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EVERYTHING YOU WANT TO KNOW ABOUT ORAL HEALTH CARE FOR CHILDREN AGES 0-5

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Healthy baby teeth and gums are essential! Learn more about how to care for baby gums and baby 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. 
    • Have you ordered your free “Kit for New Parents” from First 5 San Mateo County? It has a baby’s dental care kit, including gum wipes, a toothbrush, timer, Potter the Otter book, and more! 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 cavitiesGerms 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 night time, 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. 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.

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 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. Start brushing your baby’s teeth as soon as they come in (see below for more details). 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.
  • 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.
  • Watch this video 40 second video about why baby teeth are important

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.
  • 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 in your lap. 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. If your child is younger than 2 years old, talk to your dentist or doctor before using fluoride toothpaste.
    • 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 mouthwashes for children that contain fluoride, as this can help children at risk for tooth decay get enough fluoride to protect their teeth. 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 dentists may tell you to make an appointment when your baby is older than one. You can tell them you are following the recommendations of the American Academy of Pediatrics and American Academy of Pediatric Dentistry and would like them to see your baby at age one.
  • 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.

Tips for your child’s first dental visit, from Health Plan of San Mateo Dental

  • 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. 
  • Schedule an appointment at a time your child will be the most comfortable, such as after a nap or after a meal. 
  • Be sure to brush their teeth prior to the appointment.
  • 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.
  • 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.