Baby’s First Tooth & Infant Oral Health
Simple, low-stress guidance on gum care, teething, bottles, and brushing from the first tooth through toddlerhood.
A baby’s first tooth is a milestone, and it is also the moment when cavity risk begins. Sugars from milk, formula, juice, and even breast milk can linger on teeth, especially overnight. The good news is that infant oral care is simple, and small daily habits make a big difference.
This guide walks through the stages from newborn gums to a full set of baby teeth, with practical tips from our pediatric team in Beaverton.
Oral care stage by stage
Newborn to first tooth
Wipe gums gently after feedings with a clean, damp washcloth or gauze. This clears leftover milk and gets your baby used to having their mouth touched.
First tooth to age 2
Use a soft, baby-sized brush with a rice-grain smear of fluoride toothpaste twice a day. Brush every surface you can see, and do not worry about perfect technique.
Ages 2 to 3
More teeth mean more places for food to hide. Keep brushing for your child, add a pea-sized amount of toothpaste around age three, and begin daily flossing where teeth touch.
When do babies get their first teeth?
Most babies get their first tooth somewhere around six months, though anywhere from four to twelve months is normal. The lower front teeth usually come first, followed by the upper front teeth. By around age three, most children have all twenty baby teeth.
Late teething alone is rarely cause for concern. If your baby has no teeth by their first birthday, we still want to see them, and Dr. Hsu can reassure you or look further.
Teething comfort, safely
- Offer a clean, chilled (not frozen) teething ring or a cool washcloth.
- Massage sore gums gently with a clean finger.
- Avoid teething gels containing benzocaine and amber necklaces. The FDA has warned about the risks of benzocaine products for young children, and necklaces are a choking and strangulation hazard.
- Call your pediatrician for a high fever, which is not a typical teething symptom.
Bottles, sippy cups, and bedtime feeding
Frequent or prolonged contact between sugary liquids and teeth is the main driver of early childhood cavities. A few gentle rules help:
- Do not put your baby to bed with a bottle of milk, formula, or juice.
- Offer water in a cup around the first birthday, and move away from bottles at about 12 to 18 months.
- Save juice for rare treats, or skip it in the early years.
- Wipe or brush after the last feeding of the night.
Pacifiers and thumbs
Both are normal for babies. Most children stop on their own, and prolonged habits become a concern only later on. Our page on thumb-sucking and pacifier habits explains when to worry and how to help.
What we do at your baby’s first dental visit
Infant visits are quick and mostly about you. Dr. Hsu will check your baby’s teeth, gums, and oral tissues, talk through feeding and cleaning habits, and may apply a thin layer of fluoride varnish. If feeding trouble has been an issue, we can also look at whether a tongue-tie or lip-tie might be part of the picture.
See our full walk-through in your child’s first dental visit.
Does fluoride toothpaste matter for babies?
Yes. The ADA and AAPD recommend fluoride toothpaste as soon as the first tooth erupts, using a smear no larger than a grain of rice for children under three. That amount is small enough to be safe if swallowed and effective enough to help strengthen enamel. If your household water is not fluoridated or you use well or filtered water, ask us during your visit whether that affects your child’s fluoride needs.
Why baby teeth matter
Baby teeth are placeholders for permanent teeth and help your child chew, speak, and grow a healthy jaw. Decay in baby teeth can cause pain, infection, and trouble eating, and it can affect the teeth developing underneath. Protecting them is worth the effort.
A simple daily routine for babies and toddlers
- Morning: brush any teeth with a rice-grain smear of fluoride toothpaste.
- After meals: offer a sip of water to rinse away food.
- Bedtime: brush thoroughly, then no more milk or juice for the night.
- Weekly: lift the lip and look for white or brown spots along the gumline, especially on the upper front teeth.
Lifting the lip sounds fussy, but it is one of the best early-detection habits a parent can have. Chalky white lines near the gums are often the first visible sign of early decay, and they are far easier to address when caught early.
Sharing spoons and other everyday myths
Parents often worry they have already caused problems by sharing a spoon or kissing their baby. Bacteria do pass between family members, which is why your own oral health matters too, but you do not have to live in fear of normal affection. Focus on what you can control: clean teeth, limited sugar exposure, and regular dental visits for you and your child.
Support for new parents in Beaverton and beyond
Families from Beaverton, Aloha, Hillsboro, and Tigard come to us with questions about everything from pacifier weaning to teething at 3 a.m. There is no such thing as a silly question. Browse our parent resources for more guidance, then call (503) 822-0096 or explore all of our pediatric services.
Questions parents (and adults) often ask
Do I need to clean my baby’s gums before teeth appear?
It is a good habit. Wiping gums with a damp cloth after feedings removes residue and gets your baby comfortable with mouth care.
How much fluoride toothpaste should I use for a baby?
A smear about the size of a grain of rice, twice daily, as soon as the first tooth erupts.
Is it OK for my baby to fall asleep while nursing or with a bottle?
Occasional dozing is normal, but try to avoid it as a regular pattern, since milk pooling around teeth overnight increases cavity risk. Wipe gums or teeth afterward when possible.
When do I start flossing?
When two teeth touch, typically between ages two and three. Floss picks are fine.
My baby’s first tooth looks discolored. What should I do?
White, brown, or chalky spots can signal early decay or enamel differences. Please schedule a visit so Dr. Hsu can take a look.
Can breastfeeding cause cavities?
Breastfeeding is beneficial, and the risk is generally low, but frequent night feedings after teeth erupt can contribute in some children. Cleaning teeth and gums after the last feeding helps.
Does insurance cover dental visits for babies and toddlers?
Many plans cover checkups and fluoride varnish for young children. We accept almost all dental insurance and will confirm what your plan includes before the visit. See our insurance and payment options page or call (503) 822-0096.
Ready to book your child’s visit?
Tell us a little about your family and we’ll reach out to find a time that works. New patients — kids, teens and adults — are welcome, and we accept almost all dental insurance and the Oregon Health Plan (OHP).