When to Start Brushing Baby's Teeth: Complete Infant Oral Care Guide

When your baby's first tiny tooth breaks through the gum, it is a milestone worth celebrating — and a signal that oral care has officially begun. You might wonder, "Baby teeth fall out anyway, so does it really matter?" The answer is a definite yes. Baby teeth hold space for permanent teeth, support proper chewing and speech development, and cavities in baby teeth can affect the permanent teeth growing beneath them. Both the American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) recommend starting fluoride toothpaste brushing as soon as the first tooth erupts. This guide covers everything from pre-tooth gum care to choosing a toothbrush and toothpaste, proper brushing technique, handling a baby who hates brushing, and scheduling the first dental visit.

Before Teeth: Gum Care (Birth to First Tooth)

Oral care starts before the first tooth even appears. Cleaning your baby's gums from birth helps maintain a clean oral environment and gets your baby used to having their mouth touched.

How to clean baby gums

• Dampen a clean gauze pad or soft washcloth with lukewarm water
• Wrap it around your index finger
• Gently wipe your baby's upper and lower gums, inner cheeks, and tongue
• Do this after feedings, especially before bedtime

Benefits of early gum care

• Removes bacteria and milk residue from the mouth
• Provides a gentle gum massage that can soothe teething discomfort
• Gets baby accustomed to having something in their mouth, making the transition to a toothbrush much easier

💡 Starting gum care from the newborn stage helps your baby become naturally comfortable with having their mouth touched. This makes introducing a toothbrush later much smoother.

Starting Brushing: As Soon as the First Tooth Appears

When to start?

Begin brushing with fluoride toothpaste the moment the first tooth erupts. For most babies, this happens between 6 and 10 months when the lower front teeth come in first. Both the ADA and the AAP recommend using fluoride toothpaste from the very first tooth.

Why baby teeth matter

• They hold space for permanent teeth to come in properly (space maintainers)
• They are essential for proper chewing and speech development
• Cavities in baby teeth can damage the developing permanent teeth underneath
• Baby teeth do not start falling out until around age 6, so they need years of care

Choosing the Right Baby Toothbrush

Selecting an age-appropriate toothbrush makes a real difference.

Stage	Recommended brush	Features
0-6 months (pre-teeth)	Gauze / silicone finger brush	Fits over parent's finger for gum massage and cleaning
6-12 months (first teeth)	Infant toothbrush (extra-small head)	Soft bristles, short head, wide handle for parent grip
12-24 months	Toddler toothbrush	Small head, soft bristles, non-slip handle
2-6 years	Child toothbrush	Age-appropriate size, soft bristles, fun designs

What makes a good baby toothbrush

• The brush head should be small (about 2-3 baby teeth wide)
• Bristles should be very soft (labeled "soft" or "extra-soft")
• The handle should be wide and non-slip (easy for parents to grip)
• Replace every 3 months or when bristles start to fray

Fluoride Toothpaste: When and How Much

Fluoride toothpaste use is the most common question parents have about baby oral care.

Age	Amount of fluoride toothpaste	Description
First tooth to age 3	Rice grain size (smear)	About 0.1g, a thin smear across the bristles
Age 3 to 6	Pea size	About 0.25g, child can spit (but still supervised)
Age 6 and older	Regular amount (1cm strip)	Child can brush and spit independently

Why fluoride toothpaste matters

• Fluoride is the single most effective ingredient for strengthening tooth enamel and preventing cavities
• Both the ADA and AAP recommend fluoride toothpaste from the first tooth
• In the recommended amounts, it is safe even if swallowed

💡 Worried about your baby swallowing toothpaste? A rice-grain-sized amount of fluoride toothpaste is safe to swallow. This amount has been carefully determined by the ADA and AAP to provide cavity protection while posing no risk of fluorosis (tooth discoloration).

How to Brush Baby's Teeth: Proper Technique

Brushing your baby's teeth is the parent's job. Children need a parent to do "finishing brushing" until about age 6-7.

Lap position — recommended!

• Lay your baby on your lap with their head toward you
• Use one hand to gently support their chin, and the other to brush
• This position gives you a clear view inside your baby's mouth
• For older toddlers, have them stand in front of you with their back against you

Brushing sequence

• Outer surfaces: gentle circular motions along the gumline
• Inner surfaces: angle the brush vertically and use gentle up-and-down strokes
• Chewing surfaces: gentle back-and-forth strokes
• Tongue: gently brush the surface of the tongue as well

Frequency and duration

• Twice daily: after breakfast and before bed (bedtime brushing is the most important!)
• About 2 minutes per session
• The bedtime brushing is critical because it prevents bacteria from multiplying overnight

When Baby Hates Brushing

Nearly every baby resists brushing at some point. This is completely normal. Forcing it can create a lasting negative association, so focus on making it a positive experience.

Making brushing fun

• Sing a song: Create or find a short toothbrushing song to sing while you brush
• Give baby their own brush: Let your baby hold and chew on one toothbrush while you use another to actually clean the teeth
• Brush together: Let your baby watch you brush your teeth — babies love to imitate
• Use a mirror: Brush in front of a mirror so your baby can see what is happening
• Practice on a doll: Brush a stuffed animal's or doll's teeth first as a game
• Praise and celebrate: "Your teeth are so sparkly clean! Great job!" goes a long way

What NOT to do

• Do not physically force your baby's mouth open and pin them down
• Do not use brushing as a punishment
• Do not use fear tactics ("The cavity monster will get you!")

💡 Even if your baby resists, keep trying consistently. Start by simply getting the brush into the mouth, and gradually increase the time. Most babies get used to it through repetition and routine.

The First Dental Visit

When should you go?

The AAPD recommends the first dental visit within 6 months of the first tooth erupting, and no later than the child's first birthday. The AAP follows the same guideline.

What happens at the first dental visit

• Examination of teeth and gums
• Assessment of cavity risk
• Guidance on proper brushing technique
• Decision on fluoride varnish application
• Feeding habit and dietary counseling
• Answering parents' questions

Ongoing dental schedule

• After the first visit, schedule check-ups every 6 months
• Regular dental visits are the most effective way to catch and prevent cavities early

Common Dental Issues in Infancy

Nursing bottle caries (early childhood caries)

This occurs primarily when babies fall asleep with a bottle in their mouth. The sugars in formula, breast milk, or juice sit on the teeth all night, causing rapid decay.

Prevention

• Never put your baby to bed with a bottle of milk, formula, or juice
• Always brush teeth before bedtime, after the last feeding
• Begin transitioning from bottle to cup after age 1
• Limit juice to a cup only, no more than 120ml per day

Thumb sucking / pacifier use

Before age 2: Thumb sucking and pacifier use are normal, self-soothing behaviors. There is no need for concern at this stage.

After age 3-4: If the habit persists, it can affect tooth alignment (malocclusion). Consult a pediatric dentist if the habit continues past this age.

Teething and oral care

Teething (approximately 6-30 months) causes swollen, sore gums, which can make babies even more resistant to brushing.

How to manage

• Offer a chilled (not frozen) teething ring
• Massage the gums with a clean, cold, wet gauze
• Continue brushing as much as possible during teething, using a very soft-bristled brush

Oral Care Checklist by Age

Age	What to do
0-6 months	Wipe gums with gauze after feedings, get baby used to mouth touching
6-12 months	Start brushing with fluoride toothpaste (rice grain size) when first tooth appears, schedule first dental visit
12-18 months	Brush twice daily (parent-led), begin weaning off the bottle, transition to cup
18-24 months	Let baby practice holding a toothbrush, parent finishing brushing is essential
2-3 years	Practice spitting out toothpaste, dental check-ups every 6 months
3-6 years	Increase to pea-size fluoride toothpaste, independent brushing + parent finishing

Track Health with BebeSnap

Keep your baby's oral health milestones organized and on track with BebeSnap.

• Health Log: Record the date of the first tooth, the order teeth appear, and dental visit schedules
• Milestone Tracking: Document oral development milestones like teething, first brushing, and first dental visit
• AI Health Consultant: Have questions about baby oral care? Ask the AI chatbot
• Feeding Log: Track feeding patterns and diet to identify cavity risk factors

FAQ

Q: Can I use fluoride-free toothpaste instead?
A: The ADA and AAP both recommend fluoride toothpaste starting from the first tooth. Fluoride-free toothpaste has significantly less cavity-prevention power. A rice-grain-sized amount of fluoride toothpaste is safe even if swallowed, so fluoride toothpaste is the recommended choice.

Q: Is it okay if my baby swallows the toothpaste?
A: Yes, a rice-grain-sized amount (under age 3) or pea-sized amount (ages 3-6) of fluoride toothpaste is safe to swallow. These amounts were set by the ADA and AAP specifically to be safe if ingested. However, make sure your child does not squeeze and eat toothpaste as a snack.

Q: Do I need to brush after nighttime feedings?
A: Ideally, yes — but this is often not practical. The most important thing is to brush as part of the bedtime routine before the last feeding. If your baby feeds during the night, at least wipe the gums and teeth with a water-dampened gauze afterward.

Q: Can I use an electric toothbrush for my baby?
A: Children's electric toothbrushes can be used from age 3 and older. They are effective at plaque removal, but parent finishing brushing is still needed until age 6-7. For children under 3, a manual toothbrush with a parent doing the brushing is safest.

Q: My baby has gaps between teeth. Is that normal?
A: Yes, and it is actually a good sign. Gaps between baby teeth create space for the larger permanent teeth that will come in later. Baby teeth that are crowded tightly together may actually lead to alignment problems when permanent teeth emerge.

References

• ADA - Fluoride Toothpaste for Young Children Guideline
• AAP - Fluoride Toothpaste Should Be Used When Child's First Tooth Erupts
• AAPD - Policy on Early Childhood Caries
• Nationwide Children's Hospital - Dental Care for Infants and Toddlers
• AAFP - A Practical Guide to Infant Oral Health
• CDC - Use of Toothpaste and Toothbrushing Patterns Among Children