When to Start and How to Brush Baby Teeth for Oral Health

There is so much going on in the early days of parenting, that it is easy to forget about taking care of a baby’s teeth. I didn’t even start thinking about my first baby’s oral health until he started eating solid food around 7 months old.

He already had several tiny teeth at that point, but his dental care was one of the last things on my mind. Since I realized I should have been addressing his oral health earlier on, I was inspired to write this post about when and how to brush baby teeth.

Please note that this post is based on recommendations from professional associations and other trusted online resources. It is for informational purposes only. Parents should always discuss their child’s individual dental needs with their pediatrician and dentist.

When to Start Brushing Baby Teeth

ABQ Pediatric Dentistry explains that the time to start brushing is as soon as a baby’s first tooth arrives, usually sometime around 6 months of age (this timeline varies of course from baby to baby).

Even before a baby’s first teeth emerge though, the AAPD (American Academy of Pediatrics Dentistry) recommends cleaning a baby’s gums with a soft, clean, damp washcloth or an infant toothbrush with water.

The CDC recommends cleaning gums once in the morning and once before bedtime to prevent bacteria buildup. 

I did not wipe either of my two children’s gums with a cloth before their first teeth emerged, but it’s a good idea to know the general recommendation for oral care anyway as something to strive for.

The AAPD also recommends scheduling the first dental visit by a child’s first birthday. While this may be the official recommendation, we did not take our first child to the dentist until he was 3 years old.

He had no apparent dental problems and regularly brushed twice a day, so in our case, it seemed fine to wait that long. Plus, we honestly did not think the dentist would even be able to get a look in our son’s mouth before this. At least not without getting a finger chomped!

Toothpaste for Baby Teeth

As soon as the first baby teeth appear, the ADA (American Dental Association) recommends using a smear of fluoride toothpaste about the size of a grain of rice to brush.

Depending on location, pediatricians may also prescribe fluoride supplements. This was the case for my baby since fluoride is not added to our local public tap water supply.

Pediatricians may also offer to give babies and tots a quick fluoride swipe at routine wellness checks.

Fluoride

Dentistry for Children & Adolescents explains that fluoride plays an important role in preventing tooth decay in children. They explain that mouth bacteria feed on sugars and starches from remaining food after eating and then produce acids.

These acids then break down protective tooth enamel, leaving the inner part of teeth exposed. This is when tooth decay occurs. Fluoride helps prevent decay by strengthening enamel, as well as inhibiting mouth bacteria from producing acid. It also helps remineralize enamel.

I like the fluoride kids’ toothpaste by the Burt’s Bees or Hello brands. When my kids get feisty about brushing their teeth, sometimes it is helpful to switch up the toothpaste flavors.

Is Fluoride Safe for My Child?

Historically, the official recommendation was to use fluoride-free toothpaste on baby teeth until a child turns 2. Today though, the ADA recommends using fluoride toothpaste as soon as baby teeth emerge. And since they recommend using such a tiny smear of toothpaste (a rice grain-sized smear), they say it isn’t harmful if a child swallows it.

As I was considering the ADA’s recommendation on fluoride toothpaste, I wondered why I had heard so much controversy about fluoride. Some say it has detrimental health effects, and others say it is essential for oral health. I never knew the details behind these opposing points of view, so I looked into it.

WebMD states that too much fluoride before the age of 8 can cause fluorosis, but that this is usually just a cosmetic issue (stains and changes to teeth’s surface). They also state that less than 1% of fluorosis cases are considered severe.

The big problem with fluoride occurs when intake is excessive and is ingested from multiple sources; such as drinking fluoridated water, taking supplemental fluoride, and swallowing a lot of fluoride toothpaste.

Healthline explains that problems from excessive fluoride intake usually occur in countries where there are very high levels of fluoride in the drinking water. In these countries, a bone disease called skeletal fluorosis may occur.

Fluoride can be found in the groundwater in these countries at levels greater than 8 ppm. This is double the amount of fluoride that is federally regulated and allowed in drinking water in the US. Healthline says that there is inconclusive evidence regarding other illnesses and their potential link to fluoride.

Toothbrushes for Baby Teeth

There are so many different types of toothbrushes marketed for kids out there that it can be hard to know where to begin. What I think is more important than getting too caught up in the specifics of types of toothbrushes, is just making sure my kids are getting those twice-daily brushings in while being gentle on their gums.

The Famous Silicone Banana Baby Toothbrush

I have found the Baby Banana toothbrush to be a great way to introduce my babies to a toothbrush.

It is easy for babies to hold and they can gnaw on the silicone bristles.

Silicone Finger Toothbrushes

I used a silicone finger toothbrush with my first baby and now with my second. The most helpful thing about this brush for me is that I can feel exactly where I am on the teeth and gums. Since I can feel where I am making contact in my baby’s mouth, I know when I have done a thorough brushing.

Silicone finger toothbrushes are also very gentle on sore gums from emerging teeth. Word of warning though, babies or young toddlers may very well bite a finger! My babies never did this intentionally, so a gentle and firm “no, no” put a stop to it.

Dentaly explains another benefit of silicone toothbrushes is that they are nonporous. This means they are easy to clean and they do not have as much bacteria buildup as regular toothbrushes. They are also a more eco-friendly option since they do not need to be replaced as often as regular brushes.

As we continue to rely on a silicone toothbrush though, I have wondered if they are less effective than regular bristled toothbrushes. They are so much softer, so do they do as good of a job?

According to a 2019 Romper article, more research is needed on silicone toothbrushes, but reputable sources say that they seem to do as good of a job as regular nylon-bristled toothbrushes. These sources come from interviews with AAPD (American Academy of Pediatric Dentistry) leaders and pediatric dentists.

Traditional Nylon Toothbrushes

A traditional nylon child’s toothbrush with soft bristles can also be fun for little ones to explore. Even a soft-bristled toothbrush can be a little pokey on sore gums though, but it’s worth trying out a variety of toothbrushes to see what works best.

How to Brush Baby Teeth for Good Oral Health

Even with all the right tools, it can be hard to know exactly how to brush baby teeth. Most parents I talk to say that brushing their babies’ teeth is challenging, if not impossible. There is a lot of squirming, thrashing, and general refusal. I would tend to agree, so below are some of the strategies I use to brush my son’s teeth.

Distraction Tactics

I often play Elmo’s Brushy Brush video on my phone as I brush my son’s teeth. It is a fun song and video of Elmo and other adults and young children brushing their teeth.

My son is captivated by it and will sit still long enough for me to get a good brush in. We also use other distraction tactics like books, singing, and toys. We hope that over time he will realize that brushing teeth is just a part of daily life and we won’t need to rely on these distractions.

I have heard that holding a handheld mirror up to a baby’s face while brushing can also help keep them entertained and agreeable while brushing, although this never worked for my babies.

Modeling Good Teeth Brushing Habits

I also try to make sure my son is seeing me brush my teeth regularly. I make a point to show him how I am moving the toothbrush, then spitting and rinsing. Children are naturally inclined to model the behavior they see around them, so this can be an easy way to encourage kids to jump on board with tooth brushing.

Developing a Teeth Brushing Routine

Once kids know that something is part of their daily routine, they start to like it or at least find it reassuring.

When it comes to learning how to brush baby teeth, there is no substitute for sticking with it and remaining diligent. Instilling this sense of routine around good oral hygiene habits serves little ones well as they grow and develop.