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Dental care

  • Dental disease, including tooth decay, can impact nutrition, growth, and development in children, and can negatively influence a child’s quality of life.  Children who have dental disease often continue to have poor oral health as adults.  

    Development of teeth

    Children get their teeth at different times, but most babies will get their first tooth between six months and 10 months. Most children will have all twenty baby teeth by the time they are three years old.

    Adult teeth replace baby teeth between the ages of six and 12 years. The wisdom teeth are the last teeth to emerge, coming through in the late teens. Your child will start losing baby teeth around the age of six. Let loose baby teeth fall out on their own. 

    Sometimes an adult tooth will come through before the baby tooth has fallen out. If this happens and the baby tooth hasn’t fallen out within two to three months, and is not loose, you should see your dentist.

    Care at home

    Brushing

    It’s important to get children in the habit of looking after and brushing their teeth as soon as the first tooth comes through.  

    Babies and toddlers will need an adult to brush their teeth twice a day, using a small, soft toothbrush. For babies without teeth, a cloth can be used to clean the gums. When teeth push through, use a toothbrush with water only. For children aged 18 months to six years, you can use a pea-sized amount of age-appropriate fluoride toothpaste.

    Once children are around two years old, they can start to help brush their teeth by holding the toothbrush. Until your child is around eight years old, they should have adult supervision or help when cleaning teeth to make sure they brush properly.

    As your child’s teeth start to fit closely together (usually between two and six years old), they should also be taught to floss their teeth daily. 

    Young children are more likely to clean their teeth regularly if it is a fun activity and part of their usual routine.

    Some suggestions for keeping young children interested in brushing include:

    • singing songs
    • brushing with others (siblings or parents)
    • using a special toothbrush that they have chosen (it may have characters printed on it or is a favourite colour)
    • giving your child a separate toothbrush to play with (e.g. while you brush their teeth, they can brush a teddy’s teeth).

    Fluoride

    Extensive research supports the safety and benefits of fluoride in preventing tooth decay. In most parts of Australia, tap water is treated and contains fluoride, making it a healthy choice for teeth. Tap water that has been boiled and cooled will still contain fluoride, so is beneficial for babies when used in formula.

    Tap water can be offered to children from six months of age and should be the main drink for all children from 12 months old.

    The use of fluoride toothpaste is important in preventing tooth decay. The type of fluoride toothpaste used will depend on the child’s age, and their risk of developing dental decay. It is important to discuss this with a dental professional.

    What causes tooth decay?

    Tooth decay occurs when bacteria in the mouth break down the sugar from food and drinks, and produces acid. This acid damages the tooth surface (enamel) causing it to dissolve and form holes (dental caries or cavities) in the tooth.

    If detected early, it is possible to stop decay from getting worse. Early decay often doesn’t produce symptoms, so by the time symptoms appear, tooth decay is in its late stages and may not be fixable. Signs of advanced decay include: 

    • cavity/hole in a tooth
    • toothache  
    • pain  
    • sensitivity to hot, cold or sweet foods.

    If your child has any signs of decay, you should see your dentist. Tooth decay may be treated with fillings or crowns, however in more severe cases, your child may need to have a tooth removed. 

    Tooth decay can be the result of a number of lifestyle factors. Avoiding sugary foods and drinks and brushing twice daily with an age appropriate fluoride toothpaste, remain the best way to maintain healthy teeth in children.

    Healthy choices for food and drink will help look after your child’s teeth (see our fact sheets  Nutrition – babies and toddlers and  Nutrition – school-age to adolescence).

    A proportion of Australian children have “hypomineralised teeth”, where the enamel does not develop properly and makes teeth weak and prone to damage. These teeth are often very sensitive and children may avoid brushing these teeth. Dental care for these teeth is challenging. Early detection and management can minimise ongoing need for dental treatment.

    When to see a dentist

    It is recommended that all children visit the dentist when the first tooth pushes through or by 12 months of age. Taking a child to the dentist early and when there are no problems with their teeth, allows them to get to know their dentist, have a positive experience and make future visits more familiar.

    All children should visit the dentist regularly (every six to 12 months) for a check-up, even if they don’t appear to have any problems. Visiting the dentist regularly can help prevention, early detection, and management of tooth decay.

    Dental trauma and first aid

    If your child has an injury to their teeth or gums, you should see your dentist. Most dental injuries occur during sport, so it is especially important for children playing contact sports to wear custom fitted mouthguards. Parents and carers should also learn first aid for a knocked-out tooth in the case of a sporting accident. See our fact sheet Broken or dislodged tooth.

    Government-funded dental care

    Free dental services are available for children in Australia under the public dental system. In Victoria, most children under 12 years of age can access government funded routine dental care through a public community clinic. Children under 17 years of age may also be eligible for subsidised public dental treatment. Dental treatment is also provided for a fee at private clinics throughout Victoria.

    The Australian Government’s Child Dental Benefits Schedule (CDBS) funds a range of dental services including examinations, cleaning, fillings, and root canals at public and private dental clinics. Children aged between two and 17 years, whose parents receive family tax benefit A, are eligible for CDBS. You can check your eligibility by contacting the Department of Human Services.

    Key points to remember

    • Children should have their first dental visit when their first tooth comes through.
    • Children should see a dentist every six to 12 months even if they have no problems with their teeth.
    • All children should brush their teeth twice a day to help prevent tooth decay.
    • The main drink for children should be tap water – avoid sugary foods and drinks.

    For more information


    Developed by The Royal Children's Hospital Dentistry department. We acknowledge the input of RCH consumers and carers.

    Reviewed August 2020. 

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.

Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.