Baby gum and tooth care from birth to the first birthday
Good oral health starts long before that first tooth arrives. The habits you build in these early months set your baby up for healthy teeth for life, and the good news is that it is simpler than it might sound. This guide takes you from birth through to your baby's first birthday, covering gum care, first tooth brushing, the right toothpaste, your first dentist visit, and the habits that genuinely protect against early tooth decay.
Caring for gums before any teeth arrive
Your baby's teeth are already present, forming under the gumline, from before birth. Even before you can see anything, looking after the gum surface is worthwhile. After each feed, gently wipe your baby's gums with a clean, damp muslin cloth or a small piece of gauze wrapped around your finger. This removes milk residue and helps manage the bacteria that naturally live in the mouth.
You do not need any products at this stage. No toothpaste, no gel, no special wipes. A clean cloth and a little warm water is all it takes. This routine also gets your baby used to having something in their mouth for oral care purposes, which makes the transition to a toothbrush easier when the time comes.
When the first tooth usually appears
Most babies get their first tooth at around 6 months, but the range is wide. Anywhere between 4 and 12 months is entirely normal. Some babies are born with a tooth already through (called a natal tooth), and occasionally a baby reaches their first birthday with no teeth yet and then gets several in quick succession. The timing of teething has no bearing on your baby's development or health.
The first teeth to appear are usually the two lower front teeth (lower central incisors), followed by the two upper front teeth. By the first birthday, most babies have between two and eight teeth, though again there is significant variation.
Start brushing as soon as the first tooth arrives
The moment you spot that first tooth, it is time to start brushing. The NHS recommendation is clear: begin brushing as soon as the first tooth appears, twice a day, using a soft-bristled baby toothbrush and fluoride toothpaste.
To brush your baby's teeth, sit them on your lap facing away from you, or lay them back in the crook of your arm so you can see clearly. Use gentle, small circular movements across the front, back, and top of each tooth. The whole process takes about two minutes and does not need to be a battleground. Many babies find it interesting at first. Some resist. Staying calm and consistent matters more than getting it perfect every time.
It helps to build tooth brushing into a predictable routine: after the morning feed and before bed. Doing it at the same time each day means your baby comes to expect it rather than being surprised by it.
Which toothpaste to use
This is where many parents are surprised by the guidance. The NHS recommends using a fluoride toothpaste with at least 1000 parts per million (ppm) of fluoride from the moment the first tooth appears. This is the same recommendation from birth to age 3.
Many toothpastes marketed specifically for babies contain lower fluoride levels (sometimes 500 ppm or less) based on older guidance or marketing preferences. These are not adequate for protecting against decay. Always check the label. Family fluoride toothpaste (1000 to 1450 ppm) is appropriate from the first tooth if you cannot find a baby toothpaste with the right level.
The amount matters too. For babies and toddlers, use only a tiny smear: roughly the size of a grain of rice, or just enough to cover the bristles thinly. There is no need to rinse afterwards. Spitting out excess toothpaste is fine, but rinsing washes away the fluoride before it can protect the teeth. If your baby swallows a smear of toothpaste, this is not harmful at the quantities used.
Your baby's first dental visit
The NHS recommends that you register your baby with a dentist and bring them for their first appointment as soon as the first tooth appears. This may feel early, but there are good reasons for it. NHS dental appointments for children are free, and early visits serve several purposes: your baby gets used to the environment before any treatment is ever needed; the dentist can check that the teeth and gums look healthy; and you can get personalised advice about fluoride, diet, and cleaning technique for your child specifically.
You do not need to wait until your baby has a full set of teeth, is a certain age, or until you think there is a problem. Going early and regularly means your child grows up seeing the dentist as a normal, routine part of life rather than something to fear.
Bottle caries: the habit that causes early decay
Early childhood tooth decay, sometimes called bottle caries or nursing caries, is one of the most preventable dental problems in young children. It is caused by prolonged exposure of the teeth to sugary liquids, particularly when a baby falls asleep with a bottle in their mouth.
Breast milk and formula both contain natural sugars. When a baby falls asleep while feeding from a bottle and the liquid pools around the teeth for extended periods overnight, the bacteria in the mouth convert those sugars into acid, which dissolves tooth enamel. This is especially damaging to the upper front teeth, which tend to be most exposed.
The highest-risk practices are: giving a baby a bottle of juice, squash, or sweetened drinks at bedtime or during the night; regularly letting a baby fall asleep mid-feed with the bottle still in their mouth so that liquid pools. Milk feeds before bed are fine; the key difference is removing the bottle before sleep and cleaning the teeth afterwards.
If you do give your baby a bottle at bedtime as part of the settling routine, try to give it earlier in the routine so you can brush teeth after the feed before sleep. Switching to water for any overnight bottle needs is a good strategy once your baby is established on solids.
Teething gels: what the NHS says
Many teething gels are sold over the counter and marketed for babies. The NHS advises parents to avoid teething gels that contain a topical anaesthetic such as lidocaine or benzocaine for babies under 2 years. These anaesthetics can numb the back of the throat, which can affect swallowing, and there is a risk of accidental overdose if too much is applied or absorbed.
Safer options for teething discomfort include a chilled (not frozen) teething ring, gentle gum massage with a clean finger, and infant paracetamol or ibuprofen where your baby is old enough and the dosage is appropriate (check the packaging or ask your pharmacist). Sugar-free teething rusks and cold foods like chilled cucumber are popular with slightly older babies who have already started solids.
Building habits that last
The goal of all of this is not perfection in the first weeks, but a consistent habit that becomes automatic. Babies who have their teeth brushed from the first tooth are generally easier to brush as toddlers because it is simply what happens in their house. If your baby resists brushing, try singing, using a toothbrush with their favourite character, or letting them hold a toothbrush themselves while you use a second one. Staying positive and matter-of-fact takes the drama out of it for both of you.
Frequently asked questions
When should I start brushing my baby's teeth?
Start as soon as the first tooth appears, which is typically around 6 months but can be anywhere between 4 and 12 months. The NHS recommends brushing twice a day from the moment that first tooth emerges, using a soft-bristled baby toothbrush and a smear of fluoride toothpaste.
What toothpaste is safe for babies?
The NHS recommends using a fluoride toothpaste with at least 1000 ppm of fluoride for babies from the first tooth. Use only a smear and do not rinse afterwards. Many baby-branded toothpastes have lower fluoride levels than recommended, so always check the label.
Do I need to take my baby to the dentist?
Yes. The NHS recommends taking your baby to the dentist as soon as their first tooth appears. NHS dental appointments are free for children. Early visits help your baby get comfortable with the dentist, and your dentist can spot any early concerns.
How do I clean my baby's gums before teeth appear?
Wipe your baby's gums gently with a clean, damp muslin cloth or gauze after feeds. This removes milk residue and helps manage bacteria on the gum surface. You do not need toothpaste or a toothbrush at this stage. Once the first tooth appears, switch to a soft toothbrush and fluoride toothpaste.
Is it safe to use teething gels?
The NHS advises avoiding teething gels containing topical anaesthetics (lidocaine or benzocaine) in babies under 2 years. These gels can numb the throat and carry a risk of overdose. Safer options include chilled teething rings, gentle gum massage, and infant paracetamol or ibuprofen from 3 months where appropriate.
Can breastfeeding damage my baby's teeth?
Breast milk alone does not cause tooth decay in the same way as sugary drinks. However, very frequent night nursing after teeth appear, with milk pooling around teeth, can contribute to early childhood caries in some cases. Good cleaning habits alongside breastfeeding protect effectively against this.
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