small head can help limit the amount of toothpaste to what is appropriate for children.
  • All accessible surfaces of each tooth need to be brushed.
  • Remind your children not to swallow fluoridated toothpaste.


Flossing is an essential part of the tooth-cleaning process. It removes food particles and plaque between teeth that brushing misses.

Advice to Parents:

  • Flossing should begin when 2 teeth touch, typically between 2 and 2½ years of age. Some children may only need a few back teeth flossed and others may need flossing between all their tight teeth, depending on dental spacing.
  • Children usually need assistance with flossing until they are 8 to 10 years of age.
  • Flossing tools, such as pre-threaded flossers or floss holders, may be helpful for children who are just learning how to floss.
  • Some children may find it easier to use a loop of floss, which is created by taking a piece of floss about 10 inches long and tying the ends together into a circle. Parents (and older children) can hold the floss tightly between the thumbs and forefingers to floss.

Remember, start early to establish a routine. If you have any questions please let your child’s physician know.