Baby teeth are important! Your child’s baby teeth are at risk for cavities as soon as they first appear, which is typically around the age of six months. Cavities that occur in the upper front teeth, sometimes including other teeth, in infants and toddlers is often referred to as Baby Bottle Tooth Decay (cavities). In some cases, infants and toddlers experience cavities so severe that their teeth cannot be saved and need to be removed.

The good news is that cavities are preventable! Most children have a full set of 20 baby teeth by the time they are age three. As your child grows, their jaws also grow, making room for their permanent (adult) teeth.


Baby teeth


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Resources for Families
Protect Your Baby's Teeth and  Gums   Protect Your Baby's Teeth and  Gums

Protect Your Baby's Teeth and Gums

This infographic demonstrates the dos and don'ts of protecting your baby's teeth and gums.


Healthy Baby, Healthy Smile

This infographic demonstrates the dos and don'ts of protecting your baby's teeth and gums.


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Teething and Pacifiers

Newborns usually have no visible teeth. Most baby teeth begin to appear generally about six months after birth. During the first few years of your child’s life, all 20 baby teeth will push through the gums and most children will have their full set of teeth by age three. As their teeth erupt, some babies may become fussy, sleepless and irritable, lose their appetite or drool more than usual. Diarrhea, rashes and a fever can also be normal symptoms for a teething baby. 


Infants and young children may suck on thumbs, other fingers or pacifiers. Pacifiers dipped in sugar, honey, juice or sweetened drinks, can lead to cavities. Cavities are caused by germs your baby gets from you. Clean pacifiers with warm soapy water, not your mouth. Don't share spoons or cups with your baby and don't share pacifiers or bottles with other babies.

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Cleaning your Child's Teeth

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, you should begin brushing your child’s teeth with a soft toothbrush with a rice size amount of fluoridated toothpaste. If proper oral hygiene is not used, cavities can occur. 

Children's mouths change quickly, when brushing their teeth make sure to lift the lip and check all teeth for signs of cavities. If you see white or brown spots on the teeth or anything unusual contact your child’s dentist or health care provider. Good oral hygiene habits include brushing thoroughly twice per day (morning and night). Teach your child to spit out the toothpaste.

For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste on a soft toothbrush and brush teeth thoroughly twice per day. Supervise children’s brushing and remind them not to swallow the toothpaste. Until you’re comfortable (usually at age 8) that your child can brush on their own, continue to brush your child's teeth twice a day with a soft child-size toothbrush and a pea-sized amount of fluoride toothpaste.

When your child has two teeth that touch, you should begin flossing their teeth once daily.

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First Dental Visit

As soon as your child’s first tooth appears, it’s time to schedule a dental visit. The American Dental Association recommends that the first dental visit take place within six months after the first tooth appears. Don’t wait for them to start school or until there's an emergency. 

Although the first visit is mainly for the dentist to examine your child’s mouth and to check growth and development, it’s also about your child being comfortable. To make the visit positive:

  • Consider making a morning appointment when children tend to be rested and cooperative.
  • Keep any anxiety or concerns you have to yourself. Children can pick up on your emotions, so emphasize the positive.
  • Never use a dental visit as a punishment or threat.
  • Never bribe your child.
  • Talk with your child about visiting the dentist.

During this visit, you can expect the dentist to:

  • Inspect for oral injuries, cavities or other problems.
  • Let you know if your child is at risk of developing cavities.
  • Clean your child’s teeth and provide tips for daily care.
  • Discuss teething, pacifier use, or finger/thumb sucking habits.
  • Discuss treatment, if needed, and schedule the next check-up.
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Preventing Decay

Cavities in infants and toddlers is often referred to as early childhood tooth decay (cavities), baby bottle tooth decay, or early childhood caries. Infant's teeth are susceptible to cavities as soon as they begin to erupt. It is the most common chronic childhood disease.

Early Childhood Caries (ECC) is a severe form of cavities in baby teeth of infants and toddlers. Baby teeth have thinner enamel (outer tooth surface) than permanent teeth, making them susceptible to cavities. Cavities often occur in the front, upper teeth, but may occur in other teeth as well.

Cavities happen when bacteria (sugars and acids from food) begins to break down the tooth enamel. The bacteria also can be transferred from a caregiver's mouth to the infant when they share a utensil or pacifier.

Prevent Decay

  • Only give your child a bottle during meals.
  • Do not put your child to bed with a bottle.
  • Get rid of the bottle by age one.
  • Encourage healthy eating habits.
  • No dipping pacifiers in sweetened liquids.
  • No sweetened beverages in the bottle.
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Fluoride is a mineral that occurs naturally in all water sources, including oceans, rivers and lakes. Fluoride is also added to some community tap water, toothpastes, and mouth rinses. Infants and toddlers who do not receive an adequate amount of fluoride may be at an increased risk for cavities since fluoride helps make teeth more resistant to cavities. It also helps repair weakened teeth. 

Bottled water may not contain fluoride; therefore, children who regularly drink bottled water or unfluoridated tap water may be missing the benefits of fluoride. If you are not sure if your tap water has fluoride, contact the North Dakota Drinking Water Program.

Discuss your child’s fluoride needs with your dentist or health care provider. They may recommend a fluoride supplement if you live in an area where the community water is not fluoridated.