Toddler Teeth: Brushing, Fluoride Toothpaste and the First Dentist Visit

Why baby teeth matter

• Tooth decay is one of the most common chronic conditions of childhood, and it is largely preventable. Baby teeth hold space for adult teeth and help with chewing and speech.
• Cavities in toddlers can cause pain, infection and trouble eating and sleeping.

The first dentist visit

• Aim for a first dental visit by the first birthday, or within about 6 months of the first tooth, whichever comes first. If you missed that, go now; it's never too late.
• A first visit is usually short: a quick look in the mouth, often with your child on your lap, plus tips on brushing, diet and fluoride.
• Look for a pediatric dentist or a general dentist who sees young children. Community health centers and public insurance programs often cover children's dental care.
• Prepare by playing "dentist" with a stuffed animal and reading a picture book about it. Keep your own tone matter-of-fact, even if dentists make you nervous.

Brushing how-to

• Twice a day, morning and before bed, with a soft child-size brush.
• Under 3: a smear of fluoride toothpaste the size of a grain of rice.
• 3 to 6: a pea-size amount. Teach spitting; no need to rinse with water afterward.
• An adult brushes, or brushes again after the child has a turn, until about age 6 to 8, when most children can do it well alone.
• Positions that work: child lying with their head in your lap, or standing in front of a mirror with you behind. Sing a two-minute song. Let them brush your teeth or a toy's first.
• Start flossing once two teeth touch.

Fluoride

• Toothpaste: the small amounts above are safe and protective.
• Varnish: the pediatrician or dentist may paint fluoride varnish on the teeth, often every 3 to 6 months from the first tooth. It takes a minute and is well studied.
• Water: fluoridated tap water helps protect teeth. Some communities have stopped adding fluoride, so check with your water utility. If your water isn't fluoridated (including well water or only bottled water), ask the dentist how best to protect your child's teeth. Since 2025 the FDA advises fluoride drops or tablets only for children 3 and older at high risk of decay.

Bottles, cups and juice

• No bottle or sippy cup of milk or juice in bed. Milk sitting on the teeth overnight is a leading cause of early decay. Offer water only at night, if anything.
• Aim to wean from the bottle around 12 to 18 months; see the cups and weaning guide.
• Juice isn't needed. If you offer it, give 100% juice in an open cup with a meal, no more than about 4 oz (120 mL) a day from 1 to 3 years, and 4 to 6 oz (120 to 180 mL) a day from 4 to 6. Whole fruit is better.
• Sticky snacks and all-day sipping or grazing keep teeth bathed in sugar. Water between meals is best.

Thumbs and pacifiers

• Thumb and pacifier sucking are normal comforts. Most children stop on their own between about 2 and 4.
• Dentists start to pay attention if strong sucking continues as adult teeth come in (around 5 or 6), since it can affect how teeth line up. Gentle encouragement and praise work better than bitter coatings or scolding. See the pacifiers and big transitions guides.

When to check in

• Mention it to the dentist or pediatrician if you see white chalky lines near the gums, brown or black spots, or your child avoids chewing on one side.
• A swollen face or gum with fever, or a tooth knocked out or pushed in after a fall, needs a same-day call to the dentist.