Last updated: July 2026. Written and reviewed by the Dentists Closeby editorial team. Sources: NHS, Gov.uk (Office for Health Improvement and Disparities), NHSBSA and NHS Inform.
TL;DR: Start brushing your baby's teeth as soon as the first one appears, using a smear of fluoride toothpaste of at least 1,000ppm twice a day. Keep only milk or water in bottles, phase bottles out by age one, and take your child to a dentist by their first birthday. NHS dental care is free for all under-18s.
Your baby's first tooth is a milestone, and it is also the moment their dental care begins. Good habits started in the first three years protect not just those 20 milk teeth but the adult teeth forming underneath them. This guide covers everything UK parents need for daily home care: when and how to brush, which toothpaste to use, how to handle teething safely, and how to keep tooth decay away. For advice on booking that first appointment, see our guide to your child's first dental visit.
Why baby teeth matter, even though they fall out
Milk teeth are not disposable. The NHS is clear that a child's first teeth "help your child to eat, speak, and smile confidently" and "help to hold space for the adult teeth" [3]. When a milk tooth is lost too early to decay, the teeth around it can drift into the gap, crowding the permanent teeth that follow.
Healthy baby teeth also matter for speech and eating. A toddler learning to form sounds and chew solid food relies on a full, pain-free set of teeth. Decay that reaches the nerve causes real pain, disturbed sleep and, in the worst cases, a hospital admission for extractions under general anaesthetic.
The scale of childhood decay in the UK is sobering. In the most recent national survey, 26.9% of five-year-olds in England had obvious tooth decay, with 22.4% having decay that reached the dentine [7]. Children affected had an average of 3.5 decayed teeth, yet only about one in ten of those teeth had been treated [7]. Almost all of this is preventable with the routines described below.
When to start brushing your baby's teeth
Start brushing as soon as the first milk tooth appears. NHS guidance says plainly: "You can start brushing your baby's teeth as soon as they start to come through" [1]. Because first teeth usually arrive around six months, that is the practical trigger for most families, but the rule is tied to the tooth appearing, not to a fixed age.
Do not wait for a mouthful of teeth before you begin. Brushing that single first tooth twice a day builds the habit early and protects it from the moment it is exposed to milk and food. A soft baby toothbrush or a clean piece of gauze wrapped around a finger both work for the very first teeth.
How to brush: technique, toothpaste and fluoride
Brush at least twice a day, with one of those times being last thing at night before bed [1][2]. Brushing before sleep matters most because saliva flow drops overnight, leaving teeth more exposed to acid. The second brush can fit whenever suits your routine.
For technique, the NHS suggests sitting your baby on your knee with their head resting against your chest, so you can see into their mouth [1]. Brush in small circles, covering every surface of every tooth, and angle the bristles gently towards the gum line. With a wriggly toddler, standing behind them and tilting their head back can give you better control.
One rule surprises many parents: spit, do not rinse. The NHS advises that you "encourage your child to spit the toothpaste out afterwards" and that "there's no need to rinse with water, as this will wash away the fluoride" [1]. Leaving a thin film of fluoride on the teeth is exactly what protects them, so skip the beaker of water after brushing.
How much toothpaste and which strength
The right amount of toothpaste and the right fluoride level both change with age. Fluoride is measured in parts per million (ppm), and the figure is printed on the tube. The table below sets out current NHS and Gov.uk guidance [2][6].
| Age | Amount of toothpaste | Fluoride level |
|---|---|---|
| Under 3 years | A smear (about the size of a grain of rice) | At least 1,000ppm |
| 3 to 6 years | A pea-sized amount | 1,000 to 1,500ppm |
| 7 years and over | A pea-sized amount | 1,350 to 1,500ppm |
The one figure every parent of a baby should remember is at least 1,000ppm fluoride for under-threes, applied as a smear [2][6]. There is no benefit in using a low-fluoride "baby" toothpaste that falls below this level, because it will not protect the teeth as well. A standard family toothpaste is fine for a baby as long as you use only a smear and the fluoride content meets the minimum.
Supervise brushing for longer than you might expect. The NHS recommends helping your child brush "until you're sure they can do it well enough themselves," which "will normally be until they're at least 7" [1]. Young children lack the fine motor control to clean every surface, so an adult finishing off the brush is worth the small daily battle.
For help choosing between a manual and a powered brush as your child grows, our guide comparing electric and manual toothbrushes breaks down what actually makes a difference.
Teething: what to expect and how to soothe it safely
Teething is a normal, if uncomfortable, part of the first two years. Most babies start teething at around six months, but the NHS notes that "others start teething before they are 4 months old and some after 12 months" [4]. There is a wide normal range, so an early or late first tooth is rarely a cause for concern on its own.
Teeth usually arrive in a predictable order, from the front of the mouth backwards, with bottom teeth generally appearing before the matching top teeth [4]. Most children have their full set of 20 milk teeth by the age of two to three [4][12].
| Teeth | Typical age they appear |
|---|---|
| Bottom front teeth (central incisors) | Around 5 to 7 months |
| Top front teeth (central incisors) | Around 6 to 8 months |
| Teeth either side of the front teeth (lateral incisors) | Around 9 to 12 months |
| First molars (back teeth) | Around 12 to 16 months |
| Canines (towards the back) | Around 16 to 20 months |
| Second molars | Around 20 to 30 months |
Teething symptoms
Common teething signs include sore or red gums, a mildly raised temperature (below 38°C), a flushed cheek, dribbling more than usual, gnawing and chewing on things, and general fretfulness or disturbed sleep [4]. These are uncomfortable but not dangerous.
Do not blame everything on teething, though. The NHS points out that diarrhoea is not backed by evidence as a teething symptom, and it advises contacting a GP or NHS 111 if your baby has a temperature of 38°C or above, seems genuinely unwell, or if you are worried [4]. A high fever is a reason to check for another cause, not to assume it is "just teething".
Safe ways to soothe a teething baby
A teething ring gives your baby something safe to chew and can be a useful distraction [5]. Some rings can be cooled in the fridge, but never put one in the freezer: the NHS warns that a frozen ring "could damage your baby's gums" [5]. Once your baby is weaning at around six months, chilled soft food such as a piece of cucumber or melon can help too, always under close supervision.
Gently rubbing the gums with a clean finger can ease soreness, and plenty of cuddles and distraction go a long way [5]. If your baby is in real pain, sugar-free infant paracetamol (from two months) or ibuprofen (from three months) can be given according to the packet instructions [5].
A vital safety point: never tie a teething ring, or anything else, around your baby's neck. The NHS states directly that this "may be a choking hazard" [5]. This applies to any product marketed to be worn around a baby's neck during teething.
What to avoid
Teething gels are not the answer many parents hope for. The NHS says "there's a lack of evidence that teething gels are effective," and recommends trying a teething ring or, if needed, infant pain relief first [5]. If you do use a gel, choose a pharmacy product designed for young children.
Two things to steer clear of entirely: homeopathic teething products, which the NHS does not recommend and links to "serious side effects" in some unlicensed versions [5]; and any teething or numbing gel containing salicylate. UK medicines guidance is explicit that "topical oral salicylate gels are no longer indicated for people younger than 16 years" for teething pain [9]. If in doubt, ask your pharmacist.
Preventing tooth decay in babies and toddlers
Tooth decay in young children is common, painful and almost entirely preventable. It remains, in the government's own words, "the most common reason for hospital admissions in children aged between 5 and 9 years" [8]. In the year ending 2025, there were 56,143 hospital tooth-extraction episodes for under-20s in England, and among the youngest children the vast majority were decay-related: 81.9% of extractions in 0 to 4 year-olds and 86.5% in 5 to 9 year-olds had tooth decay as the primary diagnosis [8].
Decay happens when bacteria in the mouth turn sugar into acid that dissolves the tooth. For babies and toddlers, three habits do most of the protective work: brushing twice a day with fluoride toothpaste, keeping sugar low, and managing bottles and cups sensibly. The next three sections cover the last two.
Bottles, cups and baby-bottle tooth decay
What goes in the bottle, and how long a child uses one, has an outsized effect on their teeth. The NHS advises that bottles should contain only "expressed breast milk, formula milk, or cooled boiled water," never juice, squash or other sweetened drinks [1]. Sugary drinks sipped from a bottle bathe the teeth in acid for long stretches, which is how "baby-bottle tooth decay" sets in.
The way a child drinks matters as much as what they drink. From six months, the NHS suggests introducing drinks in "a non-valved free-flowing cup," which empties quickly rather than letting a child suck slowly on sugars [1]. A free-flow cup without a valve encourages sipping and swallowing instead of prolonged pooling around the teeth.
Phase bottles out by the first birthday. NHS guidance is to "not encourage the use of baby bottles after your baby is 1 year of age," moving instead to an open cup or a free-flow cup [3]. Bedtime is the most important time to get right: only ever offer breast milk, formula or cooled boiled water at night, never a sweetened drink [1].
Diet and sugar for little teeth
Sugar is the single biggest dietary driver of decay, so keeping it low protects teeth directly. The Gov.uk oral health toolkit for dental teams gives a strong recommendation to "minimise consumption of sugar-containing foods and drinks" for the under-threes [6]. It is both the amount and the frequency that matter: frequent sugary snacks give the teeth no time to recover between acid attacks.
The best drinks for young children are simple. The NHS advises that "the best drink for your child is unflavoured milk or water" [3]. Water and plain milk are the only drinks a toddler needs between meals, and they are kind to teeth.
Two easy wins reduce hidden sugar. Choose sugar-free medicines where you can, which the Gov.uk toolkit recommends for young children [6], since regular medicines like some infant painkillers and vitamin drops can be surprisingly sweet. And if your child uses a dummy, "do not dip it in anything sweet, such as sugar or jam," as the NHS warns [1]. A sweetened dummy is a direct route to decay on the front teeth.
Fluoride varnish and NHS dental care
Fluoride varnish is a quick, painless treatment a dental team can paint onto the teeth to strengthen them against decay. The NHS says that "from the age of 3, children should be offered fluoride varnish application at least twice a year," and younger children may be offered it too if the dentist judges it helpful [2]. It takes seconds and is part of routine NHS dental care.
Crucially for families, all of this is free. NHS dental treatment, including check-ups and fluoride varnish, is free for anyone under 18 (or under 19 and in full-time education), with no proof of income needed [10]. Cost is never a reason to delay taking a child to the dentist. If your child needs private treatment for any reason it is available too, but for routine care the NHS covers children in full.
The NHS recommends taking your child to the dentist "when their first milk teeth appear," and by their first birthday at the latest [2]. If you have not yet found a practice, our guides on registering with a dentist and how to find a good dentist walk through the steps, and it is worth reading up on how often children should visit once they are registered.
Dummies and sucking habits
Dummies are a normal comfort for many babies, but a few simple habits keep them tooth-friendly. NHS guidance is to "only offer a dummy when it's time for sleep" and to "aim to stop using dummies completely by 12 months," partly because prolonged dummy use can affect how teeth and speech develop [11]. Restricting the dummy to sleep times from an early stage makes the eventual goodbye easier.
Never sweeten a dummy. As above, the NHS is clear that a dummy should not be dipped in sugar, jam, honey or any sweet substance [1]. Honey carries an added risk and should never be given to babies under one year old for reasons beyond dental health.
Extra support in Scotland, Wales and Northern Ireland
England's guidance above applies across the UK, but the devolved nations run additional early-years programmes worth knowing about. In Scotland, Childsmile is a national programme delivering supervised nursery toothbrushing, fluoride varnish and family support in every health board area [13]. In Wales, Designed to Smile works with children aged 0 to 7, providing toothbrushes and fluoride toothpaste and encouraging a first dental visit before a child's first birthday [14]. In Northern Ireland, the Happy Smiles programme supports pre-school children in the most deprived areas with toothbrushing and sugar-reduction advice [15].
If you live in one of these nations, ask your health visitor, nursery or dentist whether your child's setting takes part. The programmes are targeted, so availability varies by area, but the core advice they promote is identical to the NHS guidance in this guide.
Frequently asked questions
When should I start cleaning my baby's teeth?
Start as soon as the first tooth appears, usually around six months. NHS guidance is to begin brushing "as soon as they start to come through," using a smear of fluoride toothpaste of at least 1,000ppm twice a day [1]. You do not need to wait for more teeth. Even one tooth should be brushed morning and night.
How much toothpaste should a toddler use?
A child under three should use only a smear of toothpaste, about the size of a grain of rice. From ages three to six, move up to a pea-sized amount [2][6]. Use toothpaste with at least 1,000ppm fluoride for under-threes, and encourage your child to spit out afterwards rather than rinse.
Should my baby use special low-fluoride baby toothpaste?
No. The NHS advises fluoride toothpaste of at least 1,000ppm for children under three, applied as a smear [2]. Many toothpastes labelled for babies contain less fluoride than this and protect teeth less well. A standard family toothpaste is fine for a baby as long as you use only a smear.
Do teething gels work?
The NHS says there is "a lack of evidence that teething gels are effective" and suggests trying a teething ring or infant pain relief first [5]. If you do use a gel, choose a pharmacy product for young children, and never use one containing salicylate, which is not for anyone under 16 [9].
Why do baby teeth matter if they just fall out?
Milk teeth help a child eat, speak and smile, and they hold the space for the adult teeth developing underneath [3]. Losing them early to decay can crowd the permanent teeth and cause pain, infection and disturbed sleep. Caring for milk teeth protects the adult teeth that follow.
Is NHS dental treatment free for children?
Yes. All NHS dental care, including check-ups and fluoride varnish, is free for under-18s and for under-19s in full-time education, with no proof of income required [10]. Cost should never delay a child's dental visit. The NHS recommends a first visit by your child's first birthday.
When should my child first see a dentist?
Take your child to the dentist when their first milk teeth appear, and by their first birthday at the latest [2]. Early visits let the dentist spot problems, apply fluoride varnish and help your child get used to the surgery. Our child's first dental visit guide explains what to expect.
Bringing it all together
Looking after baby and toddler teeth comes down to a handful of daily habits: brush twice a day with the right amount of fluoride toothpaste, keep bottles to milk or water and retire them by age one, go easy on sugar, and see a dentist by the first birthday. None of it is complicated, and all of it is free on the NHS for children.
Those small routines, repeated every day, are what keep the 26.9% decay statistic from including your child. If you have not yet found an NHS or private dentist for your family, search for a dentist near you on Dentists Closeby and book that first appointment. Getting your child into the chair early is the best start you can give their smile.
Sources
- Looking after your baby's teeth - NHS.uk, reviewed 1 April 2025, accessed 2026-07-22
- Taking care of children's teeth - NHS.uk, reviewed 30 June 2025, accessed 2026-07-22
- Baby and toddler tooth care - NHS.uk (Best Start in Life), accessed 2026-07-22
- Baby teething symptoms - NHS.uk, reviewed 14 May 2026, accessed 2026-07-22
- Tips for helping your teething baby - NHS.uk, updated 23 October 2025, accessed 2026-07-22
- Delivering better oral health: Chapter 2, summary guidance tables for dental teams - Gov.uk (OHID), updated 10 September 2025, accessed 2026-07-22
- National Dental Epidemiology Programme: oral health survey of 5-year-old schoolchildren 2024 - Gov.uk, published 11 February 2025, accessed 2026-07-22
- Hospital tooth extractions in 0 to 19 year olds 2025: short statistical commentary - Gov.uk, published 17 February 2026, accessed 2026-07-22
- Oral salicylate gels: not for use in those younger than 16 years - Gov.uk (MHRA Drug Safety Update), accessed 2026-07-22
- Free NHS dental treatment - NHSBSA, accessed 2026-07-22
- Help your baby learn to talk - NHS.uk, reviewed 26 April 2023, accessed 2026-07-22
- Everything you need to know about teeth - NHS Inform (Scotland), updated 26 March 2025, accessed 2026-07-22
- About Childsmile - Childsmile (NHS Scotland), accessed 2026-07-22
- Designed to Smile: improving children's dental health - Gov.wales, accessed 2026-07-22
- Happy Smiles pre-school oral health programme - HSCNI (Northern Ireland), updated 17 July 2024, accessed 2026-07-22
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