Baby teeth need care from the day they appear. Our infant dentistry visits give San Antonio parents a pediatric dentist’s view of their baby’s mouth, plus practical help with teething, feeding, and brushing. The American Academy of Pediatric Dentistry (AAPD) recommends a first checkup when the first tooth erupts or by the first birthday; see First Visit for what that appointment looks like.
When do babies start getting teeth?
Every baby follows their own schedule. The first teeth to appear are usually the lower front teeth, often somewhere around six to eight months, though some babies start earlier and some later. All 20 baby teeth have usually come in by about age three. Permanent teeth begin arriving around age six, starting with the first molars and the lower front teeth.
Teething can make babies fussy and drooly. A clean, chilled teething ring or gentle gum massage with a clean finger can help. If you’re unsure whether something is normal, ask us at your baby’s visit.
How to clean your baby’s gums and first teeth
- Before teeth: wipe your baby’s gums with a soft, damp cloth after feedings.
- Once teeth arrive: brush twice a day with a soft infant toothbrush. The AAPD recommends a smear of fluoride toothpaste about the size of a grain of rice for children under three.
- Between meals and at bedtime: wipe or brush away milk before your baby falls asleep when you can.
Cavity-causing germs can pass from parents to babies through shared spoons, cups, and straws, so it helps to keep those separate. Your own dental health matters too. The AAPD encourages expecting mothers to get routine dental care and oral hygiene guidance during pregnancy.
Bottles, sippy cups, and early childhood cavities
Early childhood caries, once called baby bottle tooth decay, is a serious and fast-moving form of decay in young children. It happens when teeth are bathed often and for long stretches in drinks that contain sugar, including milk, formula, and juice. When a baby falls asleep with a bottle, those liquids pool around the teeth and feed the bacteria that weaken enamel.
If your baby needs a bottle to settle at bedtime, fill it with water only. Babies who resist the change often accept it gradually: add a little more water to the milk each night until the bottle is all water.
Sippy cups are a bridge between the bottle and a regular cup. Between meals, fill them with water, and save milk and juice for mealtimes. Our Nutrition Counseling covers snacks and drinks in more detail.
Pacifiers and thumb sucking
Sucking is a natural reflex that soothes babies and helps them sleep. Most children stop on their own between ages two and four. A habit that continues once the permanent teeth come in can affect how teeth line up and how the jaws grow, and children who suck hard are more likely to see changes than those who rest a thumb loosely in the mouth.
Pacifiers affect teeth in much the same way, but they’re easier to limit than a thumb. If a habit is hanging on, we can talk through ways to wean and, when needed, Habit Appliances.
Does my baby need a dentist before any teeth come in?
Not usually, but if you have concerns about feeding, latching, or how the tongue or lip moves, we’re happy to take a look. Tongue ties and lip ties can be evaluated at any age; see Laser Frenectomies.
Is fluoride toothpaste safe for babies?
Yes, in the right amount. The AAPD recommends a rice-grain-sized smear for children under three, which gives cavity protection with very little toothpaste.
Can breastfeeding cause cavities?
Breastfeeding has many benefits. Once teeth come in, though, any milk that stays on the teeth for long periods, especially overnight, can raise cavity risk. We’ll look at your baby’s routine with you, without judgment, and suggest small changes if needed.
Related: First Visit, Fluoride, Laser Frenectomies, Habit Appliances