​Everyone

• Routine, routine routine! Practicing good oral health is all about establishing and keeping a daily oral health routine, following the instructions below.
• Brush your teeth and tongue morning and night–2 times a day at least–with fluoride toothpaste and a soft toothbrush that is the right size for you for 2 minutes. 
• Spit out the toothpaste, but don’t rinse it off with water or mouthwash.
• Floss at least once before bedtime.
• Eat foods and drinks low in added sugars. Too much sugar in the mouth for too long can cause tooth decay and gum disease.
• Snack on healthy foods and drinks at specific times, not all throughout the day.
• Drink tap water with fluoride.
• See the dentist at least twice a year for a check-up.
• If you take medications, ask your doctor or dentist if they may increase your risk for oral health problems. For example, some medications cause dry mouth or oral yeast infections. Take the steps your doctor and dentist recommend to best care for your oral health while on these medications.

Pregnancy

• ​It is safe and important to see the dentist during your pregnancy.
• Changes to your body during pregnancy may make your gums more sore, red, or likely to get a mild (reversible) form of gum disease. It is important to keep gently brushing and flossing your teeth. Use a soft toothbrush with fluoride toothpaste.
• If you have morning sickness and vomiting, protect your teeth from the acid that can cause teeth erosion by rinsing with tap water or a teaspoon of baking soda and a cup of water. Before bed, rinse with an alcohol free mouthwash with fluoride.
• Having a healthy mouth yourself will help your child to have a healthier mouth too.
• If you smoke or use tobacco, quit. See here for help.
• For additional information, see the pregnancy and oral health webpage here.

Babies​

• Take your baby to their 1st dental appointment when their 1st tooth comes in, or by their 1st birthday. If your child’s dental office tells you they see babies starting at age 2 or older, schedule the appointment as close to your baby’s first birthday as possible. Ask the office if it’s possible to schedule a quicker initial ‘get to know you’ visit when your baby turns one. Click on the video above or here to learn more.
• Wipe the baby’s gums with a soft wet cloth after each feeding. During nighttime feedings, keep a bottle with water in it nearby and give them a little water after the feeding to rinse their mouth.
• If your baby needs a bottle to fall asleep, it should only have water in it. Babies that fall asleep with a bottle with milk in it can get tooth decay called “Baby Bottle Syndrome” because the milk pools in their mouth and bathes it with sugars that cause tooth decay. If your child falls asleep while feeding, remove the bottle as soon as you notice they are no longer sucking.
• Start brushing your baby’s teeth with a small smear of fluoride toothpaste when their first tooth appears with a soft toothbrush. You can use a rubber finger brush for babies. Use a rice sized amount of toothpaste until they’re about 3, when you can switch to using larger pea sized amounts. 
• Start flossing their teeth when they have two teeth that touch. You can use floss picks if they are easier to use.
• Babies should not be given juice to drink.
• Parents/ caregivers need to keep their mouths healthy and not share utensils with their baby. Rinse your baby’s pacifier with water to clean it. Do not use your mouth to clean it. Bacteria from the parent’s mouth can transfer to the baby’s mouth.
• According to the American Academy of Pediatrics, when your baby is 6 months, your pediatrician can start to do oral health checkups and apply fluoride varnish. All infants and children should have fluoride varnish every 6 months until age 5.  Children might need it every 3 months if they have a higher risk of dental decay. These fluoride varnish applications are covered for free by public (HPSM Dental) and private dental health insurance plans.

Kids

• It’s all about establishing and keeping to a daily oral health routine! Do not skip the daily oral health routine, even when it gets hard. Brush and floss together as a family. See our books and songs page for ways to make the routine more fun.
• Kids need their parents/ caregivers to help them brush and floss their teeth until they’re about 7-8 years old, and have the skills to do it themselves.  
• Kids should see the dentist twice a year, and get fluoride treatments and sealants to protect their teeth.
• Kids should drink lots of water, and should not drink juice, sodas, and other sugary drinks. If they have juice or a sugary drink, it should only be about 4 ounces (half a cup) or less.
• Kindergartners- in California, public school kindergartners need to see a dentist for a checkup and complete the Kindergarten Oral Health Assessment to turn into their school at the start of the school year. See here for more information.
• According to the American Academy of Pediatrics, all children should have fluoride varnish every 6 months until age 5.  Children might need it every 3 months if they have a higher risk of dental decay. These fluoride varnish applications are covered for free by public (HPSM Dental) and private dental health insurance plans.
• The American Dental Association recommends that every child have an orthodontic evaluation by 7 years of age.
• Ask your child’s dentist about what protective gear they should wear in their mouth if they play sports.

Healthy baby teeth and gums are essential! Information about caring for baby gums and teeth, teething, pacifiers, bottles and more

Caring for your baby’s gums

• Breast milk is best! Breastfeed your baby for 6 months or longer if you can. See our Family Health Services’ webpage about breastfeeding here for more information.
• Clean your baby’s gums after every feeding, and before bed. Use a clean, damp washcloth. This will wipe away germs and sugars that can cause cavities. It will also help get your baby used to having their mouth cleaned.  During nighttime feedings, keep a bottle with water in it nearby and give them a little water after the feeding to rinse their mouth.
  • Have you ordered your free “Kit for New Parents” from First 5 San Mateo County? It has a books with more information about oral health and lots of other tips and tools for caring for young children. Click here to order yours.
• Babies naturally pick up bacteria from their surroundings that builds the immune system. Families with healthy mouths pass on helpful bacteria to babies, but if there is untreated oral disease in the family, infants can be exposed to the germs that cause cavities. Germs can pass from your mouth to your baby’s mouth. Use a different spoon to taste your baby’s food. Clean your baby’s pacifier with water. Do not use your mouth to clean it. After your baby is born, it is important for you to keep brushing your mouth twice daily with fluoride toothpaste. You also need to floss, eat healthy foods, and get dental care. When your mouth is healthy, your baby is more likely to have a healthy mouth, too.
• Pacifiers: Keep them clean, and do not dip them in any other type of food or liquid. If your child uses a pacifier or sucks their fingers, talk to your dentist about how to get your child off this habit. Sucking habits usually stop between the ages of 2 and 4. If the sucking continues, ask your child’s dentist or pediatrician other ways to discourage sucking. These habits can cause problems as your child’s teeth and mouth develop, like crooked teeth and changes to the shape of their face and mouth.
• Bottles: Bottles should only have water, formula, or breast milk in them. At nap times or nighttime, if you put your child to bed with a bottle, it should ONLY contain water. Do not put your child to bed with a bottle filled with breast milk, formula, juice or sugary drinks like fruit-flavored drinks or soda. The sugars from these liquids can stay on their teeth and gums and cause decay, called “Baby Bottle Syndrome.” If your child falls asleep while feeding, remove the bottle as soon as you notice they are no longer sucking.
  • Wean your baby off their bottle by age 1 by getting them to drink from a cup by their first birthday. Babies can start using a cup around the age of 6 months. Training cups should be used for only a short time.
• Pacifiers, bottles, and oral thrush (oral yeast infection): oral thrush is a common infection in babies, but you can help prevent it. If you bottle feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. 

Healthy baby teeth are important

• Your child will get a full set of 20 “baby teeth” or primary teeth starting around 4-10 months old, but they can come in as late as 12 months old. The last of the baby teeth come in when they’re about 2-3 years old, but this timeline will vary for each baby. 
• Baby teeth are just as important as adult teeth, even though they fall out. Children need clean and healthy baby teeth to eat, talk, smile, and feel good about themselves. Baby teeth give the face its shape and hold space for adult teeth to come in the right way. Cavities in baby teeth can lead to cavities in adult teeth.
• Start brushing your baby’s teeth with a smear of fluoridated toothpaste as soon as they come in (see below for more details). You can sit down and place the baby in your lap with their head against your stomach, or cradle them in the crook of your elbow. You can tickle their lips with the toothbrush to get them to open their mouth.
• Teething can cause discomfort, and your baby may have different symptoms associated with teething, which are normal. To help your baby feel better, you can gently rub your baby’s gums with clean, wet gauze, your finger, or a small, cool spoon. Give them a clean, chilled (not frozen) teething ring- but don’t dip it in anything sweet or in other foods. If you have concerns about your baby’s symptoms call their dentist or pediatrician.
  • Learn more about teething by clicking these links, in English and in Spanish / Español.
  • You can keep track of your child’s baby teeth using a teeth chart. The baby teeth development chart is available from Smile, California here.

Everything you want to know about: brushing, flossing,  toothpaste, mouthwash, and ways to keep it fun with games! 

• Take your child in for their first dental visit when their first tooth comes in, or by their first birthday (see below for more details). 
• Schedule regular dental visits every six months for your child. These twice yearly visits are covered for children ages 0-20 by Health Plan of San Mateo. Click here for more information about covered services.
• Choose healthy drinks and snacks, and stay away from juice if possible. When your baby starts eating solid foods, choose foods with no added sugar. If juice is introduced, it should not be introduced until after your child turns one year old (even 100% juice). It is recommended to add an equal amount of water to juice if giving juice to children.
• Check for tooth decay at home- “Lift the lip:”  One easy way to check your child’s teeth for early signs of tooth decay is to lift or gently push the upper lip so the teeth and gums are visible. Look at the upper teeth- the front and back of the teeth—for plaque on the gum line, and white, brown, chalky, or black spots on the teeth. Repeat the process with the lower teeth. If you see spots or anything unusual, have your child’s teeth checked by a dentist or medical provider as soon as possible. Your child may fuss, cry or wiggle while you check their teeth. As you both get more comfortable with the process, it will get easier. Click here for these “Lift the Lip” instructions from Cavity Free Kids.
• Brushing - Brush teeth twice a day with fluoride toothpaste, for two minutes each time, and floss at least once a day at bedtime. You can use a two minute timer to make sure they brush for long enough.
  • ​Click here to get information about how to correctly brush teeth.
  • ​Download a “monthly toothbrushing calendar” and fill out daily with your child to make sure your child is brushing twice a day. Brushing calendar-English​ and Brushing Calendar - Spanish / Actividad de Calendario- Español
  • Click here for a fun 2 minute Elmo brushing teeth song you can play while you brush your child’s teeth.
  • Click here to go to Sesame Street in Community’s Oral Health page, with lots of videos, songs, and games about oral health for your child.
  • Here are a number of FREE brushing apps that could make brushing more fun for your child:
    • Disney Magic Timer (free): Google Play Store | Apple App Store
    • Toothsavers Brushing Game (free): Apple App Store | Flash Game
    • Sonicare Kids (free): Google Play Store | Apple App Store
    • Daniel Tiger’s Day and Night (free): Google Play Store | Apple App Store
• It is important to start daily brushing and flossing habits as soon as the baby’s first tooth appears. The younger your child is when you start to brush and floss their teeth, the easier it will be for them to form good habits. Young children like to do things by themselves. It’s good to let children brush their teeth while an adult watches. But children under age 7 or 8 cannot brush their teeth well yet. An adult needs to brush the child’s teeth too. Find a position where your child is comfortable and you can see your child’s teeth while you brush. For example, sit on the floor with your baby’s or young child’s head against your stomach. Or stand behind your child in front of the mirror.
• Even after your child starts to brush their own teeth, you should still watch while they brush. This helps you make sure they are cleaning their teeth the right way. By around age 10 or 11, most children should be able to brush their teeth without supervision. You can model good habits by brushing your teeth with them when they brush theirs.
• Toothbrush - Brush with a soft bristled toothbrush that is appropriate for your child’s age. Check the toothbrush to see what ages it is for, or ask your dentist. If using an electric toothbrush, make sure not to brush too hard, because that may damage your child’s gums. A new toothbrush may be needed every 3 months because bristles can get worn down or broken. A worn toothbrush doesn’t do a good job of cleaning the teeth.
• Toothpaste - Use toothpaste that has fluoride in it. Fluoride is an important ingredient (mineral) in toothpaste and is safe to use. It helps make teeth stronger and protects them from cavities and decay. Click here for more information about the safety and importance of fluoride for oral health.
  • Use a grain-of-rice sized amount of toothpaste for infants and toddlers under 3 years old. You can also use a rubber finger brush for infants.
  • Use about a pea sized amount of toothpaste for children ages 3-6.
• Spit don’t rinse- Teach your child to spit out all of the toothpaste, but don’t rinse after with water or mouthwash. “Spit, don’t rinse.” This allows the fluoride in the toothpaste to stay on the teeth, which helps protect them and can reduce the chances of decay by as much as 25%!
• Floss - As soon as your child has two teeth that touch, begin flossing every day, at least at nighttime before bed.
  • Click here to learn more about how to floss correctly.
• Mouthwash- Children may start to use mouthwash once they are at least 6 years old, or not at risk of swallowing it. Choose alcohol-free mouthwashes for children that contain fluoride. Choose a mouthwash that has the “American Dental Association (ADA) Seal of Approval” (or logo) on it. This website from the ADA lists mouthwashes that have their seal of approval.

Take your child to the dentist when their first tooth comes in, or by their first birthday

• Make your baby’s first dental appointment visit when their first tooth comes in, or by their first birthday.
• It is important your baby gets a dental checkup starting by 1 year old, and gets used to going to the dentist. The dentist will check for decay and other problems. They can show how to properly clean your child’s teeth, and may offer advice on your child’s diet, pacifier and bottle use, and oral care products for your family.
• Before the appointment, prepare a list of questions or concerns for the dentist. See below for more tips about how to prepare for your child’s first dental visit.
• Some dental offices may tell you they see babies starting at age 2 or older. You can let them know you’d like to make a first ”get-to-know-you” visit with the dentist when your baby is 1, as recommended by the American Academy of Pediatrics and the American Academy of Pediatric Dentistry.
• Dental check-ups and cleanings are covered twice a year by Health Plan of San Mateo Dental (HPSM Dental) for children and teens 0-20 years old. Go to their webpage here to see covered dental services for children.
• If you do not have any way of getting to the dentist for a visit covered by Medi-Cal, Health Plan of San Mateo offers transportation assistance to the dentist. Click here for more information about the ride benefit.
• If your dentist does not speak your language, and you need language interpreter services at your dental appointment, Health Plan of San Mateo has free interpreter services. Click here for more information about HPSM’s free language services.

Tips for your child’s first dental visit

• Tell your child about the appointment and what to expect. Play games to familiarize your child with the experience.
  • ​Have them sit in a chair and pretend to be the dentist by counting and brushing their teeth. Then let your child pretend to be the dentist with a stuffed animal or doll. 
  • Click here for some online oral health games to play with your child.  
• Read books or watch videos about going to the dentist with their favorite characters. 
  • Click here for a 2 minute Sesame Street video about visiting the dentist.
  • Click here for a 4minute Daniel Tiger video about going to the dentist. 
  • Here are some children’s books about going to the dentist you can download in English and Spanish: Stella's Shiny Smile / La Sonrisa Brillante de Stella / Miguel the Crocodile / Miguel el Cocodrilo
• Schedule an appointment at a time your child will be the most comfortable, such as in the morning after breakfast, after a nap, or after a meal. 
• Be sure to brush their teeth prior to the appointment.
• HPSM Dental members: bring both your HPSM ID card and your Medi-Cal BIC card to your dental appointments.
• During the appointment, bring a list of any medications your child is currently taking in order to give a complete medical history.
• Have your child bring their favorite stuffed animal or toy for comfort.