Many parents assume tooth brushing starts once a child is old enough to hold a brush. In practice, the habits that protect baby teeth begin months earlier, with a soft cloth on the gums, and the toothpaste rules change twice before school age. Getting those few details right prevents a lot of the decay we see in young children.
Decay in baby teeth is common in Australia. National survey data suggest roughly one in three children aged five to six have already had decay in their baby teeth, and much of it begins in the toddler years. It is also one of the most preventable problems in children's health, which is why the routine below is worth the effort.
Before the first tooth, wipe the gums
Once a day, wrap a clean, damp face cloth or a piece of gauze around your finger and wipe gently over your baby's gums. This removes milk film, and it gets your baby used to someone touching inside their mouth. Babies who are familiar with that sensation tend to accept a toothbrush more easily later.
From the first tooth to 18 months, a soft brush and water
The first tooth usually arrives somewhere between six and ten months, although a little earlier or later is normal. From that point, change to a baby toothbrush with a small head and soft bristles, and brush twice a day. Australian guidelines recommend water only, with no toothpaste, until 18 months, unless your dentist or oral health therapist has suggested fluoride toothpaste earlier because your child is at higher risk of decay.
Cradle a baby in the crook of your arm so the mouth faces up and you can see what you are doing. Lift the top lip gently with one finger to reach the front teeth near the gum, which is where early decay often starts as dull white lines.
From 18 months to six years, a small amount of children's toothpaste
At 18 months, introduce a low-fluoride children's toothpaste. These contain less fluoride than adult toothpaste. Use just a smear across the bristles, as the Australian Dental Association (teeth.org.au) advises for children aged 18 months to 6 years. That small dose is enough to strengthen enamel, while keeping the amount swallowed low. Young children who regularly swallow large amounts of fluoride toothpaste can develop white flecks on the adult teeth forming underneath, a condition called fluorosis.
Teach your child to spit out the foam after brushing and skip the rinse with water. The fluoride left behind keeps working on the enamel. Younger toddlers often cannot spit well yet, so until they can, simply wipe away the excess.
From six years old, children can move to a pea-sized amount of standard family fluoride toothpaste.
Practical ways to brush a toddler who resists
Brushing a two-year-old is rarely tidy. A few changes make it more manageable.
Change your position. Sitting on the floor with your child lying back on your lap, head towards you, gives a view much like a dentist's chair. Standing behind an older toddler at the mirror and tilting their head back slightly also works. Face to face is the hardest angle.
Aim the bristles at the gumline in small circles, and cover the outer surfaces, the inner surfaces and the chewing tops. Two minutes is ideal. A calm one minute that gets done is better than a battle that ends after ten seconds.
Give your child a turn with their own brush first, then say it is your turn to finish. Children cannot clean their own teeth properly until they can write their name neatly or tie their shoelaces, usually around seven or eight, so a parent should brush or check until then.
Keep it at the same times every day. A song, a sand timer, or brushing your own teeth beside them all help it feel normal rather than optional.
The night brush carries the most weight
If one brush has to be skipped, it should never be the one before bed. Saliva flow slows during sleep, and saliva is the mouth's main defence against the acid produced when bacteria break down sugars. Whatever is left on the teeth at bedtime has hours to do damage. Brush after the last milk feed or drink, and offer only water after that.
Feeding habits matter as much as the brush
The pattern most linked to early decay is a bottle of milk, formula or juice taken to bed or sipped on through the night. Liquid pools around the top front teeth and keeps them coated in sugar. Similar problems can come from a sippy cup of juice or milk carried around all day.
Introduce a cup from around six months and aim to stop bottles by about 12 months. Make water the drink between meals, keep juice and cordial out of the everyday routine, and be wary of fruit pouches, sweetened yoghurts and sticky muesli bars, which cling to teeth longer than whole fruit does. For snack ideas, see our article on tooth-friendly food for children.
Booking the first dental visit
A first check is recommended when the first tooth appears, or by the first birthday. The visit is short and usually happens with your child on your lap. It lets a dentist or oral health therapist look for early warning signs, check your brushing technique and talk about fluoride for your family. Our guide to a child's first dental visit explains what to expect.
Many families are eligible for the Child Dental Benefits Schedule, which covers a range of basic dental services for eligible children aged up to 17. Children under 18 in New South Wales can also use public dental services. Ask us if you are unsure if your child qualifies.
What parents ask us
Baby teeth fall out anyway, so why fuss over them?
Baby teeth help children chew, speak clearly and hold space for the adult teeth. Decay in them can cause pain and infection, can lead to early tooth loss and crowding, and may affect the adult teeth developing below. Some back baby teeth stay until around age 12.
Is fluoride toothpaste safe for toddlers?
Yes, in the amount recommended for their age. It is one of the most effective ways to prevent decay. Our article on fluoride safety covers the evidence in more depth.
Teething makes my baby hate brushing. Should I stop?
Keep going gently. A soft brush can actually feel soothing on sore gums. If a particular spot is clearly tender, brush around it for a day or two. Our article on teething has more on easing discomfort.
Does my child need mouthwash?
Usually not. Most young children cannot rinse and spit well enough, and brushing with the right toothpaste is enough. Once back teeth touch each other, flossing between them can help, and we can show you how.
A gentle first check for your child
Our dentists, together with oral health therapists Sabrina Tran and Jennifer Nguyen, see babies, toddlers and older children, with a focus on prevention. You can read about our general and family dentistry, see new patient offers on our deals page, or contact the team in Melrose Park to book.
