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First (or 'baby' or ‘milk') teeth usually start to appear when your child is around 6 months old. All 20 baby teeth should appear by the age of 2. For more information see our ‘Tell me about' leaflet Dental Care for Mother and Baby.
The first permanent 'adult' molars (back teeth) will appear at about 6 years, before the first baby teeth start to fall out at about 6 to 7. The permanent 'adult' teeth will then replace the 'baby' teeth. It is usually the lower front teeth that are lost first, followed by the upper front teeth shortly after. All permanent teeth should be in place by the age of 13, except the ‘wisdom' teeth. These may appear any time between 18 and 25 years of age. All children are different and develop at different rates.
Cleaning your child's teeth should be part of their daily hygiene routine.
You may find it easier to stand or sit behind your child, cradling their chin in your hand so you can reach their top and bottom teeth more easily.
When the first teeth start to come through, try using a children's toothbrush with a small smear of toothpaste.
It is important to supervise your child's brushing until they are at least seven.
Once all the teeth have come through, use a small-headed soft toothbrush in small circular movements and try to concentrate on one section at a time.
Don't forget to brush gently behind the teeth and onto the gums.
If possible make tooth brushing a routine - preferably in the morning, and last thing before your child goes to bed.
Remember to encourage your child, as praise will often get results!
Fluoride comes from a number of different sources including toothpaste, specific fluoride applications and perhaps the drinking water in your area. These can all help to prevent tooth decay. If you are unsure about using fluoride toothpaste ask your dentist, health visitor or health authority. All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). After three years old, they should use a toothpaste that contains 1350ppm to 1500ppm.
You can check the level of fluoride on the packaging of the toothpaste. You should supervise your children's brushing up to the age of 7, and make sure they spit out the toothpaste and don't swallow any if possible.
There are many different types of children's toothbrushes. These include brightly coloured brushes, ones that change colour, ones with favourite characters on the handle, and some with a timer. These all encourage children to brush their teeth. The most important point is to use a small-headed toothbrush with soft, nylon bristles, suitable for the age of your child.
Toothache is painful and upsetting, especially in children, and the main cause is still tooth decay. This is due to too much sugar and acid, too often, in the diet.
Teething is another problem which starts at around 6 months and can continue as all the baby teeth start to come through. If your child needs pain relief, make sure you choose a sugar-free medicine. Remember to check with the doctor or pharmacist that you are being prescribed sugar-free medicines at all times. If the pain continues then contact your dentist for an appointment.
The main cause of tooth decay is not the amount of sugar and acid in the diet, but how often it is eaten or drunk. The more often your child has sugary or acidic foods or drinks, the more likely they are to have decay. It is therefore important to keep sugary and acidic foods to mealtimes only. If you want to give your child a snack, try to stick to vegetables, fruit and cheese. Try to limit dried fruit as it is high in sugar and can stick to the teeth.
It is also worth remembering that some processed baby foods contain quite a lot of sugar. Try checking the list of ingredients: the higher up the list sugar is, the more there is in the product. Sometimes, on labels, sugar is called fructose, glucose, lactose or sucrose.
Thorough brushing for two minutes, twice a day, particularly last thing at night, will help to prevent tooth decay.
Children can sense fear in their parents, so it is important not to let your child feel that a visit to the dentist is something to be worried about. Try to be supportive if your child needs to have any dental treatment. If you have any fears of your own about going to the dentist, don't discuss them in front of your child.
Regular visits to the dentist are essential in helping your child to get used to the surroundings and what goes on there. A child can be much more anxious if it is their first visit to a dental practice. Pain and distress can happen at any time and it is important to prepare your child with regular visits.