Brushing baby teeth: an Australian parent guide

Baby teeth matter. They help children eat, speak and smile, and they hold space for the adult teeth growing underneath. Decay in a baby tooth can cause pain, infection and missed days of childcare, and it can affect the developing adult tooth.

The good news is that the routine is simple and cheap. The hard part is doing it twice a day, every day, with a child who would rather be doing anything else. This guide covers the Australian recommendations, the practical bits and the signs that need a dentist.

When teeth arrive#

Most babies get their first tooth around six months, though the range is wide. Some are born with a tooth; others are still waiting at 12 months. By about two to three years, most children have all 20 baby teeth.

You do not need to wait for a full set. Start cleaning the gums early with a clean, damp gauze pad or face washer, and start brushing as soon as the first tooth appears.

The Australian brushing routine#

The advice changes with age, and it is different from some overseas guidance. For most children in Australia:

Use water only until 18 months unless a dentist has assessed your child and recommended toothpaste earlier. From 18 months to six years, use a pea-sized amount of low-fluoride toothpaste. From six, move to adult-strength fluoride toothpaste.

Brush in the morning and before bed. The bedtime brush is the most important one because the fluoride stays on the teeth overnight. Spit out the toothpaste but do not rinse with water. Rinsing washes away the fluoride that protects the teeth.

How to brush a baby's teeth#

You do not need to be gentle to the point of doing nothing. You do need to be systematic.

1. Sit your baby on your lap or stand behind them at the sink, with their head supported against you.
2. Cup their chin gently and lift their top lip so you can see the teeth and gum line.
3. Use small, circular movements on the front, back and chewing surfaces of each tooth.
4. Brush along the gum line, where plaque collects.
5. Gently brush the tongue if your child will let you.
6. Spit, do not rinse.
7. Clean the brush and let it air dry. Replace it every three to four months, or sooner if the bristles are frayed.

For a baby, you may only manage a few seconds at first. That is fine. The goal is coverage and routine, not a perfect two minutes. As your child grows, aim for about two minutes.

Toothpaste: the part parents get wrong#

The most common mistakes are using too much toothpaste, using the wrong strength too early, and letting children eat toothpaste.

• Too much toothpaste increases the risk of dental fluorosis, which causes white marks on developing adult teeth. A pea-sized amount is enough for a child aged 18 months to six years.
• Adult toothpaste is too strong for young children unless a dentist recommends it.
• Rinsing removes the protective fluoride. Spit, do not rinse.
• Eating toothpaste is not harmless. Keep tubes out of reach and supervise.

If your child cannot spit reliably, use a small amount and wipe away the excess. Do not give up on fluoride altogether. Ask your dentist if you are unsure.

Bottles, cups and drinks#

What your child drinks matters as much as how you brush.

• Do not put your baby to bed with a bottle of milk, formula, juice or sweet liquid. The sugar sits on the teeth for hours and causes decay.
• Offer water between meals and with meals. Tap water is usually fluoridated in Australia, which helps protect teeth.
• Avoid juice, cordial, soft drink and flavoured milk in bottles. These are sugary drinks, even when they seem healthy.
• Move to a cup around six months, when your baby can sit up and hold a cup with help. A free-flow cup is better for teeth than a bottle or a sippy cup used all day.
• Do not dip dummies in honey, sugar or sweet liquids. Honey is also not safe for babies under 12 months because of the risk of botulism.

Milk is an important drink for babies and toddlers, but it should not be available in a bottle all day or overnight. If your child needs a feed overnight, take the bottle away when they finish and clean their teeth in the morning.

Food and snacks#

You do not need to ban every treat. Frequency matters. Every time your child eats sugar, the teeth are exposed to acid for a period afterwards. Grazing on sweet or starchy snacks all day is harder on teeth than a dessert eaten at a meal.

Practical habits:

• Offer sweet foods with meals rather than constantly between meals.
• Choose water after snacks.
• Offer cheese, yoghurt, fruit, vegetables and wholegrain foods for snacks.
• Avoid sticky, chewy lollies and dried fruit as everyday snacks; they cling to teeth.
• Do not add sugar to food or drinks.

The first dental visit#

Take your child to the dentist by their first birthday, or when their first tooth appears, whichever comes first. The first visit is usually short and friendly. It is about getting your child used to the chair and giving you advice, not expecting a full examination.

In Australia, eligible children can get basic dental care through the Child Dental Benefits Schedule. Check your child's eligibility with Services Australia or ask your dentist. Public dental services are also available in many areas, though waiting lists vary.

Do not wait for a problem. Early decay can be painless, and a small white spot is much easier to manage than a cavity.

Teething#

Teething can cause drooling, gum rubbing, irritability and a mild rise in temperature. It does not cause high fever, vomiting, diarrhoea or a rash. If your child has those symptoms, look for another cause and see a doctor.

What helps:

• a chilled teether or a clean, cold face washer
• gently rubbing the gums with a clean finger
• extra cuddles and patience
• paracetamol or ibuprofen appropriate for your child's age and weight, if needed for pain, following the label

What to avoid:

• amber teething necklaces or bracelets, which are a strangulation and choking risk
• teething gels or tablets unless a pharmacist or doctor has advised them
• frozen hard foods that could damage gums
• alcohol-based remedies

Brushing battles#

Some children love brushing. Most do not. A few practical ideas:

• Brush at the same times every day so it becomes routine.
• Let your child hold a toothbrush while you brush, or brush a teddy's teeth first.
• Use a mirror, a song or a two-minute timer.
• Try an electric toothbrush if your child finds it interesting; a manual brush is fine too.
• Brush your teeth at the same time so your child can copy you.
• For a strong refuser, try a different position, such as lying on the floor or sitting on your lap.
• Keep it short and calm. Do not force or pin your child down. If it becomes a daily struggle, ask your dentist or child health nurse for help.

Common mistakes#

• Brushing only once a day, or skipping the bedtime brush.
• Using too much toothpaste, or the wrong strength.
• Rinsing after brushing.
• Putting a bottle in the cot.
• Letting a child sip juice or cordial all day.
• Waiting for a problem before seeing a dentist.
• Using teething necklaces or unproven remedies.

When to get help#

See a dentist if your child has:

• white, brown or black spots on the teeth
• a hole or cavity
• pain, sensitivity or swelling
• bleeding gums
• a broken or knocked-out tooth
• teeth that are not coming through as expected
• a dummy or thumb habit that is affecting the bite

If your child still uses a dummy, our dummy weaning guide explains the dental and speech trade-offs and a gentle plan for stopping.

For a knocked-out adult tooth, seek urgent dental care immediately. For a baby tooth, do not try to put it back in. If your child has facial swelling, fever or trouble swallowing, seek urgent medical care.

The bottom line#

Start early, brush twice a day, use the right amount of toothpaste for your child's age and do not rinse. Keep bottles and sugary drinks away from bedtime. Book a dental visit by the first birthday. It is a small routine that protects a lot.