Let's be honest — most parents don't think about brushing their baby's mouth until that first tiny tooth peeks through. Before that? It's all cuddles, feeds, and cute giggles — oral hygiene doesn't even cross the mind.
But Dr Mariam Khandwalla, a paediatric dentist and orthodontist at both Kenyatta National Hospital and Aga Khan University Hospital, says caring for your baby's mouth starts right from birth.
"From day one, when you give your newborn a bath, you need to wrap your finger, making sure it is hygienic, with a clean, soft linen cloth and swipe through their mouth," she says.
That simple routine does more than just keep things clean. It also calms your baby. "Wiping through also helps massage the gum pads, which helps the child settle better," she adds.
And the earlier you start, the better. "When it starts from day one, then the child gets used to feeling something in the mouth," Dr Khandwalla points out.
But when should you bring in the toothbrush?
"I usually recommend about one and a half years because they can follow instructions," she says.
Until then, stick to a soft, clean cloth. Even the gentlest toothbrush can be too harsh for sensitive baby gums. But once your little one is ready for brushing, the technique matters.
"Start from the back, take the small 0-2 years brush and once you are done brushing them, wipe with a cloth. This is to ensure all the plaque is wiped off because the child is in a psychological phase where whatever is put in the mouth is considered food. So even if you are going to put the brush, they are going to chew on it," she explains.
Catch 22?
While most parents focus on teeth, the tongue and palate need attention too. Dr Khandwalla says that although some babies may gag, the benefits outweigh the brief discomfort.
"You assess how much you can access. What is the tolerability for the child? If he or she is able to extend really fully, give them a swipe. " The palate also collects residue and a visible white coating if left unchecked. That daily clean-up matters for your baby's overall oral health.
Breastmilk can still cause cavities
Breastfeeding is known for building immunity, bonding, and aiding development, including the orofacial musculature, the muscles and structures supporting your baby’s face and jaws. But many parents don't realise that breastmilk, despite being natural, can still lead to cavities.
"It is healthy for the overall health of the body, but it is not healthy when it is sticking to the tooth because it invites the bacteria," Dr Khandwalla explains.
It is for this reason that you should not leave your baby latched to the breast throughout the night. Why? "Because he/she will be slowly taking in the milk, and the only teeth that will be spared by the bacteria are the lower four, because that’s where the tongue is sitting. It is protecting those teeth, but the rest—they are open to attack by bacteria," she says.
And it's not just breastfeeding that needs caution—bottles pose the same risks, especially during nighttime feeding. "Take a clean cloth, dip it in normal room temperature water and wipe the teeth and swipe the tongue," Dr Khandwalla advises.
Want to soothe with a pacifier? Think again
Many parents rely on pacifiers to soothe their little ones, unaware of how they may alter jaw development in the long run. "When you are putting the pacifier in, the tongue lies low. The ideal position of the tongue—it's supposed to sit on your palate for proper arch development. Now, when you are putting the pacifier, it's the pacifier that is sitting on the palate," she explains.
That seemingly harmless soother can disrupt the natural growth of your child's jaw. "The jaw will be moving backwards, so the upper arch doesn't develop. You may notice that children who use pacifiers have an increased distance between their maxilla and the mandible if they are chronic users. And then, when you are looking at their dentition, you notice a curve. The upper teeth are flaring outwards and upwards. Similar to chronic bottle users," she adds.
Less is more, even with toothpaste
When it comes to toothpaste, a little does go a long way. Especially in areas where fluoride levels in water have increased. "Currently, there is a lot of fluoride in the water, an increase from the recommended 0.7 parts per million to 1 part per million," Dr Khandwalla points out.
“Too much toothpaste, combined with your child's natural tendency to swallow rather than spit, can do more harm than good. Their expectoration (spitting) ability is not that great. They tend to swallow. Secondly, excess toothpaste doesn't mean clean teeth," she says.
So, how much should you use? For babies, only a rice-grain-sized amount of low-fluoride toothpaste. As they grow, that can increase slightly.
"Then slowly, as the child is progressing, you go to like half a pea size. Like, even for us adults, a pea size is more than enough. You don't have to line it up like the way the advertisements show. Less is more," she adds.
Tiny teeth, big impact
It's tempting to overlook baby teeth, assuming they'll fall out eventually. But neglecting them can affect more than just your child's smile.
"Every baby tooth has a succeeding tooth," Dr Khandwalla says. "Picture a three-year-old with a full set of baby teeth and one with lots of cavities who has had like five teeth removed. Do you think both of them can function the same way, chew the same type of food, not be picky…absolutely not."
Teething, diarrhoea and the myths parents believe
That first tooth often shows up around six months, and so does the drama. Many parents quickly link teething to diarrhoea, but Dr Khandwalla says there's more happening beneath the surface.
"We just happen to coincide. Remember, this is happening at the age of six months. The maternal immunity, the immunity that has been passed on from the mother to the child, is waning off and the child is building his/her immunity," she explains.
It's also around this period that dangerous practices like deciduous canine gouging happen — a harmful tradition where the primary tooth bud of the baby canine is forcibly removed.
