Preventing Tooth Decay in Young Children

Topic Overview

Tooth decay, called dental caries, is caused by bacteria eating away the outer protective layer (enamel) of a tooth. Help prevent tooth decay in young children by adopting the following healthy habits:

• Teach your child to brush and floss every day. Clean your baby's gums with a soft cloth or gauze pad to remove plaque before the first teeth come in. When your child's first teeth come in, clean his or her teeth with a soft toothbrush. If your child is younger than 3 years, ask your dentist if it's okay to use a rice-sized amount of fluoride toothpaste. Use a pea-sized amount for children ages 3 to 6 years. Start flossing your child's teeth when he or she has teeth that touch each other. For more information, see the topic Brushing and Flossing a Child's Teeth.
• Take good care of your own teeth and gums. Saliva contains bacteria that cause tooth decay. Keep your own teeth and mouth healthy so you are less likely to transfer these bacteria to your baby. Avoid sharing spoons and other utensils with your baby. Also, don't "clean" your baby's pacifier with your mouth.
• Prevent prolonged contact with sugars in formula and breast milk. Remove a bottle from your baby's mouth before he or she falls asleep. This practice helps prevent mouth bacteria from producing acids that cause baby bottle tooth decay. Also, clean your baby's teeth after feeding, especially at night.
• Be smart about juice. Juice is not part of a healthy diet. Compared to a piece of fruit, fruit juice doesn't have the valuable fiber, it usually has more calories, and it is absorbed differently. Unless the label says that a fruit drink is 100% juice, beware that many fruit drinks are just water, a little juice flavoring, and a lot of added sugar. If you must give juice, water it down. The American Academy of Pediatrics advises no more than 4 fl oz (120 mL) to 6 fl oz (180 mL) of 100% fruit juice a day for children 1 to 6 years old.^{footnote 1} This means ½ cup to ¾ cup.
• Introduce cups for drinking beverages at age 12 months or earlier. By this age, frequent bottle-feedings, especially with juice or other high-sugar liquids, make a child more likely to develop tooth decay. At night, you could fill the bottle with plain water. During the day, offer an empty cup for your child to play with. For more information, see the topic Weaning.
• Provide your older baby or toddler with healthy foods. Give your child nutritious foods, and combine them in ways that help reduce the risk for tooth decay. For example, offer meals that include whole grains, vegetables, and fruits. Mozzarella and other cheeses, yogurt, and milk are good for teeth and make great after-meal snacks. They help clear the mouth of harmful sugars and protect against plaque. Make an effort to rinse or brush your child's teeth after he or she eats high-sugar foods, especially sticky, sweet foods like raisins.

Normal amounts of fluoride added to public water supplies and bottled water are safe for children and adults. If your child needs extra fluoride, your dentist may recommend a supplement or a gel or varnish that he or she would apply to your child's teeth. Use supplements only as directed. And keep them out of reach of your child. Too much fluoride can be toxic and can stain a child's teeth.