Tiny Teeth

A short guide to healthy teeth for the under fives 

Toothy tips

It’s a toddle!

Good teeth help your child feel confident.

But tooth decay can cause pain and worry, even in small children.

When it comes to children’s teeth, regular brushing and visits to the dentist are important.

What, when and how your child eats and drinks is also important and this booklet gives simple facts on how you can keep your little ones grinning from ear to ear.

Taking care

of tiny teeth

Here are lots of simple ways you can help protect your child’s teeth.

Register your child with a dentist by the time they are 6 months of age and visit regularly.  Children are treated free under the NHS.

From 6 months, introduce infants to a free-flow cup and aim to discontinue bottles by their first birthday.

Toothpaste

power!

Start to brush your baby’s teeth as soon as they begin to come through – this is usually around the 6 month mark but may be earlier or later.

Make sure to use a toothpaste containing at least 1000ppm fluoride, as this helps to prevent and minimise tooth decay. Check the toothpaste packet, or ask your dentist if you aren’t sure.

Make sure children don’t eat or lick toothpaste from the tube. Children under 3 years only need a smear of toothpaste. From age 3 to 6, children should use a pea-sized amount.

Brush your child’s teeth for about two minutes last thing at night and at least once more during the day.

After brushing, encourage your child to spit out – not rinse!
Rinsing will wash away the fluoride so it won’t work as well.

It’s a good idea to supervise tooth brushing at least until your child is seven or eight years old.

Be

tooth-friendly

Tooth decay is caused when bacteria in the mouth (in dental plaque) use the sugars in foods we eat and drink for fuel. At the same time, they also produce acid. Acid attacks the teeth and can begin to break down the tooth, eventually causing holes known as cavities.

Reducing the amount of sugar in your child’s diet, and how often it’s eaten or drunk will help prevent tooth decay.

Acidic drinks (such as fizzy drinks, even the sugar-free ones) can also be a problem for teeth by wearing away the tooth’s surface.

Fizzy drinks, juice drinks and sugar-sweetened squashes are not tooth-friendly and should not be a part of a child’s daily diet.

If you do choose to give sugary drinks to your child, make sure they are:

  • well-diluted
  • given in a cup, not a bottle
  • given at mealtimes only
  • never given at bedtime.

Water and milk are tooth-friendly drinks you can offer instead of the drinks above.

It is important to recognise that honey, fruit smoothies, fresh fruit juice and dried fruit all contain sugars that can cause tooth decay.

Dried fruit can stick to teeth so it is better to have it as part of a meal and not as a between-meal snack. Choose fruit canned in juice rather than fruit in sugary syrup.

Remember,

the more often tots eat sugary foods or have sugary or acidic drinks the more damage is caused to tiny teeth.

Avoid sugar containing foods at bedtime. If your child is thirsty before bed, offer water.

Say cheese

Milk, cheese and yogurt provide calcium which helps maintain teeth.

Try swapping biscuits and cakes for tooth-friendly snacks like sticks of hard cheese and plain yogurt.

Sugar has many different names. On food labels look out for sucrose, fructose, glucose, maltose, dextrose, honey and syrups, and concentrated fruit juice. Lactose, the sugar in milk, does not harm teeth in the same way as these sugars.

Smiles

of snack ideas

Peeled and chopped fruit and vegetables

Plain yogurt and sliced grapes

Crumpets and cheese spread

Plain popcorn

Pepper sticks and houmous

Pitta or flatbread with tzatziki and tomato slices

Cucumber and carrots with crackers and cream cheese

Cheese (sliced or cut into sticks) and sliced tomatoes

Milky matters

As well as calcium for children’s bone and dental health, milk provides:

Iodine

for normal growth

Phosphorus

for energy release

Protein

for growth and development

Potassium

for muscle and nerve function

Vitamin B2

for normal skin and vision

Vitamin B12

for normal immune function

From 6 months, whole cow’s milk can be added to cooking or mixed into cereal. You can also give whole milk yogurt, fromage frais and cheese. Whole milk can be given as a drink after age 1 year.

You may choose to continue giving breastmilk for as long as suits you and baby.

Once your child is 2 years old, you can introduce semi-skimmed milk if they are eating a variety of foods and growing well. Otherwise stick to whole milk. 1% and skimmed milk don’t provide enough fat and energy for under 5s.

Milk-like drinks are not nutritionally similar to cow’s milk, and may be low in protein and other important nutrients. They may also contain added sugars which act differently to lactose (the sugar in milk) and may harm children’s teeth, so make sure to check the label!

Rice drinks aren’t suitable for under 5s because of the levels of arsenic they contain. Other alternatives to cow’s milk can be served after your child is 1 year old.

Your questions

answered

My child loves dried fruit. Is it OK to give this as a snack?

Dried fruit is high in sugar so it is best to only give it to children with meals, rather than as a snack between meals.

I’ve heard bottles are bad for teeth. When should I stop giving my baby a bottle?

You should introduce an open cup or a free-flow cup (with no valve) when your baby is 6 months old.

Prolonged bottle feeding is not recommended because older babies and toddlers can begin to rely on bottle drinking for comfort.

Aim to finish with the bottle by their first birthday.

It’s best not to put anything in a bottle other than breastmilk, formula or water.

Should I stop giving my child fruit juice?

New guidelines recommend limiting fruit juice because it’s acidic and the sugar content can be harmful to teeth. If you give your child fruit juice ensure it is well-diluted and given at mealtimes only.

I think my child’s allergic to cow’s milk. Should I change to a soya drink?

Allergy to cow’s milk is not as common as people think, affecting about 1 in 50 infants. It is much less common in older children (most outgrow their allergy by the time they start school). Always get advice from a Registered Dietitian (through your GP) before excluding cow’s milk. 

Soya products should only be used if advised by a dietitian or GP, as children who are allergic to cow’s milk may also be allergic to these. If you do give soya-based drinks it is important to choose one with added calcium, and remember that some contain added sugars, which are not good for teeth.

Are sugar-free squashes safe to give my toddler between meals?

These drinks are not good for dental health and provide little nutritional value. They usually contain artificial sweeteners which are not recommended for toddlers.

Is it OK to give my child tea or coffee?

Giving tea or coffee to young children may reduce their absorption of iron (especially with food) and is not recommended. They also contain caffeine which is a stimulant and can disturb children’s sleep.

My child keeps asking for sweets and fizzy drinks! What can I do?

Sweets and fizzy drinks can harm your child’s teeth, as well as taking away their appetite for more nutritious foods. It’s not advisable to give fizzy drinks to toddlers. It’s OK to give your toddler sweets occasionally, but try not to offer them regularly so that your child won’t expect them and you’ll avoid tantrums. If you do let your child have sweets, it’s best to give them at the end of a meal, as this is less harmful for their teeth. Also have plenty of alternative snacks available.

What type of toothpaste is best for young children?

For children under three years use fluoridated toothpaste containing at least 1,000ppm (parts per million) fluoride. For children aged three to six years a pea-sized blob is needed containing 1,350-1,500ppm fluoride. Check the toothpaste packet for this information or ask your dentist. Always supervise toothpaste use and help your child brush their teeth until at least seven years old. Also make sure they don’t eat toothpaste from the tube! Your dentist can also give you advice on whether your child would benefit from extra protection such as fluoride varnishes.

My child makes it difficult for me to brush his teeth. What can I do?

When it comes to tooth brushing, it is best to start young – as soon as your baby’s teeth appear. Make it a fun part of your child’s morning and bedtime routines – sing songs while you brush and use different coloured or cartoon-themed toothbrushes.