The Complete Guide to Keeping Your Child in Great Oral Health at Every Age

Originally published July 8, 2019 as The Best Oral Health Habits for Your Young Child

With your supervision and good example, your child can begin the path to a lifetime of good oral health during the earliest stages of childhood. All oral habits—including tooth brushing and flossing, thumb-sucking, biting and chewing, nutrition, protection during sports, and even breathing—affect the way young children’s faces, jaws, teeth, and overall health develop. And as children become teens, good oral habits and care expand to include avoiding smoking, vaping, and oral piercings.

Here are answers to the most common questions you may have about your children’s oral health habits at various points in their lives.

Infants and Babies

Should I give my baby a bedtime bottle?

Avoid bedtime bottles. The American Dental Association recommends that babies and young children finish their bedtime bottles before they go to bed. However, if your young child takes a bottle to bed, be sure to fill it with water only. When children drink from bottles as they fall asleep, sugar from other types of drinks—even those with only natural sugar, such as juice or milk—remains in their mouths overnight and can lead to cavities in their developing teeth.

When should my child stop using a pacifier?

Try to discontinue pacifier use by age 1. “Constant sucking on a pacifier can negatively affect the shape of a young child’s developing jaw bones,” says Donna Greco, DMD. As a child matures, improper facial development can lead to serious health issues including behavioral, breathing, and sleep problems. By weaning your child off the pacifier by age 1, you can help to avoid these issues.

Toddlers

At what age should my child start seeing the dentist?

If you’re planning your child’s first birthday celebration, plan a dental appointment too. Because young children’s teeth normally begin to appear between 6 and 12 months of age, shortly before your child’s first birthday is a perfect time for a first dental visit! Your child’s new teeth will benefit from proper dental care and good oral hygiene habits right from the beginning.

At what age should my child stop using a sippy cup?

It’s best to teach young children to drink on their own from a regular cup by the age of 18 months or so. Similar to the effects of sucking on a pacifier, the way young children suck from sippy cups does not encourage a mature swallowing pattern. This can affect the way the muscles in a child’s mouth and face develop, and may lead to future health issues.

When should children stop sucking their thumbs?

If your child is past age 18 months, encourage her to stop sucking her thumb. It’s natural and normal for infants and very young children to suck their fingers and thumbs. Their sucking reflex enables them to get nutrition, and the habit can be soothing for them. Most children who suck their thumbs will stop as they learn to eat solid food and drink from a regular cup. Those who persist past age 18 months may have difficulty developing a mature swallowing pattern, which—similar to issues resulting from extended pacifier and sippy cup use—can result in health issues requiring correction. For children past 18 months old who haven’t given up thumb-sucking, you can try gently encouraging them to stop. If your child is older than age 2 ½ and still sucks her thumb, ask your dentist about fitting her with a simple oral appliance that is painless and helps to replace the thumb-sucking habit with an entertaining tongue exercise.

Should I be concerned about my child’s mouth breathing?

If your young child is mouth breathing, tell your pediatrician and your child’s dentist. When a child breathes mostly through her mouth, her tongue stays in a downward position, causing a change in her craniofacial growth direction. This can strain her jaw joint and the muscles surrounding it, which may lead to headaches, facial pain, sleep apnea, and TMJ pain. In young children, mouth breathing may also contribute to ADHD and other behavioral issues, bed-wetting, irritability, daytime sleepiness or hyperactivity, and snoring.

Without treatment, this orthopedic condition can cause your growing child’s face and/or head to grow long and skinny, instead of round. This can lead to narrowing of the child’s nasal passages and the back of her throat, which in turn creates a breathing disorder. However, a specially trained dentist (who may work in collaboration with pediatricians and ENT specialists) can correct this—often with a simple oral appliance—and restore proper breathing function and facial growth, especially while your child is still growing. That’s why it’s important for you to screen your child early, preferably by age 5.

From a medical perspective, children who breathe mostly through their mouths are more likely to develop strep throat and enlarged tonsils and adenoids. When this is the case, a physician may recommend removing your child’s tonsils and adenoids, but this doesn’t fix the source of the problem, which is the orthopedic issue that causes the mouth-breathing. Only correcting the underlying orthopedic condition can help a child to regain the ability to breathe nasally. As the problem resolves, the child’s nasal passages will open up, and their adenoids and tonsils will shrink.

How do I know if and when my child needs orthodontic treatment?

The practice of waiting to begin orthodontic treatment until children have all their permanent teeth is changing. Frequently, beginning orthodontic treatment in early childhood will result in a simpler and more comfortable process; will help children to develop healthy lifelong oral habits; will alleviate more serious related health issues; and will shorten overall treatment time.

In fact, many of the warning signs that a child needs orthodontic treatment will appear in early childhood. As soon as these appear, it’s time to consult your dentist, because early treatment may be a solution. These signs can include:

Asthma
Bed-wetting (which may indicate a sleep disorder)
Behavioral problems (see below)
Bite issues (crossbite, overbite, underbite)
Chronic congestion
Crowded teeth/mouth
Ear infections
Enlarged tonsils or adenoids
Forward head posture
Mouth breathing
Sinus issues
Sleeping problems
Snoring
Speech issues

Behavioral problems such as ADD, ADHD, and anxiety may appear to have nothing to do with dentistry, but they can stem from problems with an underdeveloped airway. Early treatment can improve the development of children’s craniofacial structures to help increase their airway volume. A larger airway allows more air to flow to the lungs and more oxygen to reach the brain, thus helping the brain to function as it should.

Are gummy vitamins bad for my child’s teeth?

When it comes to your child’s teeth, gummy vitamins may do more harm than good. They taste good and many children love them—but that’s because many brands of gummy vitamins have a high sugar content. “They are literally vitamin fortified candy,” says pediatrician Kirstin Campbell, MD. Gummy vitamins may also contain a smaller variety of vitamins and lower amounts than traditional chewables, due to limitations of the gummy delivery system.

Dr. Campbell also cautions against “overdoses” of gummy vitamins and other types of children’s vitamins. Because of the enjoyable flavor, unsupervised children may consume unsafe amounts of these vitamins, which in some cases could lead to kidney stones and other serious health issues. Instead, teaching your child to eat a healthy diet is one of the best ways to help her achieve good oral health.

When should my child start learning to floss?

When your child reaches age 18 months or so, it’s a great time to introduce flossing. As soon as your child has multiple teeth that touch each other, you can begin. In the drugstore, you’ll find children’s flossers with bright colors and animal shapes; or you can just choose regular dental floss. Use whatever is most comfortable for you and your child. Whatever you choose, the most important thing is to introduce the concept of flossing and make it part of your child’s oral care routine.

With your help and your patient example, children as young as age 3 can begin to try flossing on their own. Keep in mind that it will take them some time to get comfortable with flossing. At this age, their motor skills are developing and will continue to do so until age 12 or so. But by starting young, children can get used to a good oral care routine. Regular practice is important. Encourage them to do their best; then you can brush and floss their teeth to be sure they are thoroughly clean. To make your job easier, ask them to lie on a couch or a bed with the top of their head you so you can see everything in their mouths. Playing audio books, music, or videos is a great way to entertain your little ones while you work!

What’s the best kind of food for my toddler’s teeth and gums?

Natural is best when it comes to your toddler’s teeth and gums. Crunchy, firm fruits and vegetables; lean meats, fish, and vegan proteins; low-carb nuts; natural foods high in calcium and phosphorus; and unsweetened drinks are best for promoting oral health and overall health.

With regard to drinks, it may be tempting to give your child fruit juice if he or she is a picky eater or cannot drink milk. But don’t be fooled by packaged fruit juices that claim to provide essential vitamins or contain added calcium. Many of these “healthy drinks” include added sugar, which can team up with oral bacteria to cause tooth decay.

Older Children and Teens

What specific oral health recommendations are there for older children and teens?

As children make the transition to their teenage years, you’ll want to be aware of additional specific concerns for their age group.

As always, it’s important for older children and teens to floss their teeth daily and brush them thoroughly twice a day. But due to more demanding school schedules at this age, it’s also important for them to focus on getting enough sleep. One study involving adults revealed a correlation between sleep deprivation and gum inflammation, and more than a third of American adults over age 30 have some form of gum disease. By prioritizing sufficient sleep, your child will develop a positive lifelong habit.

If your child or teen participates in sports, ask your dentist about a custom mouthguard, which can help to protect their teeth from damage.

Young people may also be tempted to try smoking or vaping, or to get oral piercings. But studies continue to show that all three of these things can negatively affect your young person’s oral health.

In addition, young people should avoid using their teeth as tools, chewing things such as ice and pencils, and teeth grinding (bruxism). Contact your dentist if you’re concerned that your child is engaging in any of these behaviors.