Infant Feeding and Oral Health

Teething happens when baby reaches 4 to 6 months of age and may present symptoms such as red and swollen gums and increased saliva.

How to help:

• Give clean teething ring
• Clean gums with cold wet cloth
• Chill teething ring for additional soothing

Avoid using any teething gels as they are not recommended.

• Supports Jaw and Teeth Development: The sucking motion during breastfeeding encourages proper growth of the jaw, palate, and facial muscles, which may help with alignment as teeth emerge
• Lower Risk of Baby Bottle Tooth Decay: Unlike bottle feeding, with direct breastfeeding, milk does not typically pool around the teeth, reducing prolonged sugar exposure and lowering the risk of early childhood cavities
• Balanced Oral Bacteria: Breastmilk contains antibodies that help promote a healthy balance of bacteria in the mouth, reducing the risk of infections and cavities

Bottle-feeding, whether with breastmilk or formula, can also support healthy oral development with a few simple precautions:

Proper Bottle Positioning: Holding the baby almost upright, allowing them to control the flow of milk, instead of laying flat while drinking, can prevent ear infections, ensure proper swallowing patterns, and prevent over-feeding. This is called paced feeding. To learn more, click here.

• Avoiding Bottle Propping: Propping a bottle or letting a baby fall asleep with a bottle can lead to prolonged exposure to milk or formula on the teeth, increasing the risk of cavities
• Transitioning to a Cup: Introducing a training cup around 6 months of age and weaning from the bottle by 12-18 months can help prevent prolonged sucking habits that may impact tooth alignment

Regardless of how you feed your baby, these habits will help support their oral health:

Always Clean the Gums: Before teeth emerge, gently wipe your baby’s gums with a soft, damp washcloth after feeding

• Wrap a moistened washcloth around the index finger and gently massage the gum tissues
• If your baby falls asleep while breastfeeding, remove breast from their mouth
• Do not use a bottle or breastfeeding as a pacifier. Use a set time for bottle feeding
• 1st tooth: after the 1st tooth erupts, stop nighttime use of bottle or feeding on demand

Start Brushing Early: As soon as the first tooth appears, use a soft-bristled toothbrush with a small head, and a smear of fluoride toothpaste (about the size of a grain of rice)

• Brush twice a day (after breakfast and before bed)
• Brush in small circles for two minutes each time
• Don’t forget to brush their tongue
• Don’t rinse the infant’s mouth with water- the small amount of fluoridated toothpaste that remains in the mouth helps prevent tooth decay
• Use dental floss when adjacent teeth are touching, it is important to clean in between teeth
• Replace toothbrush every 3-4 months, or when the bristles become worn
• For infants with special health care needs: adapting a toothbrush to brush the teeth. Click here to read about oral care for children with disabilities

What to avoid:

• Testing the temperature of a bottle with your mouth
• Allow anyone to kiss your infant on the lips
• Share utensils such as spoons with your child
• Pre-chew food for infants or blow on foods to cool them
• Clean a pacifier of bottle nipple by putting it in your mouth

Avoid Sugary Drinks in Bottles: Never put juice or sweetened drinks in a bottle, as they can lead to cavities

• Don’t give anything to eat or drink (except water) after brushing at night

Schedule a Dental Visit: Schedule their first visit before his/her first birthday or within 6 months after the first tooth comes in

When to Wean your baby: Wean your baby from the bottle, gradually, begin to offer a cup of water or juice (9 to 10 months). 12 to 14 months of age: most children can drink from a cup

Safety First:

• Do not allow your baby to walk around with his/her bottle
• Do not give your child sweets as a treat; give stickers, crayons, coloring books or bubbles instead

Does Breastfeeding Cause Cavities?

Breastmilk alone does not typically cause cavities, but frequent nighttime feeding without cleaning the baby’s mouth can increase the risk. Wiping the gums or brushing after feeding can help prevent decay.

Can Formula Feeding Lead to Cavities?

Formula itself is not harmful to teeth, but extended exposure (such as sleeping with a bottle) can increase the risk of decay. To reduce this risk, avoid prolonged nighttime bottle use and clean your baby’s mouth regularly

• Do not put the infant to sleep with a bottle or sippy cup
• Do not allow prolonged bottle feedings
• Do not add drinks other than water to sippy cups (e.g., fruit drinks, pop (soda), fruit juice).
• Do not give juice before 12 months of age
• Limit fruit juice to mealtimes
• Limit eating in between meals
• Limit foods with added sugar, such as candy, cookies, cake, fruit-flavored drinks, and pop (soda).
• Many foods contain one or more types of sugar, and all types of sugar can promote tooth decay. To help choose foods low in sugar, read food labels.
• Lift your child's lips to check for suspicious small white or brown spots on his/her teeth, white or brown spots: indicate dental decay (cavities), schedule an appointment with your dentist right away

If parents choose to have their infant suck a pacifier, the following precautions are recommended:

• Never attach a pacifier to a ribbon or string around the infant's neck
• Pacifier should be sturdy, flexible, firm, and not brittle
• Keep the pacifier clean
• Do not dip a pacifier in sweetened foods (e.g., honey, syrup) to encourage sucking
• Never orally clean a pacifier, then give it to the infant