Oral Health: Infants and Toddlers

Published on 03 May 2021

Your child depends on you for healthy baby teeth. These teeth are important as healthy teeth look good, help your child eat well and are important for speech. They also help retain space for the eruption of the permanent teeth which helps prevent crowding. The baby or milk teeth are essential for good growth and development of your child. Good oral health from an early age will help them keep their teeth for a lifetime.


Oral Hygiene

  1. Start brushing as soon as the first baby tooth comes through the gums. This includes cleaning the teeth after meals.
  2. Buy a soft, small-headed brush and make sure that you only use a smear of fluoride toothpaste.
  3. Have your infant sit on your lap, both facing the same direction, so that you can get easy access to his or her mouth.


  1. Breast milk is recognised as the best form of nutrition for infants.
  2. If a bottle is used always hold the baby while bottle-feeding and do not put the baby to bed with a bottle.
  3. What you put in the bottle is very important for your child’s oral health. Use only expressed breast milk or formula for bottle-feeding.
  4. Do not put fruit juices or any other sweetened drinks in your baby’s bottle. The sugar in the drinks can damage your child’s baby teeth and cause early decay.
  5. Babies should not be left to fall asleep with a bottle of milk or juice as this can lead to rampant decay called “baby-bottle decay”.
  6. If you are using a pacifier to calm or soothe your child do not dip them in sugar or honey. Discontinue the use of pacifier by 2 years of age.


Oral Hygiene

  1. Adults should position themselves behind a seated or standing toddler, both facing the mirror, reach around to brush the toddler’s teeth.
  2. Use a smear of fluoride toothpaste on a soft, small-headed toothbrush.
  3. Brush twice a day, morning and night, for 2 minutes and brushing at night before bed is very important.
  4. Encourage your child to spit the toothpaste out after brushing and not rinse the mouth.
  5. Hold the brush at 45 degree angle to the gum line and brush gently by moving the brush back and forth in short, tooth-wide strokes.
  6. Make sure you brush the outer, inner and chewing surfaces of all the teeth in upper and lower jaws.
  7. Check your child’s brush regularly and replace it every 3 months or soon after the bristles start to wear out.


  1. Frequent consumption of high sugar containing foods and drinks can contribute to tooth decay.
  2. Reduce the frequency and amount of sugar intake by selecting healthy nutritious snacks such as fruit pieces, cheese, chopped vegetables and sandwiches
  3. Avoid eating sugary foods in between meals. If your child eats sweet sticky foods, they are best eaten at mealtimes rather than between meals
  4. Acidic and sugary drinks including fruit drinks, fruit juices, cordials, soft drinks and sport drinks are not recommended for infants and toddlers.

Common Problems

This is the time when a baby’s first few teeth begin to come through the gums. When the teeth break through the surface the gums may swell and become tender. Teething is easy to spot as your child may become restless or cry constantly. This may also be associated with disrupted sleep and eating habits, cheek redness, drooling and chewing or biting on their toys. But it is not usually associated with an increase in temperature. You can help your child by applying cold cloth wrapped in ice cubes and by using safe teething rings. You can also try using teething gels before feeds to relief pain.

Pacifier or Thumb Sucking
Many parents choose to have their infant suck a pacifier or dummy to calm them. Some children may also suck their thumb or finger. The effects of these habits on teeth are minor if used for a limited period of time, but if used for a long time it may cause problems in the way the teeth develop. Discontinue the use of a pacifier by 2 years of age and never dip the pacifier in sugar, honey or other sweetened drinks.

Early Childhood Caries
Early childhood caries (ECC) is the form of dental caries that affects the teeth of infants and young children and has been identified as an important health problem that affects the growth, development and quality of life of many preschool children and impacts on the family as a whole. ECC is caused by long and frequent exposure of a child’s teeth to sugar.

Teeth are at risk of dental caries from the time they start to appear in the mouth and therefore children from 6 months old onwards are at risk of developing ECC. Severe form of ECC develops very quickly and teeth may be destroyed within 6 months of its onset.

ECC can be prevented by brushing the baby teeth with a toothpaste containing fluoride as soon as the first tooth starts to come through the gums. It is also good to clean the gum areas that remain toothless. If a bottle is used for feeding, always hold the baby while feeding and do not put the baby to bed with a bottle. Discontinue the use of bottle by 12 months of age. Avoid giving sweet drinks such as fruit drinks, fruit juices and other sweetened drinks to your child.

Lift the Lip
Early identification of this caries can help prevent or stop the progression of this disease. Parents should lift their child’s lip regularly to check for signs of tooth decay.

Stage 1: Healthy teeth and gums
Stage 2: Chalky, white spots or lines on the tooth near the gum line. This could mean start of tooth decay. Take your child to a school /community dental clinic as soon as possible.
Stage 3: Yellow / brownish discolouration or cavities. Visit a dental clinic immediately
Stage 4: Well advanced decay or loss of tooth structure. Visit a dental clinic immediately

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  • Start brushing the baby teeth as soon as the first tooth starts to come through the gums.

  • Use a soft, small-headed brush.

  • Start using fluoride toothpaste as soon as their first tooth comes through the gums. Only a smear of fluoride toothpaste should be used for children under 6 years old.

  • Start brushing your child’s teeth as soon as their first tooth comes through the gums. This helps your child get used to this routine at an early age. It is difficult to start this habit with a toddler as it is common for them to be fussy and difficult. Try using a reward system like offering a sticker for each day of brushing or make a game out of it by starting a brushing chart. Adult modelling – an older person brushing their teeth regularly in front of the child might work. This will help them know both how to do it and the importance of doing it.

  • Baby teeth are important and need proper care as they can cause problems if they are neglected. Poor dental health can affect growth and development by interfering with nutrition, speech production, school participation, self-image and social functioning. Dental problems in early childhood increase the risk of future dental problems. The first set of teeth is important in saving space for permanent teeth and helps them from being crooked. They are also important for the proper growth of face and jaws.

  • Primary or baby teeth are usually developed before your child is born and will start to come through at around 6 months on the lower front teeth. All 20 baby teeth will be through by about 2-3 years old. The baby teeth will not fall until 5-7 years old, with the last ones falling off around 12 years old.

  • Most children do suffer some pain during teething. Their cheeks may appear red and warm to touch. Using special gels and teething rings can help reduce the pain. Sometimes, paracetamol-based medicines can be helpful but remember to follow the instructions on the bottle.

  • MOH recommends that the first dental check-up for your child should be done by the first birthday. Bring your child to our dentist for a simple check-up to make sure the teeth are growing well. Dental care is best introduced when there is no pain. The first dental visit is for parents to learn the right techniques of taking care of your child’s first teeth. Take the opportunity to clear any doubts you have with the dentist.

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