If there aren’t any teeth but you have a feeling they’re on the way, please read more information about teething here.
If you look back at my cavity process blog, cavities = acid + teeth and acid is made from cavity-producing bacteria after they consume sugar/carbohydrates.
Fortunately, cavities are largely preventable! Let’s explore the key factors influencing cavity development and how to manage them at home!
Bacteria
1. Brushing and maybe flossing too!
Once you spot a glimmer of a tooth, grab that first toothbrush! It’s time to keep those tiny teeth free of bacteria and sugar. Look for a toothbrush with soft bristles and the smallest toothbrush head possible, as a baby’s mouth is tiny. Some babies may resist by using their tongue, cheeks and lips to push you away, so a smaller brush head will help you reach where you need to go. At this stage, I personally don’t recommend continuing wiping with a moist cloth because I find fingers can make it harder to see the area you are cleaning. Plus, a baby’s bite can be surprisingly strong!
Start brushing 2 times a day, after breakfast and before bedtime. Ensure the nighttime brush happens after the last bottle or breastfeeding session. Nighttime brushing is most important because saliva flow decreases at night. With less saliva to wash away bacteria, they can stick to teeth more easily, form stronger colonies and produce more acid. To put this into perspective, not brushing increases the risk of cavities by 2.6 times compared to brushing twice daily. This explains why some babies can develop cavities before their first birthday!
Take a close look at your baby’s new teeth. Do they touch? If so, flossing should begin. Think of flossing as using a string to brush the sides of teeth where the toothbrush can’t reach. Floss sticks can help you floss without putting your hands in Baby’s mouth - some have a flavoured coating to make the experience more enjoyable!
If you’re confused about how to hold a baby or toddler while brushing and flossing, check out my blog, “How to Firmly Yet Safely Stabilize Your Child during Brushing and Flossing”. It’s not as intuitive as it sounds!
Lastly, lift your baby’s lips during brushing to check for cavities and infection. For images and more details, refer to my blog “Check for cavities and infection during brushing”
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2. Fluoride
Using toothpaste is second nature for adults, but do you know why we use it? Toothpaste primarily delivers fluoride to our teeth. However, excessive fluoride intake during tooth development can lead to dental fluorosis, which affects the appearance of adult teeth (can appear chalky white, yellow or brown and pitted in severe cases). Since babies can’t spit until around age 3, fluoride toothpaste is typically not recommended for children at low risk of cavities until that age.
To simplify early brushing, I suggest skipping toothpaste altogether - just use a dry toothbrush and rinse the toothbrush afterwards. I remember when I first started brushing my baby girl’s teeth at 7 months, all I had energy for was reaching for the toothbrush beside the nursing chair and brushing for 15 seconds.
As your child nears age 3, you can introduce non-fluoridated toothpaste to help them adjust, as sometimes toddlers find toothpaste “spicy” and the foaming sensation can be overwhelming. A note that if your child is at high risk of cavities (eg. put to bed with a bottle of milk), fluoride toothpaste may be recommended even in infancy. This is because the benefit of preventing cavities outweighs the risk of dental fluorosis. Please consult your child’s dentist for specific recommendations.
I love how Zoe Malin explained the importance of fluoride in dentistry. Please read her article, “Should you use fluoride-free toothpaste?” (for children over age 3) here: NBC News - Fluoride-Free Toothpaste.
3. Prepare for first dental visit by age 1:
How do you know if you’re reaching all the right spots while wiping gums or brushing teeth? Well, that’s where your dentist comes in! The checkup is usually quick and hopefully, you get two thumbs up. But if you need any guidance, we’re here to help. Your dentist may also review other cavity risk factors, as we do at Dentalgarten, to set you up for success! Got questions about pacifier or thumbsucking habits? We can answer those too!
4. Parents, your mouths matter too:
Research shows that mothers with untreated cavities nearly double the odds of their children developing cavities.1 We highly encourage parents to visit the dentist regularly to lower the family’s cavity risk.
Sugar in Snacks (not breakfast, lunch and dinner)
1. Less than 3 sugary foods and beverages between meals per day
Between 4-6 months, your baby will start eating solids! At first, they might have one, then two, then three solid food explorations a day, gradually matching your own breakfast, lunch and dinners. Eventually, snacks will be introduced between meals.
What dentists worry about is frequent snacking, also known as grazing. Grazing could mean a snack every 30 minutes, even something as small as a single piece of cereal. Each time bacteria consume carbohydrates, they produce acid, and it takes 30-60 minutes for the acidic environment in the mouth to neutralize. This means if a child grazes all day, their teeth are exposed to an acidic environment for most of the day! To prevent grazing, I encourage setting designated snack times to establish a feeding routine.
In my blog “Let’s Make a Snack”, we also explore the stickiness, acidity and sugar content of various snacks. Feel free to continue learning there!
References:
- Weintraub JA, Prakash P, Shain SG, Laccabue M, Gansky SA. Mothers' caries increases odds of children's caries. J Dent Res. 2010 Sep;89(9):954-8. doi: 10.1177/0022034510372891. Epub 2010 May 26. PMID: 20505046; PMCID: PMC3327504.
