Looking after children's teeth

When it comes to oral care for children, getting off to a good start is essential. Teeth play an important role in jaw development, eating and speech. They need to be healthy and well-cared for from the beginning.

Getting off to a good start

In New Zealand tooth decay is a significant problem, with almost half our children having cavities by the time they reach five years of age.

To give children the best chance of good oral health, pregnant women need to take care of their own oral health and eat a healthy diet with plenty of folic acid and calcium. This provides the essential building blocks their babies need for forming strong, healthy teeth; a process that begins in the womb.

5 ways to prevent tooth decay

As soon as your child's teeth appear they are at risk of decay – this is usually at around 6 months. To help prevent tooth decay: 

  1. Brush teeth twice a day. Tooth enamel is softened for about 30 minutes after eating acidic foods, so try brushing before breakfast and last thing at night.
  2. Use regular-strength fluoride toothpaste – a speck for babies, a small dot for toddlers and a pea-sized amount for preschoolers and older children.
  3. Ensure your child has a healthy diet that is low in sugar. Food and drink that are high in sugar allow bacteria and acids that create tooth decay to thrive in your child’s mouth. 
  4. Check teeth regularly. Lift the lip every month to check for signs of tooth decay (holes).
  5. Have regular dental check-ups. Enrol your child with your local Community Oral Health Service and make sure they have regular dental check-ups from an early age. Dental care for children is free. Your midwife or nurse will be able to help you to enrol your child.

Care of baby teeth

  • Clean baby teeth. As soon as the first baby tooth comes through you need to start cleaning it. Use a damp cloth or a soft baby toothbrush with either water or a speck of baby toothpaste. A good way to do this is to sit baby on your lap, with you both facing the same way.
  • Look out for spots or stains on your child’s teeth. By lifting your child’s lip up you will be able to see if there are signs of early decay on the front teeth. See a family or paediatric dentist or dental therapist at the first sign of any discolouration.
  • If you give your baby a dummy don’t sweeten it first (for example with honey or syrup), as this coats the teeth with sugar and holds it there to decay teeth.
  • Watch for signs of gum disease (gingivitis); red, swollen areas that bleed easily when brushed. Gingivitis in children can be quickly treated by a dentist.

If you are bottle-feeding your baby:

  • Put only breast or formula milk in the bottle. 
  • Bottle feeding fruit juices or other sweetened drinks bathe your baby’s teeth in bacteria-feeding sugars for a long period of time, this should be avoided.
  • Always hold your baby when feeding – never put a baby down with a bottle.

Toddlers and oral care

undefinedToddlers are more independent and often will want to brush their own teeth. By all means let them have a go, but it is important to then ensure that all surfaces are thoroughly cleaned by brushing them yourself as well. Most toddlers and young children can’t yet manoeuvre their toothbrush to reach all surfaces of their teeth.

Brushing tips for toddlers:

  • Choose a toothbrush with soft bristles and a small head that can reach to the back of the mouth. Change the toothbrush regularly, whenever it begins to look worn-out, or at least every three months.
  • Brush your child’s teeth twice a day with a small dot of fluoride toothpaste.
  • A good way to brush is in front of the mirror, both facing it. Crouch behind your toddler, or sit him on your knee. Positioning the brush at a 45-degree angle to the gums, brush all surfaces of every tooth back and forth in small, tooth-wide strokes.
  • Avoid brushing teeth straight after meals as tooth enamel is softened for 30 minutes after eating acidic foods. Try brushing before breakfast and last thing at night.
  • Encourage your child to spit out but not to rinse  rinsing strips off protective fluoride left behind from the toothpaste.

Children’s dental hygiene

Children should start to floss from age four. At first parents will probably need to do this for their child.

Around six years of age your child will get his first adult molars behind his baby teeth. These, and his other teeth, will benefit from a pea-sized amount of fluoride toothpaste each time you brush his teeth.

Until your child is at least eight or nine years old, you should continue to help him brush his teeth. By this age, he should have developed the dexterity and understanding required to do a thorough job.

Brushing tips for children:

  • Choose a toothbrush recommended for your child's age. Change the toothbrush regularly, whenever it begins to look worn-out, or at least every three months.
  • Encourage your child to brush their teeth twice a day with a pea-size amount of fluoride toothpaste. 
  • A good way to brush is in front of a mirror. Positioning the brush at a 45-degree angle to the gums, brush all surfaces of every tooth back and forth in small, tooth-wide strokes. Assist younger children to ensure all teeth are cleaned correctly. 
  • Avoid brushing teeth straight after meals as tooth enamel is softened for 30 minutes after eating acidic foods. Try brushing before breakfast and last thing at night.
  • Encourage your child to spit out but not to rinse  rinsing strips off protective fluoride left behind from the toothpaste.

Tooth-friendly foods

Nutrition plays a key role in oral health throughout a person’s life.

Good oral care and a healthy balanced diet with foods containing calcium (milk products and vegetables), fluoride (fluoridated water, seafood, tea, gelatin) and phosphate (leafy vegetables, fruit, meat and poultry) are essential in the prevention of cavities. The following tips may also help in reducing the risk of cavities:

  • Minimise sugar in your child's diet – a diet of high in sugar allows the bacteria and acids that create tooth decay to thrive in your child’s mouth. 
  • Avoid sticky, sugary snacks between meals – these 'glue' the sugar to the teeth, increasing the risk of decay.
  • Drink water and sugar-free drinks.
  • Avoid fizzy drinks – even diet soft drinks are acidic and can erode the teeth. 

Local school & community dental services 

Basic dental health care is free for New Zealand children and young people up to age 18 – see It's easy to protect your family's smile (from HealthEd) for more information. 

It is a good idea to enrol your child in your local community-based dental service before their first birthday. This allows for problems to be prevented, detected and addressed early. It also helps your child develop a positive association with dental visits, rather than an aversion to them.  

To find your local community dental service try contacting your:

  • Local school dental clinic or District Health Board, 
  • your GP,
  • Plunket nurse,
  • WellChild provider,
  • or visit teeth and gums (NZ Ministry of Health) or freephone 0800 Talk Teeth (0800 825 583).