Wait, Do I Have to Brush My Infant's Teeth?

The thing about infants is just as you think you've got a handle on things, things change. Got the whole bottle routine down? Oh, great — time to introduce solids. She's finally sleeping through the night? Nope, she's now screaming at 3 a.m. because she's going through a sleep regression. And just as one of those baby teeth emerges and interrupts that adorable gummy smile, you wonder if another responsibility needs to be added to the list: brushing your infant's teeth.

The mere thought may immediately spark feelings of dread. If it's anything like the directive to brush my dog's teeth, it will be a ~struggle.~ But while I wouldn't have believed it before my baby was born, baby > dog — and so, no matter how difficult the task will be, it's away we go if my infant son needs his teeth brushed.

Before diving in, though, I wanted to speak to some experts in the field. I consulted two pediatric dentists who gave me the full low-down on oral health for tiny humans.

What is teething?

"Teething" gets thrown around a lot as the explanation for pretty much everything that feels wrong with your baby, from them being fussy to not sleeping at night. Like many babies, my son was putting stuff in his mouth when he was as young as 4 months old, and I can't tell you how many times my relatives, with their sage-like wisdom, proclaimed, "He's teething." He was not.

Dr. Mori Aletomeh, DMD, of Pearly Smiles Pediatric Dentistry, explains that usually, teething begins at around 7 months (typically the front two teeth are first), and every four months or so your baby will get four more teeth in until they have 20 in total, the last ones usually coming in at around 29-30 months. However, this timeline can vary greatly from child to child. Interestingly, they go through teething again between the ages of 6 and 12, when kids grow in their permanent sets.

Dr. Quinn Yost, DDS, MSD of Milk Tooth, shares how you can tell your child is teething. "A lot of times you can see a little swelling or bump in the gums where it's going to be, or you notice they're more handsy or drooling a lot." He also says it can look like a blood blister or infection, but "you're not going to get an infection from teething; that's almost unheard of."

When should you start brushing your kids' teeth?

Dr. Yost’s response was surprising. "My thing is preventative dentistry, and I'm into building a healthy oral microbiome ... that happens right away. I actually like to see moms when they're pregnant because we're all about building healthy bacteria."

He then shared with me the findings of a study where pregnant women chewed Xylitol gum (which changed the bacteria in the moms' mouths), and when their babies were 5 years old, they had 70% less cavities than the moms who didn't chew the gum.

Whelp, maybe for baby number two.

However, the more common response is to brush their teeth as soon as they come in. Yet again, you ideally should start even earlier than that! Dr. Aletomeh recommends using a finger brush or a wet washcloth to go into their mouths and wipe away after bottle feedings so that they get used to having someone in their mouths.

Yost suggests using a xylitol gel on the finger brush, so you're doing two things — "You're getting them comfortable with you being in their mouths and the other thing it does is putting that xylitol in there is promoting that healthy bacteria." When the teeth come in, switch to a soft bristle brush. Aletomeh recommends ones that say 0-3 years on the front.

Regarding toothpaste, Aletomeh says you can forgo it in the beginning and just brush with water. Once they have a handful of teeth (or rather, a mouthful), you can use a very small amount of toothpaste (according to the AAPD, a "rice grain" amount).

Once your child can learn to spit (typically around 3 years old), you can use a pea-sized amount of toothpaste. And FYI, we adults don't need more than that either! Aletomeh likes the brands Crest, Tom's, and Hello, all of which offer fluoride and non-fluoride varieties. Both doctors tout the brand Risewell because it contains an ingredient called hydroxyapatite, which is a natural material that helps make your teeth stronger.

Why do we have to brush their teeth if they're just going to fall out?

Even baby teeth can get cavities. In fact, Aletomeh shares that cavities progress faster in baby teeth. If the teeth develop cavities, your baby will be in chronic pain, which could lead to a refusal to eat and the spreading of infection. Additionally, it can cause speech problems.

Both dentists further explained that the baby teeth hold space for the adult teeth underneath. "If you lose those baby teeth earlier, all those six-year molars that are coming in trickle forward… then those adult teeth and the bone won't have room to come into," says Aletomeh. If this does occur, visit a pediatric dentist who can make spacers to avoid movement.

So then, how do we brush their teeth?

I was happy when Yost told me, "You're not going to do a great job." I'm all about a low bar. He says that using xylitol toothpaste promotes healthy bacteria, which will lead to fewer cavities.

Both dentists advise brushing your child's teeth while they are lying down. Using two hands, Yost says to use one to hold the toothbrush and brush their teeth and one to pull the lip away. Even better, if possible, enlist your partner. Aletomeh says that one adult should be behind the head "playing dentist" while the other is at the feet as the "entertainer" trying to distract the baby.

Consistency is key. Keep it positive and fun (maybe play The Happy Song); eventually, this will become another part of your routine.

What about flossing?

Any adult who listens to their own dentist knows they need to floss, but is it necessary to do this on your infant as well? It depends. For kids who have teeth spread out with space in between them, there's no need. However, if you have kids with teeth that touch, you do need to floss… womp, womp.

Before you panic, Yost told me, "You're not going to be able to floss your 1 1/2-year-old's teeth because they're not gonna let you, and you're gonna injure them." But as they get more used to brushing twice a day and if their teeth are touching, floss is needed.

When should we bring our child in for their first pediatric dentist appointment?

The AAPD recommends that patients go for their first dental checkup with a board-certified pediatric dentist (you can find one here) within six months of their first tooth eruption or by their first birthday. Both dentists agree with this recommendation.

Anything else we can do to avoid cavities?

I assumed Aletomeh would tell me sugar was the obvious culprit (duh), but she explained that "it's really the processed foods that we eat" that can cause cavities. Less processed food is the key (bye-bye, Goldfish and pretzels). She shares that fruit makes for a better snack because, while containing natural sugar, it won't stick to the teeth. Also, the more you brush, the less time food has to sit around on your teeth.

If your child does get a cavity, don't beat yourself up. Yost explains, "Cavities are not fair. There are so many things that go into it. You can be the most diligent health-conscious parent… and you or your kid can get cavities." Genetics play a huge part, as they can affect how hard or soft your teeth are, and so do your hormones, which affect your salivary flow and content.

It seems like it's time to introduce my son to my old pal, Raffi (you get me, millennial moms). Happy brushing all!