When your child was a baby, cleaning her teeth wasn’t such a big task — after all, there weren’t many to worry about. But now that all (or most) of her pearly whites have come in, you’ll have to step up the dental care.
Far from just being “practice teeth,” baby teeth play a big role in your child’s overall health. Not only do primary teeth help small tots chew and speak, but they also set the foundation for her future dental health.
For example, if a child loses a baby tooth too early — from, say, decay — the other teeth may shift around, which can crowd out the adult teeth and prevent them from coming in correctly.[1]
All this is to say that keeping those tiny teeth healthy and strong is a big priority — and your toddler is also able to lend a helping hand as she learns good dental habits. Follow these steps to set your child up for success with her oral hygiene routine.
How to brush your toddler’s teeth
Baby teeth are vulnerable to decay as soon as they break through the gums. The best line of defense? Brushing regularly. Here’s how.
Brush twice a day
Make it a priority to brush your child’s teeth twice a day for two minutes at a time, in the morning after breakfast and in the evening right before she goes to bed. Be prepared to be the brusher-in-chief — according to the American Academy of Pediatrics (AAP), parents should help kids brush their teeth until at least around age 6 to 8 (and maybe longer), at which point they may be able to brush, rinse and spit on their own. (A good rule of thumb: Once your child is able to tie her laces perfectly by herself, she likely has the manual dexterity to brush on her own.)
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Get the right brush
The best toothbrush for your child depends on how cooperative she is at brushing time. Is she happy to open wide? Then a brush with a long handle that lets you maneuver around your eager brusher’s mouth may be best. Got a case of bathroom lockjaw? Try a finger toothbrush, which slips onto your index finger and has soft bristles at the tip, and may help get a stubborn toddler used to having her teeth cleaned. Or buy a colorful brush with her favorite character or one that lights up, plays music or makes a noise after the job’s done — maybe she can even choose it herself.
Whatever type of toothbrush you use, replace it every three to four months, according to the American Dental Association (ADA).[2]
Make brushing fun
Does two minutes seem like forever to your wee wiggler? Sing a song, tell a story or download a timer app your child can watch as you brush — anything to distract and make the time pass more quickly.
Buy the right toothpaste
The AAP recommends using a tiny smear of fluoride toothpaste (no bigger than a grain of rice) to brush your toddler's teeth until she’s 3.[3] That’s also when you can bump up the amount of fluoride toothpaste to a pea-size amount and also show her how to rinse post-brushing.[4] Chances are, she’ll be a fast — and most enthusiastic — student when it comes to spitting.
Skip the mouthwash
It might look bright and appealing, but mouthwash and toddlers don’t mix. The ADA recommends waiting until at least the age of 6 before introducing mouthwash to your child’s brushing routine, because kids can accidentally swallow too much of it.[5]
Teach the right technique
You want to introduce proper tooth care habits to your toddler, so give her lots of chances to master her technique. Stand your child on a step stool in front of you, then have her face a mirror and brush her teeth with your hand over hers. This way, she can watch you and learn how to brush more easily.
Work on one tooth at a time, using a gentle back-and-forth motion across the chewing teeth and inner surfaces, then switch to a circular motion along the sides, holding the brush at a 45-degree angle.
On areas of her mouth that don’t have teeth yet, lightly brush the gums, and don’t forget the tongue — a popular hangout for bacteria.
How to floss your toddler’s teeth
According to the ADA, as soon as your toddler grows two teeth that are touching, you and your tot can go on a plaque hunt with some trusty floss[6] — she’ll love pulling it out of the little box and snapping off the string too.
Choose your floss
You can use your regular (or flavored) floss on your toddler’s teeth or try one of those handheld plastic flossers shaped like a dino or other kid-friendly character. Flossers that have handles are easier to use and usually more accepted by kids.[7]
Use the correct technique
For early flossing sessions, stand behind your child facing a mirror to ensure you have control of her head. Floss her teeth as you would your own, using your index fingers and thumbs to guide the floss gently in between her teeth. Slide the floss up and down against the tooth surface and (carefully) under the gum line, flossing each tooth with a clean section.
Work from back to front
Focus on her molars first (if there are any) and work your way from the back of her mouth to the front. You probably won’t be able to get to all those teeth — it’s the rare tot who can last through a flossing session without fidgeting — and that’s just fine.
If it boosts her interest, you can even let her have a go at it. Your toddler may lack the finesse to floss efficiently until she’s around 10 or 11, but practice makes perfect.
When should your toddler go to the dentist?
You should make your child's first dentist appointment as soon as she sprouts her first tooth — usually around the age of 6 months — and no later than 1 year, even if she hasn’t gotten a tooth yet.[8]
At this appointment, your dentist will likely apply a fluoride varnish to your child’s teeth to prevent tooth decay. She’ll probably need to come back every six months for a routine checkup, unless your dentist recommends otherwise.
You can take your toddler to a family dentist who has experience with young children or a pediatric dentist who has additional training in children’s oral health.
Tips for healthy toddler teeth
Good oral hygiene involves more than just brushing and flossing (though that’s a good start). Here are a few more ways to help care for your tot’s teeth.
- Limit (or avoid altogether) sugary foods and drinks. Sugar can cause decay and cavities.
- Set sippy cup limits. Sipping on milk or juice all day bathes your toddler’s teeth in a steady stream of sugar, so if your child uses a sippy in between meals, try to fill it with only water.
- Don’t put her to bed with a sippy cup or bottle. For the same reason, you shouldn’t put your tot to sleep with her bottle or sippy. Children who often take their bottle or sippy cup to bed and drink from it throughout the night have a higher risk of tooth decay, which also known as bottle rot.
- Serve up foods that are rich in calcium. Yogurt, broccoli and milk, which can help strengthen your child’s teeth, are all good choices.[9]
- Drink fluoridated water. Fluoride is a mineral found in drinking water that helps prevent cavities. You can check the fluoride levels in your tap water on the CDC’s website, or give your child a pediatrician-recommended vitamin with fluoride in it. Talk to your doctor about which one is right for your child.
Dental problems in toddlers
From cavities to gingivitis, baby teeth are prone to many of the same problems as adult teeth. Here are a few childhood dental problems to look out for:
Cavities
Cavities, little holes in the teeth, are fairly common in young children. According to the AAP, about 28 percent of kids have had at least one cavity by the age of 3.[10]
They can form when common bacteria that live in the mouth produce acids that break down the tooth enamel. Luckily, it’s a quick fix — a dentist can plug the hole with a filling, and if caught early enough, they may be able to avoid a filling altogether and use a drill-free remineralization treatment instead.[11]
Gingivitis
Red, swollen gums can be a sign of gingivitis, also known as periodontal disease, an infection of the tissues surrounding the teeth that’s caused by a buildup of plaque.
Your child’s dentist can diagnose the problem during an exam, but they might refer you to a periodontist. Regular brushing and cutting back on sugary foods can help prevent gum disease in children.[12]
Teeth falling out prematurely
Baby teeth naturally fall out when the permanent ones gradually push up underneath them, which means that losing a first tooth early (before age 5) is almost always the result of decay or a mouth injury.
Losing a primary tooth prematurely, though, leaves no space holder for an adult tooth to sprout, which can cause the new, permanent tooth to be tilted, crooked or completely blocked. If your toddler loses a tooth early, go to a dentist right away to have a space maintainer inserted.
Missing teeth
It’s rare for a tooth to never pop up. But if your toddler doesn’t have a full set of 20 primary teeth after her third birthday, it’s a good idea to ask the dentist for X-rays.
Most likely, the pictures will reveal that a missing tooth is lurking under the gums and just taking its sweet tooth time to poke through. But if it’s not, the dentist may decide to insert a space maintainer into your child's mouth to keep the surrounding teeth from moving into the unclaimed territory.[13]
Crowded teeth
If your tot’s teeth seem to be fighting for room, this could mean that there may be crowding issues with her permanent ones too. Baby teeth hold space in the mouth for the larger permanent teeth to grow in, so crowded teeth might be a sign that your toddler doesn’t have enough jaw space for her future big-kid teeth.
But since you won’t know for sure until those permanent teeth come in, be extra diligent about cleaning and flossing now, since cavities love crowded choppers.
Crooked or spaced-out teeth
No, you don’t need to start saving up for braces yet — there’s no direct link between crooked baby teeth and crooked permanent ones. And toddler teeth with gaps between them are actually a good thing, as larger permanent teeth will likely fill those spots nicely (and straighten the remaining baby teeth while they’re at it).
Tooth discoloration
Do your tot’s pearly whites look less than lustrous? Because baby tooth enamel is thinner than the permanent kind, it doesn’t take long for plaque (bacteria from food) to build up and wreak havoc.
Sometimes, the iron in a multivitamin can stain baby teeth, and too much fluoride can cause white spots or streaks. An injury, illness, infection or fall can also darken toddler teeth, as can certain medications taken during tooth formation (either in utero or by the tot herself).
Too many teeth
Very rarely, a toddler will sprout an extra tooth or two, usually behind or in between the upper teeth. These supernumerary teeth, as they’re called, usually run in families — and they occur more commonly with permanent teeth.
If your child does have extra baby teeth, however, they will most likely fall out on their own when your child’s permanent teeth come in. If they don’t, your child’s dentist will extract them, as is the case with permanent supernumerary teeth.
Toddler teething
Just when it seemed like the teething stage was finally over, the 2- or even 3-year molars start to erupt — and those can be even more painful to cut than the incisors or canines were.
You can expect the lower second molars to appear sometime in between 23 months and 31 months, and the upper second molars to come in sometime between 25 months and 33 months.[14]
The familiar teething remedies — like cold washcloths or teething toys — can come in handy here, but if your child is in a lot of discomfort, it might be worth putting in a call to your doctor or dentist to see if there’s anything else you can do to ease the pain.
When it comes to caring for toddler teeth, you’ll do the majority of the work for your child in the early years (brushing and flossing is hard work for those little fingers). But if she sticks to a good oral hygiene routine, she’ll be building good habits for life — and when it comes to toddler dental care, that’s the most important thing of all.
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