Your baby's first tooth usually breaks through the gum (erupts) at about 6 months. Many times you might not know that your baby has a new tooth coming in until you see it or hear it click against an object, such as a spoon. Some babies may show signs of discomfort from sore and sensitive gums, be cranky, drool, and have other mild symptoms. These symptoms usually begin about 3 to 5 days before a tooth erupts and go away as soon as the tooth breaks through the gum. For more information, see the topic Teething.

By the time your child is 6 months of age, your doctor should assess the likelihood of your child having future dental problems.^{1, 2} This may include a dental exam of the mother and her dental history, as the condition of her teeth can often predict her child's teeth. If your doctor feels your child will have dental problems, be sure your child sees a dentist before his or her first birthday or 6 months after the first primary teeth appear, whichever comes first. After your first visit, schedule regular visits every 6 months or as your dentist recommends.

Experts recommend that your child's dental care start at 12 months of age.² Babies with dental problems caused by injury, disease, or a developmental problem should be seen by a dentist right away. A children's dentist (pediatric dentist) is specially trained to treat these problems.

If these dental problems are not limited to the surfaces of the teeth, your baby should also be seen by a children's doctor (pediatrician) or your family doctor. For more information, see the topics Mouth and Dental Injuries and Mouth Problems, Noninjury.

You can begin to practice good dental health habits with your child at the appearance of the first tooth:

• If you bottle-feed, do not put your baby to bed with a bottle of juice, milk, formula, or other sugary liquid. The opportunity for tooth decay to develop increases while these liquids stay in the mouth (bottle mouth). Do not prop the bottle up in your baby's mouth. Remove the bottle as soon as your baby is done feeding or is asleep.
• Breast-feeding your infant to sleep is safe. You can start offering liquids from a cup when your baby is about 6 months old.
• Young children get and give lots of kisses. But saliva contains bacteria that can cause tooth decay. You can help prevent early childhood tooth decay in your child by making sure that your family practices good dental health habits. If a family member has gum problems, he or she may transfer the bacteria to your baby. Talk to your family about this.
• When your child's first teeth come in, start cleaning them with a soft cloth or gauze pad. As more teeth come in, clean teeth with a soft toothbrush. Because too much fluoride can be toxic and can stain a child's teeth, ask your doctor or dentist if it's okay to use fluoride toothpaste.
• Give your child nutritious foods to maintain healthy gums, develop strong teeth, and avoid tooth decay. These include whole grains, vegetables, and fruits. Try to avoid foods that are high in sugar and processed carbohydrates, such as pastries, pasta, and white bread.
• Discuss your child's fluoride needs with your dentist if your local water supply does not contain enough fluoride. To find out, call your local water company or health department. If you have your own well, have your water checked to find out if your family needs fluoride from other sources. Normal amounts of fluoride added to public water supplies and bottled water are safe for children and adults. If your child needs extra fluoride, your dentist may recommend supplements. Use these supplements only as directed. And keep them out of reach of your child. Too much fluoride can be toxic and can stain a child's teeth.

Keep your child away from cigarette smoke (secondhand smoke). Tobacco smoke may contribute to the development of tooth decay and gum disease.³