A beautiful smile showing beautiful teeth is what everybody wants, but caring for baby and toddler teeth is not always an easy thing. Getting your child to eat the right thing and then cleaning their teeth can be difficult, whilst getting them to even open their mouth when they go to the dentist can be an achievement in itself.

Tooth decay is Australia's most prevalent health problem - more common than cancer or heart disease. So how do you start your child off on the best possible road to good dental health - and a beautiful smile.

Tooth Development
A baby's primary teeth, also known as baby teeth or deciduous teeth, begin to form 5 weeks after conception and by the time a baby is born, all 20 primary teeth are present in the jawbone but under the gums. The age from which baby teeth begin to erupt varies greatly and it is not uncommon for a difference of 6 to 12 months - the diagram and table below show the most common order (and age) for primary teeth to appear.

First teeth begin to appear between six and twelve months of age and most children have their full set of primary teeth in place by age three.
    













Above images kindly supplied by HEINZ.  

Teething
As their teeth come through, some babies may become irritable, fussy, sleepless and lose their appetite or dribble more than usual; the gums may become red, swollen and if pressed, they may feel hard and pointed. A rise in temperature, redness, pain and swelling can accompany teething. Additionally, restlessness, sleeplessness at night, infections rashes and diarrhoea have some association with teething, however it's important to check with your doctor if these symptoms persist.

Some babies may have sore or tender gums when their teeth begin to erupt. Gently rubbing the gum with a clean finger, a small cool spoon or a cool wet cloth can provide some relief. If there is a lot of pain, your dentist or doctor may recommend a children's pain reliever. To help soothe the irritation that teething can cause, offer your baby a teething ring to chew on. Don't offer a 'comfort' bottle to chew upon as the contents could contribute to 'nursing bottle' decay even with only the smallest amount of sugar.

Cleaning
Begin tooth cleaning as soon as the baby teeth erupt. This can be done with a moist cloth. A toothbrush can be used as soon as it is tolerated, usually between 1-2 years, but without toothpaste. Introduce your baby to toothpaste from around two years of age or as directed by your dentist. Use a pea-size amount of fluoridated toothpaste that's been formulated for children, on a small soft toothbrush. Toddlers should be encouraged to spit the toothpaste out.

Children usually require assistance and encouragement with cleaning teeth up to six or seven years of age. Do this by standing or sitting behind the child and leaning over - the same way a dentist works.

Both manual and electric toothbrushes are good for children - just ensure you're buying the right type of brush based on your child's age and mouth size.
 
Visiting the Dentist
A child's first visit to the dentist should be as early as can be done with adequate cooperation, usually from around the age of 1 and no later than 3 years. Parents are advised to take their child to the dentist at an early age to help prevent any problems, which may occur as the child grows and develop - children who visit the dentist regularly from an early age are much less likely to experience dental problems during their childhood and are unlikely to experience a future fear of dentists.

It is important for parents to make dental visits enjoyable for their children. Parents can help their child feel comfortable by making sure he or she doesn't hear scary stories about dental visits. Don't let them know if you feel any anxiety about going to the dentist yourself.

You can seek a midwives assistance for all or just some of the services above - for example, contact your local midwife after the birth for home-help with settling or feeding your newborn.

Diet
A child's diet is likely to assert the most significant influence on whether they get decay or not. The worst foods are those that are high in sugar and are released slowly into the mouth. These include lollies that are sucked slowly, drinks that are consumed slowly over long periods (eg juice in a nursing bottle) and chewable Vitamin C tablets (grinding ascorbic acid powder into the teeth).

Give babies and toddlers a balanced, healthy diet with plenty of calcium and vegetables, and keep sugary snacks to a minimum.

The most common dental decay problem seen in infants and toddlers is nursing decay. Bottle and breast-fed babies are both susceptible. Babies left with a bottle as a pacifier and those who are frequently nursed, especially at night, run the danger of bottle or nursing decay due to the prolonged exposure to the carbohydrates in milk (human milk is no exception) or juice. As soon as practicable, any time from about 8-9 months, start your baby drinking from a cup as this reduces the drinking time and therefore the time that sugars are in contact with the bacteria and the teeth.

If your tap water is not fluoridated, discuss with your dentist the need for topical fluoride and/or fluoride supplements.
 
The key principles for good oral health in babies and children and caring for baby and toddler teeth are:

• Enjoy a wide variety of nutritious foods, especially those rich in calcium and low in acids and sugars
• Enjoy healthy snacks, with cheese and fruit being ideal after-school choices
• Drink plenty of tap water - especially if fluoridated
• Brush gently and thoroughly, with a fluoride toothpaste from age 2 onwards (with a low concentration for children up to 7 years)
• Use a soft compact head toothbrush
• Clean teeth at least twice a day, after breakfast and last thing before bedtime
• Have regular dental checkups - don't wait for a problem to occur
• Dental checkups start with toddlers