It is never too early to begin focusing on your baby’s oral health. Starting a proper hygiene routine early is the most effective way to prevent tooth decay, which is a common chronic condition in early childhood. This guide walks caregivers through the specific recommendations for when to start brushing, which type of toothpaste to use, and the correct application amounts.
When to Start Brushing
Oral care should begin even before the first tooth erupts, establishing a routine and removing bacteria from the gums. You can gently wipe your baby’s gums once or twice daily with a clean, soft, damp cloth or a silicone finger brush. This simple cleaning helps reduce bacteria and gets your baby accustomed to having their mouth cleaned.
The transition to using a brush and toothpaste begins as soon as the first tooth breaks through the gum line, which typically occurs around six months of age. Even a single tooth is susceptible to decay, making it necessary to start brushing twice a day right away. Making this a part of the daily routine, such as after breakfast and before bed, sets a foundation for lifelong healthy habits.
Understanding Fluoride Content
Current recommendations from leading health organizations, including the American Dental Association, suggest using fluoridated toothpaste from the moment the first tooth appears. Fluoride is a naturally occurring mineral that strengthens tooth enamel, making it more resistant to acid attacks from bacteria and sugars. This protective benefit helps prevent early childhood cavities.
For infants, a toothpaste with a low concentration of fluoride is appropriate, often between 500 and 1,000 parts per million (ppm). The benefit of using fluoride must be balanced against the risk of dental fluorosis, which is a change in the appearance of permanent teeth caused by consuming too much fluoride while they are still forming. Fluorosis typically results in faint white streaks or spots on the enamel, although it is usually a mild, cosmetic concern.
Non-fluoridated “training” toothpaste lacks the cavity-fighting benefit that fluoride provides. Some parents may choose to use a non-fluoride option initially until they are comfortable with the brushing process. However, for a child at a higher risk of developing cavities, the protective benefits of a small amount of fluoride toothpaste outweigh the risk of mild fluorosis.
Safe Application Amounts
Carefully controlling the amount of toothpaste is the primary method for preventing excessive fluoride ingestion in infants and toddlers who cannot yet spit. For children from the time the first tooth appears until their third birthday, the recommended amount is a “smear” of toothpaste. This tiny quantity should be no larger than the size of a single grain of rice.
The goal is to ensure the fluoride contacts the tooth surfaces to provide topical protection. Caregivers should supervise the entire brushing process to ensure only this minimal amount is applied. It is helpful to press the paste into the bristles of the brush so that it does not easily fall off.
Once a child reaches three years of age, the recommended amount increases to a pea-sized dab of fluoridated toothpaste. At this stage, children are typically beginning to learn how to spit out the toothpaste after brushing, which further reduces the amount they ingest. Continue to supervise brushing until the child is around seven or eight years old, which is usually when they have the dexterity to clean their teeth effectively on their own.
Choosing the Right Tools and Technique
The toothbrush should be small, soft-bristled, and specifically designed for infants. The brush head must be appropriately sized to fit comfortably inside a baby’s mouth and reach all surfaces of the emerging teeth. Soft bristles are necessary to be gentle on the baby’s sensitive gums and new enamel.
When brushing, position your baby comfortably, perhaps with their head resting in your lap, which allows for a clear view of their mouth. Use gentle, circular motions to clean all surfaces of the teeth, including the front, back, and chewing surfaces. Pay close attention to the area where the tooth meets the gum line, as plaque accumulates easily there.
The focus should be on thoroughly cleaning all surfaces of the teeth and establishing a consistent routine. The process does not need to last the full two minutes recommended for older children. As more teeth erupt, particularly those that begin to touch one another, daily flossing should also be introduced to clean the surfaces a toothbrush cannot reach.