Oral health for babies and toddlers (0-2 years)

Baby teeth (sometimes called deciduous, primary or milk teeth) are important for children to:

  • eat well
  • speak well
  • have a healthy smile.

Strong teeth in childhood set children up for good oral health later in life. Baby teeth hold the space for adult teeth—the early loss of baby teeth can cause crowding of the adult teeth.

Tooth decay (holes) can start as soon as teeth appear. Plaque, a sticky film of bacteria (germs) and left-over food, coats the teeth and causes tooth decay. If not brushed away, the bacteria in plaque uses the sugars in foods and drinks to make acid. Over time, this acid dissolves the tooth away, causing a hole.

The timing of baby teeth

Baby teeth usually start appearing around 6 months of age, but this varies from child to child. The image below shows a full set of baby teeth and which point they may appear, starting with the central incisors. Children usually have all of their baby teeth by 3 years of age.

A diagram of baby teeth and adult teeth detailing which teen are expected to erupt and when for each

Teething can be uncomfortable and upset babies, there are ways you can ease teething problems.

How to prevent tooth decay in babies and toddlers

Decay can start in baby teeth as soon as they appear and can progress quickly, so it’s important to get into the habit of checking your child’s teeth regularly for signs of decay.

Decay looks like brown or white spots on the teeth that do not rub off. Also, check the gums for signs of swelling or infection, which can look like pus or a ‘pimple’ in the mouth.

Infant tooth decay is preventable. Make a dental appointment as soon as possible if you think your child has tooth decay or any other problems with their mouth.

Below are some further steps you can take to prevent tooth decay in your child.

Ensure the whole family has good oral health

Babies are born without the bacteria (germs) in their mouth that can cause decay. Bacteria can be passed to newborn babies if bottles or dummies are "cleaned" by a parent or caregiver before passing to a baby. Sharing spoons is also a common way for decay-causing bacteria to be passed to babies.

If your baby uses a dummy, have spares on hand and sterilise or clean them in hot soapy water.

Look after the oral health of the family to avoid spreading decay-causing bacteria to babies—brush twice a day with fluoride toothpaste and visit a dental practitioner regularly. Make sure each child has their own toothbrush and change them every 3-4 months.

For babies

Brush teeth as soon as they appear

Clean teeth as soon as they appear in the mouth. This is usually around 6 months of age, but this varies between children.

Use a small, soft toothbrush to gently clean teeth morning and night. For children under 18 months, just wet the toothbrush with water. Don't use toothpaste unless advised by a dental practitioner.

You can also use a damp washcloth or gauze wrapped around your finger if your baby won’t accept a toothbrush.

Drinks for babies (birth to 12 months)

Breastmilk or infant formula is the baby’s main drink until they are 12 months of age. Babies younger than 12 months are not able to drink cow’s milk.

Babies fed on breastmilk do not need any extra drinks. Breastmilk is all the food and drink they need for around the first 6 months.

Babies fed on formula can be fed cooled boiled tap water if extra fluid is needed.

From 6 months, small amounts of cooled boiled water can be given to babies as well as breastmilk or formula.

If using a bottle, only put breastmilk, infant formula or water in your baby's bottle. Don’t feed babies younger than 12 months sugary drinks such as juice, soft drinks, cordial and flavoured milk as they increase the risk of tooth decay. They can also fill your baby up, stopping them from drinking breastmilk or formula. Learn more about what your baby should be drinking.

Tooth-friendly feeding

Avoid settling babies to sleep with a bottle, even if filled with milk or formula as milk will pool around the teeth and cause tooth decay. Try an alternative comfort at bedtime, like a teddy or blanket, singing a lullaby or telling a bedtime story.

Never put honey, sweet foods or flavouring on a dummy as this can also cause tooth decay.

Try to introduce a cup from 6 months and stop using a bottle from 12 months.

Choose healthy foods low in sugar for older babies and toddlers. Tooth-friendly foods do not contain added sugars and honey. Visit the Growing good habits website for more information on introducing first foods.

For toddlers

Brushing toddlers’ teeth

It can sometimes be tricky to clean children’s teeth, especially as they move into the ‘toddler’ phase. But it's important to brush their teeth as soon as they appear. When brushing your toddler's teeth, be sure to:

  • brush along the chewing surfaces of the teeth
  • use a circular or jiggling motion on the outside surfaces, being sure to brush the gums gently
  • repeat on the inside surfaces continuing to use a jiggling motion
  • spit out the toothpaste, but don't rinse.

Here are some tips to help with brushing your toddler’s teeth:

  • Aim to clean your child’s teeth when they are relaxed and not too tired.
  • Position them so you can clearly see their teeth and they feel secure. You can try:
    • sitting your toddler on your lap
    • sitting on the lounge with your toddler’s head lying back on your lap to make it easier to see their teeth.
  • Include toothbrushing as part of the bath or bedtime routine.
  • Give lots of positive reinforcement for good toothbrushing behaviour.
  • Talk about toothbrushing with your child and practice brushing the “teeth” of one of their toys.
  • Clean their teeth daily because plaque (a sticky, invisible film of bacteria and left-over food) will form in your toddler's mouth just as it does in your own.
  • Encourage children to brush their own teeth but supervise and assist them until they are about 8 years of age.

Toothbrushes

  • Use a child-sized soft toothbrush and replace it every 3 months, or when the bristles become worn and shaggy.

Toothpaste

  • If your local water supply is fluoridated:
    • Birth to 18 months: brush your child's teeth without toothpaste.
    • 18 months to five years: brush your child's teeth with a small pea size amount of low fluoride toothpaste.
  • If your local water supply is not fluoridated, speak with your dental practitioner about when to start using a fluoride toothpaste.
  • Avoid rinsing your toddler’s mouth or giving foods or drinks (including water) after brushing. This will wash away the protective fluoride from the teeth.
  • Low-fluoride toothpaste is often labelled as children’s toothpaste and has half the fluoride concentration of regular toothpaste. Keep toothpaste out of reach of your children. They should not be allowed to use toothpaste without supervision.

Tooth-friendly foods for toddlers

Small children have small tummies and are very busy learning about their world. To grow up strong and healthy, they require small, frequent and nutritious meals and drinks from a wide variety of foods every day. Foods and drinks that promote good health also promote good oral health.

It is important to establish healthy eating and drinking habits and daily dental care at an early age, so you set your child up with lifelong healthy habits. Choose healthy foods low in sugar for older babies and toddlers. Tooth-friendly foods do not contain added sugars and honey. Visit the Growing good habits website for more information on introducing first foods.

Food choices that help avoid tooth decay

When we eat and drink, the bacteria in plaque use the sugars and carbohydrates in food to make acid. Some food and drinks, such as soft drinks and fruit rollups are acidic. Acid makes holes in teeth (decay).

Tooth tips

  • provide healthy mini meals throughout the day
  • choose from a wide variety of foods every day
  • save snack foods and treats for special occasions
  • eat less sugar
  • do not add sugar to encourage fussy eaters
  • do not reward or comfort with sweets.

Foods like muesli bars, rollups, health bars and honey are not recommended as snacks. They contain high concentrations of added and natural sugars and will stick to the teeth more readily. Fresh fruit and vegetables are the best choice

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Meals and snacks

  • baked beans
  • vegetable soup
  • left over pasta or rice
  • corn on the cob
  • hard-boiled egg
  • grilled cheese on toast
  • homemade pizza on pita bread
  • jaffles
  • raw vegetables cut into sticks
  • fresh fruit cut into child-sized pieces
  • plain milk, yoghurt, cheese and custards are excellent sources of calcium

Experiment with different breads: bread rolls, raisin bread, pikelets, crumpets, crispbreads and scones are all great energy foods for children.

Sandwiches

  • smooth peanut butter*, bean sprouts, grated carrot and sultanas
  • smooth peanut butter* and bananas
  • tuna and tomato
  • chicken, chopped celery and walnuts*
  • cottage cheese, chopped apple and dates
  • egg* and lettuce
  • apple and cream cheese
  • cheese and tomato
  • cheese and vegemite

*Note: If you have a strong family history of allergy, avoid eggs, nuts and shellfish until the age of 3 years.

Most of the sugar we eat comes from commercially prepared foods. You can reduce your sugar intake by using the information on food labels as a guide to sugar content.

  • look at the quantity per 100g column to enable comparison with other foods
  • look for foods with less than 10g of total fat and 3g of saturated fat
  • look for foods with less than 15g of sugar
  • other names for sugar include honey, sucrose, fructose and glucose syrup.

Tooth-friendly drinks for toddlers (from 12 months)

Plain cool water is the best drink for toddlers. If your toddler does not like drinking water, try adding shaped ice cubes, fruit slices for flavour, or serve it cold from the fridge in a special novelty water bottle. Role-modelling is the best way to encourage toddlers to drink water.

Full-cream milk is an important part of your toddler’s diet as it has protein, calcium and other nutrients for growing toddlers.

Fruit juices, herbal teas, soft drinks and other drinks are not needed for toddlers. They increase the risk of tooth decay and of your child becoming overweight. If your child drinks them too much, they may not be hungry to eat other healthy foods.

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Regular full-cream cow’s milk is a healthy drink for toddlers over 12 months up to 2 years old. Aim for your toddler to drink no more than 500mL of milk each day. They will be less likely to eat food if they are full of milk.

The following milk types and formulas are not suitable for babies and/or toddlers:

  • skimmed or reduced-fat milks are not suitable for toddlers below 2 years of age
  • goat’s milk is also not suitable for babies younger than 12 months of age
  • soy, rice and oat drinks are not suitable for babies and young children as they lack important nutrients for growth
  • follow-on and toddler formulas are not needed for toddlers from 12 months of age, your young child will get all the nutrition they need from eating a variety of food.

Children over 12 months old can drink small amounts of juice as part of a healthy diet. Juice should be limited to no more than 120-180mL in one day.

Keep in mind that while fruit juices can be high in vitamin C, they lack fibre, which is an important nutrient found in whole fruit. Even 100% fruit juices have high natural sugar content; too much can increase the risk of tooth decay or your child gaining extra weight. Whole fresh fruits and vegetables are a better choice as they are a good source of vitamin C with much less sugar and more fibre than fruit juice.

Encourage tap water rather than sweetened drinks and fruit juices. Water costs less and is the best thirst quencher. Try offering fresh fruits and vegetables instead of fruit juice or soft drink. Soft drinks, cordials and fruit drinks have a lot of sugar and little to no important nutrients. These are unnecessary for babies or children.

Take your child for their first dental check-up before their second birthday

It's important to take your child to their first dental check-up before their second birthday. This will pick up any problems early and will help make your child comfortable having their teeth checked.

Your child may be eligible to have a free dental check-up at a public oral health clinic. If your child is not eligible for free public oral health care, seek care from a private dental practitioner. Read more on how to prepare for your toddler’s first dental visit.

More information