Dental Health and Children

Tooth decay (dental cavities) is the most common chronic disease of childhood and can lead to toothaches that interfere with eating, sleeping,school attendance and performance. It can also lead to serious infections and expensive treatments. The good news is they can be prevented! 

When should I start brushing my child’s teeth?

Right away! Even before your baby starts teething, you should keep his or her mouth clean using a washcloth to wipe their gums. Once teeth develop, you should use a soft baby toothbrush and a small amount (the size of a grain of rice) of fluoride toothpaste to brush their teeth.

How do I brush my child’s teeth?

  • Brush your child’s teeth for two minutes twice a day, usually after breakfast and before bed.
  • Start with a small amount (the size of a grain of rice) of fluoride toothpaste.
  • After your child turns 3, start using a pea-sized amount of toothpaste.
  • When your child is able, teach him to spit out extra toothpaste. Do not give young children water to rinse after brushing because they will likely swallow it.
  • When your child is older, you should still help and/or supervise her toothbrushing. Watch for good brushing technique and to make sure the right amount of toothpaste is used. Supervise your child until they are able to do it well on their own, which is usually once he is about 8 years old.

When should my child start flossing?

  • Flossing should start as soon as your child has two teeth that touch.
  • Initially, you should floss your child’s teeth. Ask your dental provider for tips on flossing the child’s teeth.
  • As the child matures, supervise her flossing. Children should master this skill around age 10 or 11.
  • Children should then clean between their teeth once a day with floss or flossers to remove food and plaque where a toothbrush cannot reach.

When should my child start seeing a dentist?

Your child should see a dentist by 1 year of age to establish a dental home. A dental home is a relationship between a dentist and patient, which includes all aspects of oral health, just like having a “medical home” with your pediatrician.

Preventing tooth decay

The amount of sugar you consume is the most important risk factor for developing cavities. The amount of sugary foods and drinks should be limited. Try to avoid juice drinks that are not 100 percent juice. Even 100 percent fruit juice has significant amounts of sugar and should be limited to no more than 4­–6 ounces per day.

Other ways to prevent tooth decay in children include:

  • Encourage children to drink only water between meals, preferably fluoridated tap water.
  • Avoid juice and other sugary drinks when possible. If given, juice and sugary drinks should only be given with meals. Constant sipping on sugary drinks during the day promotes cavities.
  • Be careful with foods that are sticky, such as candy or fruit rolls. These types of food can stick to your child’s teeth and cause cavities.

Does drinking from a bottle affect my child’s teeth?

Milk, formula, and juices all contain sugar. Sucking on a bottle that is filled with milk or formula for a long time can lead to tooth decay and cavities. This is most common when your child uses a bottle as a pacifier. Never put your child to bed with a bottle and transition to a cup when your child turns 1 year old.

Does it matter if my child gets a cavity in a baby tooth?

Even though baby teeth are not permanent, a cavity in a baby tooth can negatively affect permanent teeth and lead to other dental problems in the future.

  • Baby teeth are the only teeth children have to chew with.  Cavities in baby teeth can affect their nutrition.
  • Baby teeth create a path for permanent teeth to come in correctly.
  • Damaged baby teeth can cause overbites or improper jaw structure.
  • Baby teeth help children form words and learn to speak properly.

Fluoride and cavity prevention

Fluoride helps strengthen teeth and decreases cavities in baby teeth as well as permanent teeth. Fluoride is very safe to use. The primary risk that has been seen with fluoride use is fluorosis, which is white spots or lines on the teeth. Fluorosis occurs with excessive fluoride use when the when adult teeth enamel are still forming (before age 8).  After age 8, there is no further risk of fluorosis.

What forms of fluoride are there?

  • Fluoride rinses are available over the counter. These are not recommended for children under 6 years old. There is no additional benefit to fluoride rinses in addition to daily use of fluoridated toothpaste for children at low risk of cavities. For children at high risk, discuss any additional fluoride use with your dental provider.
  • Fluoride varnish is a concentrated form of fluoride that is applied directly to the teeth. This should be done by your pediatrician or dental provider every 3–6 months once teeth erupt.
    • The day the fluoride varnish is applied, your child should eat soft foods and should not brush her/his teeth that night. The next day, your child should brush twice daily with fluoridated toothpaste as normal.
    • You may notice your child’s teeth look yellow or discolored after fluoride varnish is applied. This will go away within 24 hours and does not cause long-term tooth discoloration.

Additional resources:


Written by Shannon Taut, MD and Andrei Taut, DDS
Reviewed by Sara Laule, MD
Updated September 2017