Brush those babies! – Baby and infant oral health

Babies are born without teeth, and the primary teeth that come through (also known as baby or milk teeth) usually fall out by 11 to 12 years of age.

Some believe that baby teeth are disposable, and only adult teeth require care. However, primary teeth allow children to chew and speak properly, and the molars orthodontically maintain space for the developing adult teeth. Like permanent teeth, primary teeth are susceptible to dental caries (decay) and, if left unattended, can cause pain and abscesses.

Daily care is needed so that children don’t develop dental caries, resulting in the need for restorations (fillings) or early extraction. It’s not just brushing that is required: bottles, dummies and diet all play an important role in how healthy a toddler’s teeth are.

When a child presents with cavities, fillings or missing teeth due to decay before 24 months of age, it is known as ‘early childhood caries’ (ECC). Although preventable, ECC is the most prevalent chronic childhood disease, five times more common than asthma and seven times more common than hay fever. Dental check-ups are important for all children, to assess the developing dentition and to identify risk factors for ECC such as:

  • developmental enamel defects
  • unsupervised brushing and flossing
  • frequent snacking
  • on-demand breastfeeding past the age of 12 months
  • night-time bottle-feeding with liquids other than water, such as milk or fruit juice.

The dentist will discuss ways in which the child can reduce the risk of decay and carers can promote good oral hygiene.

The Australasian and American Academy of Paediatric Dentists, along with the American Academy of Pediatrics, recommend an initial oral health check at the time of the eruption of the first tooth and no later than 12 months of age, followed by regular check-ups.

Most children will have their dental check-ups done with a family dentist in a private practice setting, though there are also some government-funded clinics available and limited facilities in public hospital clinics. Children with additional dental needs may be referred to a paediatric dentist.

Tips for mums and dads:

  • Oral hygiene: Tooth brushing and flossing on a daily basis is important in helping dislodge food and reduce bacteria plaque levels.
  • Diet: Parents should be aware of components of diet that affect dental health, such as the cariogenicity (that is, the potential to cause decay and caries) of certain foods and beverages, the effect of frequent consumption of these substances, and how diet affects the demineralisation and remineralisation of tooth enamel.
  • Fluoride: Using a fluoridated toothpaste and drinking fluoridated tap water assist in the formation of enamel and remineralisation of early signs of decay.
  • Caries removal: If mothers have active dental caries, they can transfer maternal MS (Mutans streptococci) to their infant. Routine professional dental care and removal of active caries with subsequent restoration can suppress maternal MS reservoirs and minimise the transfer of MS to the infant, thereby decreasing the infant’s risk of developing ECC.
  • Delay of colonisation: Avoiding saliva-sharing behaviours (such as sharing spoons with babies) can help prevent early colonisation of MS in infants.
  • Xylitol chewing gums: Evidence demonstrates that mothers’ use of xylitol chewing gum can prevent dental caries in their children by prohibiting the transmission of MS.

Dr Michele Tjeuw
Paediatric dentist


Every Child magazine – vol. 18 no. 3, 2012.

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