‘Milk teeth’ aren’t permanent but they’re important. Dr Howard Lee on the business of caring for first teeth

Permanent teeth start to come through when a child’s about six, but the ‘milk’ teeth – the first set – are just as important. They start to come through in the first few months and by the time your baby’s three, he or she should have a set of twenty. These ‘milk’ teeth help your baby’s speech development, are vital for chewing solid food and they guide the permanent teeth into position. If milk teeth are lost prematurely, the adult teeth may be incorrectly positioned and overcrowded, making them difficult to clean – and unattractive. So milk teeth are worth looking after.

After your baby’s born, plaque will begin to form as soon as the first tooth appears – a major cause of oral-hygiene problems. Plaque is a thin film of bacteria, which constantly forms on all teeth, especially near the gum line, between teeth and on the biting surfaces of back teeth. Bacteria in plaque use sugars in food and drink as a source of energy, so ensuring that your baby has a good diet is the main thing that you can do to help.

• Don’t let your baby go to sleep with a bottle containing milk
• Make sure your child doesn’t have a sugary drink at night after they’ve brushed their teeth
• Avoid baby foods sweetened with added sugar or concentrated fruit juice
• Don’t add sugar to home prepared weaning foods
• Sweetened fruit juices and cordials should not be given in babies bottles, as they contribute to decay and encourage a ‘sweet tooth’
• Never dip a dummy or comforter into anything sweet. The phrase ‘no artificial preservatives or sweeteners’ can mean that sugar is present in the product
• Offer foods with plenty of calcium, vitamins and minerals to encourage healthy teeth to form.

Start brushing early

As soon as teeth start to appear, you should buy a toothbrush recommended for babies and brush the teeth twice a day. Babies accept things that are familiar to them, so do let them hold a brush, without toothpaste. They’ll probably brush their teeth, their hair, and probably their favourite toy – or even the cat – with it.

Let your baby watch you brush your teeth – your baby will learn by watching you if you encourage them to join in – make it ‘fun’. The easiest way to brush a child’s teeth is from behind, with them sitting on your knee. Then, gently brush each tooth with a tiny smear of fluoride toothpaste on the brush (remember that a child will swallow most of the paste). Fluoride is a naturally occurring element, which will make teeth more resistant to dental decay.

• Only use a pea sized amount of fluoride toothpaste
• Use a soft to medium brush with a small head which allows it to reach all parts of the mouth easily and comfortably
• Don’t keep a brush for more than three months or after the bristles have started to spread out
• Teeth and gums should be brushed thoroughly everyday with fluoride toothpaste, going all round each tooth
• Use a circular ‘scrub’ technique, with the bristles aiming down where the tooth and gum meet.

Have regular check-ups. This will ensure that your baby’s familiar with the environment, even though treatment won’t usually begin until they’re about two.

Remember that yourNHS dental treatment is free until your baby’s first birthday and children receive free dental treatment until they’re 16; 18 if they’re in full time education.

The state of the nation’s teeth has improved dramatically over the last two decades:

• Today 55% of 5 year olds have never experienced tooth decay:
• 20 years ago this was just 28%
• Today 50% of all 12 year old children have never had tooth decay:
• 20 years ago this was only 7%