Ask the Pediatrician: How important is it to take care of baby teeth?

Seeing your baby’s first tooth is an exciting milestone. Most little ones will get their first (primary) teeth around 6 months of age, though tiny teeth can emerge as early as 3 months.

Did you know cavities can develop as soon as your baby has teeth? Since baby teeth will eventually fall out, it might not seem that important to take good care of them. Surprisingly, your child’s first teeth are essential to the health of their permanent teeth — and the foundation for lifelong health.

Cavities can form when the shiny surface of our teeth — the enamel — is harmed by common bacteria living in our mouths. The bacteria feed on sugary substances left behind from what we eat and drink. In the process, they create acids that attack tooth enamel, opening the door for tooth decay.

Even the natural sugars in breast milk and formula can kick-start the process of tooth decay. And even though primary teeth start falling out when kids are around 6 years old, what happens before then will influence your child’s dental health over the long term. Research shows proper diet and dental hygiene habits during a child’s infant and toddler years reduce the risk of tooth decay as they become older.

Even though we have made great strides in preventing tooth decay, it is the most common chronic health problem in children. In fact, 23 percent of all kids will get cavities before their fifth birthday.

Here are steps recommended by the American Academy of Pediatrics for preventing cavities in babies and young children.

No bottles in bed. Putting your child to sleep with a bottle allows the sugars found in formula and breast milk to linger on teeth, setting the stage for tooth decay. (In fact, many doctors and dentists refer to early cavities as baby bottle tooth decay).

Handle pacifiers, spoons and cups with care. Tooth decay-causing bacteria can easily move from mouth to mouth. So, for example, you should avoid putting a pacifier in your mouth and then giving it to your child or tasting your baby’s food before offering them a bite from the same spoon.

Cleanse little mouths after each meal. Even before your infant’s first teeth breakthrough, it is important to get into a healthy routine. Wipe the gums with a clean, damp washcloth or gauze pad after each feeding. When baby teeth come in, switch to a soft-bristled toothbrush with a smear (about the size of a grain of rice) of fluoride toothpaste. Around your child’s first birthday, create a healthy routine of brushing two times daily for two minutes each time. Consider setting up a bedtime routine of brushing your child’s teeth after their last feed, reading them a book and then getting them to bed at a regular bedtime: brush, book, bed.

Studies suggest that breastfeeding during a child’s first year can help reduce the risk of tooth decay by half. This may be because of other effects breast milk has the immune system or microbiome (the balance of good and bad bacteria). Still, whether you give your baby breast milk or formula, you should wipe their gums and any erupting teeth after feedings to minimize risk of decay.

Introduce a cup around your child’s first birthday. Teaching young ones to drink from a cup can help prevent tooth decay. Plan to begin moving your child from the breast or bottle to a lidded cup around 12 months. Milk, breast milk and formula can be given at mealtimes, but fill your child’s cup with plain water in between.

Skip the sugary drinks. Fruit juice, soda and sweetened drinks aren’t good for your little one’s teeth. In fact, the AAP does not recommend juice for babies under 12 months. After that, limit juices to 4 ounces per day and mix them with water (half-water, half-juice is best).

Limit sticky fruits and treats. Sticky foods that promote tooth decay include raisins and other dried fruits, gummy candies, taffy, fruit roll-ups and snack bars with honey or molasses. Try to limit these foods in your child’s diet and have kids brush or rinse with plain water after eating them.

Make water the family drink of choice. Regular tap water, which usually contains fluoride to strengthen tooth enamel, is the healthiest drink for your child’s teeth. Drinking plenty of water cleanses your child’s mouth and helps maintain saliva flow, which also washes away decay-causing bacteria.

When your baby’s first tooth appears, it is time to schedule their first dental visit. This is the ideal time to learn more about dental care for kids and what you will need to do as they grow.

Dr. Patricia Braun is a professor of pediatrics at the University of Colorado Schools of Medicine and Dentistry and a mother of two.