Hesperian Health Guides

Taking Care of Baby Teeth

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HealthWiki > Where There Is No Dentist > Chapter 5: Taking Care of Teeth and Gums > Taking Care of Baby Teeth


A child’s baby teeth are being made before birth while the baby is still inside the mother’s womb. During the last months of pregnancy and the first few months after the child is born, the baby teeth take their final form. Pregnant mothers and young children need good food and good health in order to have strong baby teeth.

Strong teeth
Weak teeth
are white and their
front surface is smooth.
have yellow marks that
are pitted and rough.
DENT Ch5 Page 62-1.png
DENT Ch5 Page 62-2.png


Baby teeth get marks on them when: 1) the pregnant mother is sick or does not eat good food; 2) the young baby is sick or does not eat good food; or, sometimes, 3) the baby’s birth was early or the delivery was difficult.

The marks are rougher than the rest of the tooth. Food sticks easily to them and turns the tooth yellow.
DENT Ch5 Page 62-3.png
The marks are also soft. They need to be cleaned well every day to prevent them from becoming cavities. A tooth with a cavity hurts. When children's teeth hurt, they do not want to eat as much.

Cavities in baby teeth can make a child’s malnutrition worse.
Remember this whenever you see a weak, poorly nourished child. When you examine a child at the health clinic, lift his lip and look at his teeth. Do this as part of your routine examination.

a person lifting a child's lip and pointing to a gum bubble.

You can fill cavities with cement (Chapter 10). Cement prevents food and air from going inside the cavity and hurting the child.

A sore on the gums may be a gum bubble. If so, it means the tooth has an abscess. That cavity should not be filled with cement. Instead, the tooth needs to be taken out (Chapter 11) before the infection gets worse.

For baby teeth to grow strong, mother and baby must stay healthy. See a story about pregnancy and dental care. Help her to understand how important this is. A pregnant mother should:

  • Eat enough good kinds of foods, both for herself and her baby growing inside (see Where There Is No Doctor, Chapter 11, and Helping Health Workers Learn, pages 25-39 to 25-44.)
  • Attend health clinic each month, so the health workers can examine her regularly and she can receive important medicines (see Where There Is No Doctor, page 250).
  • Not use the medicine tetracycline, because it can cause the teeth to turn dark. You, the health worker, must remember — do not give tetracycline or doxycycline to a pregnant woman or to a young child. If she needs an antibiotic, use a different one.


For baby teeth to stay strong, and to prevent marks from turning into cavities, mother should:

DENT Ch5 Page 63-1.png
  • Continue to breastfeed and never feed her child juice or sweet tea from a bottle. Start giving soft foods, such as mashed banana or papaya, when the child is 6 months old.
  • Wipe her baby’s teeth with a clean cloth after the baby eats. This cleans the baby’s teeth and helps the baby get used to teeth cleaning. Later he will be happy with a brush.


Around 1 year of age, there will be several baby teeth. At that time, mother should start using water — not toothpaste — on a soft brush or brushstick. (With toothpaste, you cannot see the child’s teeth clearly because of the bubbles it makes.) She should scrub the sides and tops of each baby tooth as well as she can.

The child can also try to clean his own teeth. That should be encouraged. However, since he is too young to clean properly, mother (or father, or older brother, sister) must clean his teeth once a day for him. Continue helping in this way until the child is old enough to go to school.

making a brush smaller by removing the hairs with tweezers or scissors.
You can make a large brush smaller, to fit more easily into a young child’s mouth.
Pull out some of the back hairs, or cut them out with scissors. Do not cut the hairs in half, because the tops are often rounded or softer, and that is better for the gums.

Why baby teeth are important

Baby teeth are just as important to children as permanent teeth are to adults. They help a child to eat, talk, and look good.

However, many people feel that it is not worth the effort to look after baby teeth. Nor is it worth fixing them. After all, parents think, the permanent teeth will take their place.

This kind of thinking is understandable. The problem is that we are forgetting one other useful purpose of baby teeth. Baby teeth keep space in the mouth for the permanent teeth to grow in. If there is not enough space, the new teeth will grow in crooked, and cavities grow faster around crooked teeth.

a child's teeth, with upper and lower molars labeled.
Permanent molars (PM) come in behind the baby molars (BM).
1PM
2BM
1BM
1PM
2BM
1BM

Under each baby tooth a new permanent tooth is growing.

At the same time, extra permanent molars are forming at the back of the mouth, inside the bone.

Front baby teeth become loose and fall out (usually 6–7 years, but sometimes as young as 5 years) ahead of back baby teeth (10–12 years). This is because the front permanent teeth are formed and ready to grow in first.

The permanent molar (1 PM) is often the first of the permanent teeth to grow into the mouth. That happens at 6 years of age.

illustration of the below: first permanent molars beginning to grow in.
1PM
2BM
1PM
2BM
illustration of the below: first permanent molars fitting together.
1PM
2BM
1PM
2BM
The first permanent molar grows into the mouth by sliding against the back of the second baby molar (2BM). Slowly but steadily the upper and lower permanent molars grow until they meet and fit tightly together.


Between the ages of 6 and 11, a child needs healthy baby molars to guide the first permanent molars into position and then to hold them there. When the first permanent molars grow into the right place, this is a good sign. It means the other permanent teeth will also grow in properly, because they will have enough space.

Note: Some people are born without enough space. But most people are not born with this problem — they lose the spaces when they remove baby teeth instead of fixing them.

HEALTHY BABY TEETH ——— help
to make
DENT Ch5 Page 72-3.png STRAIGHT PERMANENT TEETH
DENT Ch5 Page 65-1.png
1PM
2BM
New tooth with space to grow in
DENT Ch5 Page 65-2.png
10 years adult


SICK BABY TEETH ——— help
to make
DENT Ch5 Page 72-3.png CROOKED PERMANENT TEETH
DENT Ch5 Page 65-3.png
1PM
2BM
Taken out before
1PM
Moving into the cavity
2BM
Not enough space
DENT Ch5 Page 65-4.png
10 years adult


Tell mothers why baby teeth are important. Good food and regular cleaning keep them healthy. They should know that new teeth coming in do not cause diarrhea and fever, but that a child may have diarrhea or fever at the same time.

If there is a cavity, fix it so the tooth can be kept in the mouth to do its important work (see Chapter 10).



This page was updated:19 Feb 2018