Start caring for your baby's mouth before the first tooth, and brush twice a day from the moment one appears. Wipe the gums with a soft, damp cloth in the early months. Once a tooth comes through, usually at around 6 months, brush it with a soft baby toothbrush, including last thing at night.
The part that confuses most parents is toothpaste, because the advice genuinely differs between countries. Australian guidance starts toothpaste at 18 months, while UK and US guidance starts a tiny smear from the first tooth. This guide sets out each country's advice exactly as it's published, then covers how to brush, bottles and sweet drinks, dummies, the first dental visit, what spots on teeth can mean, and what to do after a fall. For when each tooth arrives, see the teething timeline.
When should I start cleaning my baby's gums and teeth?
From the early weeks, then properly from the first tooth.
- Before teeth. Australia's healthdirect guide to children's teeth says to start cleaning your baby's gums with a clean, moist gauze pad or washcloth when they're just a few days old. The Sydney Children's Hospitals Network in Australia suggests gently wiping the gums with a clean, damp cloth after each feed.
- From the first tooth. The NHS guide to children's teeth says to start brushing as soon as the first milk tooth breaks through. The American Dental Association's MouthHealthy baby teeth page says to brush baby teeth twice daily as soon as they appear.
healthdirect in Australia notes that baby teeth help guide adult teeth into the right place, which is one reason to look after them even though they'll fall out.
What toothbrush should I use?
A small, soft baby toothbrush. Australia's healthdirect suggests replacing your child's toothbrush every 3 to 4 months, or sooner if the bristles are worn or frayed, and starting to floss once your child has 2 teeth that touch. Your dentist can show you how.
How much toothpaste should my baby use?
This is where the advice differs most. Each version below is stated as the source gives it.
| Age | Australia | UK | US |
|---|---|---|---|
| First tooth to 17 months | Water only, unless a dentist advises toothpaste | Smear, at least 1000 ppm fluoride | Smear the size of a grain of rice |
| 18 months to 3 years | Pea-sized, low-fluoride children's toothpaste | Smear, at least 1000 ppm fluoride | Smear the size of a grain of rice |
| 3 to 5 years | Pea-sized, low-fluoride children's toothpaste | Pea-sized (see ppm below) | Pea-sized |
Australia: water first, toothpaste from 18 months
Australia's healthdirect says to brush with water and no toothpaste up to 17 months, and to use toothpaste only if your baby's dentist has checked their teeth and says they're at high risk of tooth decay. From 18 months to 5 years, it says to brush twice a day with a soft toothbrush and a small pea-sized amount of fluoride toothpaste.
Victoria's Better Health Channel guide to tooth decay in young children in Australia specifies a small pea-sized amount of children's low-fluoride toothpaste from 18 months to 5 years, then a pea-sized amount of standard fluoride toothpaste from 6 years. Western Australia's HealthyWA fluoride page, which refers to the Australian guidelines for fluoride toothpaste, says the same: no toothpaste up to 17 months, a pea-sized amount of low-fluoride toothpaste from 18 months to 5 years, and adult-strength toothpaste from 6.
UK: a smear from the first tooth
The NHS says children under 3 should use a smear of toothpaste with no less than 1000 ppm fluoride (check the box), brushed by a parent or carer. It adds that your dentist may advise a family toothpaste with 1350 to 1500 ppm. From 3 to 6 years, the NHS says to use a pea-sized amount of toothpaste with 1000 to 1500 ppm fluoride.
The UK's Oral Health Foundation, in its guide to caring for baby teeth, also says to use a smear of toothpaste with at least 1000 ppm fluoride for children under 3. Its page on children's teeth from age 3 gives a pea-sized amount containing 1350 to 1500 ppm fluoride from 3 years, a slightly higher range than the NHS's 1000 to 1500 ppm.
US: a rice-grain smear, then a pea
The AAP's guide to good oral health says to start as soon as the first tooth erupts and use a tiny smear, the size of a grain of rice, until age 3, then a pea-sized amount from 3. The American Dental Association gives the same amounts, with a pea-sized amount from 3 to 6.
Whichever advice you follow, use only the amount given and store toothpaste out of reach, as the Better Health Channel advises. The Oral Health Foundation's fluoride page says too much fluoride while teeth are forming can cause faint white marks (dental fluorosis), which it describes as usually mild and rare, and that using only a smear or pea-sized amount and spitting rather than swallowing reduces the risk. If you're unsure, or live somewhere without fluoridated water, ask your dentist or health visitor what suits your child.
How do I brush my baby's teeth?
- Get comfortable. The NHS guide to looking after your baby's teeth says the easiest way is to sit your baby on your knee with their head resting against your chest.
- Use the right amount of toothpaste, or water only, for your baby's age and where you live.
- Brush gently in small circles over every surface of each tooth, and along the gum line.
- Aim for about 2 minutes once there are several teeth. The NHS suggests twice daily for about 2 minutes, last thing at night and at least one other time.
- Spit, don't rinse. Once your child can spit, the NHS says to spit out and not rinse, because rinsing washes away the fluoride.
Children need help for longer than many parents expect. The NHS says to keep helping until at least age 7, Better Health says until about 8, and the AAP suggests supervising until children have mastered it, usually at around 10. The NHS also warns not to let children walk or run around with a toothbrush in their mouth.
| Time | What happens |
|---|---|
| After breakfast | Brush teeth (with toothpaste if your child's age and your local advice include it) |
| During the day | Water or milk to drink; sweet foods kept to mealtimes |
| Evening | Last milk feed, then teeth brushed |
| Bed | Into the cot with no bottle |
This is an example day; adjust it to your baby and your routine. Bedtime routine shows where brushing fits at night.
Why are bottles in bed bad for teeth?
Milk and sweet drinks that sit on the teeth during sleep can cause early childhood caries, a severe type of tooth decay in babies and toddlers. Better Health explains that as a baby sleeps, milk can pool in the mouth and feed the bacteria that cause decay, while saliva flow is low. Australia's healthdirect says not to let your child fall asleep with a bottle of milk, formula, juice or any sweet liquid. The AAP says putting your child to sleep with a bottle lets the sugars in formula and breast milk linger on the teeth.
- Finish the bottle before the cot, then brush.
- Breastfeeding is different. The Australian Breastfeeding Association in Australia says breastfeeding to sleep or overnight doesn't mean your child will get tooth decay, which is more strongly linked to frequent sugar, poor cleaning and other health factors. It explains that milk from a bottle can settle around the teeth, especially if a baby falls asleep with a bottle in their mouth. See feeding or rocking to sleep.
- Move to a cup. Better Health suggests a cup from about 6 months and cups only by around 12 months; cups and dropping bottles has a plan.
What about juice and other sweet drinks?
healthdirect in Australia says babies can get tooth decay from bottles of fizzy drinks, flavoured milk, sports drinks, cordial or fruit juice, and suggests water when your child is thirsty. The AAP doesn't recommend juice for babies under 12 months, and the NHS says the best drinks for young children are plain milk and water. Better Health also suggests avoiding constant grazing through the day. Juice for babies covers juice by age.
Can I dip my baby's dummy in something sweet?
No. Better Health says never to dip dummies in sweet substances such as honey, jam or sugar, and Australia's healthdirect says a dummy dipped in honey or another sweet substance can cause tooth decay. The NHS, the AAP and the Oral Health Foundation give the same advice. Honey also carries a risk of botulism for babies under 12 months; see honey and babies.
The AAP's guide to caring for baby teeth also suggests not putting your baby's dummy in your own mouth before giving it back, and not tasting their food from the same spoon. Dummies covers safe dummy use and when to stop.
Does teething change how I brush?
Keep brushing, gently, even when gums are sore. Better Health's guide to teeth development suggests gently massaging the gum or offering a chilled (not frozen) teething ring, and advises against amber teething necklaces and teething gels. The AAP's first tooth facts say a true fever isn't caused by teething, so a temperature of 38°C (100.4°F) or more needs to be treated as possible illness. Teething covers symptoms and relief, and fever in babies explains when a temperature is urgent.
When should my baby first see a dentist?
| Source | Advice |
|---|---|
| healthdirect (Australia) | By the first tooth or the first birthday |
| SCHN (Australia) | First tooth or first birthday, whichever comes first |
| NHS (UK) | When the first milk teeth appear, or before 12 months |
| Oral Health Foundation (UK) | By age 1 |
| AAP (US) | By the first birthday or within 6 months of the first tooth |
| American Dental Association (US) | After teeth come through, no later than the first birthday |
Children's dental care is free on the NHS in the UK. In Australia, healthdirect says the Child Dental Benefits Schedule can help with costs for eligible families.
What is fluoride varnish?
It's a protective coating painted on the teeth. The AAP says paediatricians may start applying fluoride varnish at about 6 months, every 6 months until age 5, or every 3 months for children at higher risk of decay. The NHS says children should be offered it at least twice a year from age 3, and younger children may have it if the dentist thinks they need it.
What do white or brown spots on baby teeth mean?
They can be an early sign of decay, so book a dental visit soon.
- Dull white band near the gum line. Better Health says this is the first sign of early childhood decay, and that a yellow, brown or black band means it's progressing.
- White or creamy-brown spots on back teeth. Better Health describes these as chalky teeth: not decay, but weaker and more prone to it.
- Dark spots. healthdirect in Australia says to see a dentist if you notice dark spots in your child's teeth.
Queensland Health's Lift the Lip program in Australia suggests simply lifting your child's top lip to check the outer surfaces of the front teeth, where white, chalky lines near the gum line can be early signs. Doing this every so often while brushing makes changes easier to spot.
A note of when each tooth arrived, any spots you've noticed and when your child last saw a dentist is useful to bring to the first visit.
What should I do if my baby injures a tooth?
Falls are common once babies pull to stand and walk.
- A knocked-out baby tooth. Don't put it back. The NHS knocked-out tooth page says a baby tooth could damage the tooth growing underneath, and to ask for an emergency dentist appointment, even if you can't find the tooth. Victoria's Better Health guide to dental injuries in Australia says to see an oral health professional immediately.
- Bleeding. The Royal Children's Hospital Melbourne in Australia says to press a clean cloth or dressing firmly on the bleeding area until it stops, then see a dentist or doctor.
- Broken or pushed-in teeth. The RCH says to make an urgent dental appointment for a broken tooth, and to see a dentist for a tooth pushed into the gum.
When should I get help?
Call 999 now if your child:
- has trouble breathing after a mouth injury, or a very swollen tongue or throat that seems to affect breathing
- has a lot of blood going down their throat
- lost consciousness or blacked out
- is 3 to 6 months old and has a temperature of 39°C (102.2°F) or higher
Get help today (a dentist straight away, or a hospital A&E if you can't be seen) if your child:
- has knocked out, broken or pushed in a tooth
- has bleeding that doesn't stop with firm pressure, or swollen lips, tongue or gums after an injury (the RCH lists these as reasons to go to hospital)
- has swelling of the face or gum with toothache
Teething doesn't cause a temperature of 38°C or more, so treat a fever as possible illness; fever in babies explains which temperatures need urgent care at each age.
Book a dental visit or talk to your GP or health visitor soon if:
- you notice white, chalky lines, or yellow, brown or black spots on the teeth
- your child is over 12 months and hasn't had a first dental check
- you're unsure which toothpaste or how much to use where you live
