How to keep child teeth healthy

Children with cleft lip and/or palate have an increased risk of dental problems. Our goal is to help you ensure your child has a happy smile, healthy teeth, and no pain.

When do teeth start to come through?

Baby teeth typically begin to emerge around 6 months of age, although this can be later in some children. Occasionally, children are born with a tooth. A child will usually have all their baby teeth by around 3 years of age. Adult teeth start to come through around 6 years of age, often before any of the baby teeth are lost.

How may the cleft affect the teeth?

When a child has a cleft that goes through the gum area, the teeth in the line of the cleft may be missing, misplaced, poorly formed, or there may be extra teeth. The bone is missing where the cleft goes through the gum, and there is usually a gap between the teeth on either side of the cleft. It is quite common for teeth in the cleft area to appear twisted or higher up than the other front teeth and to come through in the roof of the mouth behind the front teeth.

Are baby teeth important?

All teeth are important! Baby teeth hold the space for the adult teeth. If baby teeth have to be removed early, this may lead to crowding and affect the result that can be achieved by the dentist when your child is older and requires orthodontic treatment.

How can I keep my child’s teeth healthy?

Dental decay is avoidable and can cause pain and infection if left untreated. Take your child to see your family dentist as soon as their teeth start to come through. It is important that children get into the habit of regular dental check-ups before they need treatment. Taking a child to the dentist only when they have toothache is not a good introduction to dental care. If you have difficulty finding a dentist for your child, speak to a member of the Cleft Team who will be able to help you.

Ask your dentist about fluoride varnish. This is like a ‘super strength’ toothpaste applied at your dental practice. Regular application of fluoride varnish will help strengthen the teeth and prevent tooth decay.

Help brush your child’s teeth at least twice a day, especially last thing at night, with fluoride toothpaste as soon as the teeth start to come through.

Encourage your child to spit out after brushing but not to rinse the mouth, as this reduces the protective effect of the toothpaste. Try not to let your child swallow the toothpaste. Children with a cleft are thought to be at higher risk of dental decay, so it is important for them to receive a higher dose of fluoride than that found in many children’s toothpastes.

For children aged 0-3 years: Use a soft ‘baby’ toothbrush. Use only a smear of toothpaste containing no less than 1,000ppm fluoride (ppm indicates the amount of fluoride in toothpaste, usually found on the tube or box). Don’t forget to gently brush any teeth in the cleft area.
For children 3 years and older: Use a small-headed children’s toothbrush. Use a pea-sized amount of toothpaste containing 1,350-1,500ppm fluoride.

Children cannot effectively brush their teeth until at least the age of 7-8 years, but they like to try. Give your child a toothbrush to brush themselves, but it is important that you ‘finish-off’ the brushing. Make brushing fun! Experiment with different flavours of adult toothpaste to find one your child likes.

Have a healthy diet:

After 12 months of age, don’t give your child a bottle at bedtime, as this may lead to tooth decay. Avoid sugary foods and drinks between meals. Only plain water or milk should be consumed between meals. Try to keep diluted fruit juice and squash to mealtimes. Fresh fruit juice is highly acidic and can cause tooth damage. If fruit juice is consumed, dilute it with water and drink
through a straw to reduce tooth contact and minimize tooth damage. Don’t give your child fizzy drinks, as even sugar-free or diet fizzy drinks (including fizzy water) cause damage to teeth because they are acidic. After weaning, only plain water should be given at night if your child is thirsty. Some children may be on high-energy supplements, which are often very high in sugar but necessary for the child’s general health. These children are at higher risk of dental decay and need to be seen by the dentist more frequently.

Is there anything else I can do to help keep my child’s mouth healthy?

It is very important to brush last thing at night and then try to avoid your child eating or drinking anything other than plain water after this. If you would like more help with brushing your child’s teeth, ask your dentist or the Cleft Team to show you simple ways to help keep your child’s teeth clean.

Things to remember

  • Take your child to see your family dentist. Book an appointment online or book through WhatsApp
  • Brush your child’s teeth twice a day with fluoride toothpaste.
  • Brush the teeth even if your child has a feeding tube and is not taking food into their mouth.
  • Ask for sugar-free medicines if possible.
  • Try to avoid giving your child a dummy.

Child teeth frequently asked questions

How many teeth does a child have?

A child typically has 20 primary (baby) teeth. These include 10 teeth in the upper jaw and 10 in the lower jaw. The primary teeth usually start to emerge around six months of age and are gradually replaced by permanent teeth starting around age six.

What age should child brush teeth?

Children should start brushing their teeth as soon as their first tooth appears, usually around six months of age. Initially, parents should brush the child’s teeth with a soft-bristled toothbrush and a small amount of fluoride toothpaste. By the age of three, children can start brushing their teeth with parental supervision to ensure they use the correct technique and amount of toothpaste. Teaching good oral hygiene habits early helps ensure lifelong dental health.

How long should a child brush their teeth?

Children should brush their teeth for two minutes, twice a day. Using a timer or a fun two-minute song can help ensure they brush for the appropriate amount of time. It’s important to supervise and assist younger children to make sure they brush all surfaces of their teeth properly.

How many teeth fall out as a child?

A child typically loses 20 primary (baby) teeth. These teeth begin to fall out around the age of 6 and continue to be replaced by permanent teeth until about the age of 12.

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