Drs. Perlman & Koidin, P.C.

(781) 599-2900
77 Broad Street
Lynn, MA 01902

Early Dental Care

Please note: Contents of this website are for informational purposes only.

Congratulations on the birth of your baby! Are you prepared for the eruption of your baby's first tooth? Follow these guidelines and your infant will be on the way to a lifetime of healthy smiles!


Your child's first tooth usually erupts between ages 4-12 months and the remainder of the 20 primary or "baby" teeth typically erupt by age 3. Gums may be sore, tender and sometimes your child can be irritable until the age of 3. Rubbing sore gums gently with the back of a cold spoon or a cold, wet cloth helps soothe teething discomfort. Teething rings work well, but avoid teething biscuits as they contain sugar that is not good for your baby’s teeth.

While your baby is teething, it is important to monitor the teeth for evidence of dental cavities. Examine the teeth for dull white spots or lines. This indicates the beginning of the cavity process. Cavities can develop rapidly in children with prolonged exposure to foods and beverages containing sugar. A bottle containing anything other than water that is left in an infant’s mouth while sleeping can cause tooth decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar (such as juice, soda, flavored waters, sports drinks and even milk), acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the salivary flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.

Caring for Gums

Your baby’s gum tissues can benefit from your careful attention even before their first tooth appears (or in dental jargon, “erupts”). After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby's gum tissue. This practice both clears your little one's mouth of any particles of food and begins the process of building a good habit of daily oral care. Do not put your baby to sleep with a bottle in his/her mouth.

Baby's First Tooth

When that first tooth erupts, it's time to begin using an infant’s toothbrush.  A toothbrush will remove plaque (bacteria) that can lead to decay.  During the teething process, your child will want to chew on just about anything - a baby toothbrush with a teether can become a favorite toy during this period.

Brushing with Toothpaste

The Academy of Pediatric Dentistry recommends that as soon as teeth begin to appear, you should begin brushing your child's teeth twice daily using a fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the dexterity to brush their teeth effectively. Children should spit out and not swallow any excess toothpaste after brushing.

Avoiding Tooth Decay

Do not give your baby any sort of sweetened liquids such as flavored drinks or soda. Even the sugars present in fruit juice, formula, and milk (this goes for breast milk as well) can cause decay, so regular tooth and gum cleaning is vital. In addition, make sure your baby never goes to bed with a bottle other than water - sugary liquids in prolonged contact with their teeth can cause early-childhood decay, which in the past was called baby-bottle caries.

Healthy primary (baby) teeth allow a child to eat and maintain good nutrition. They also affect proper chewing and eating, provide space for and guide the eruption of the permanent teeth, permit normal development of the jaw, and affect the development of speech. The self-image that healthy teeth gives is immeasurable. The front four primary teeth remain in the mouth until 6-7 years of age. The primary molars and canines are not replaced until 9-13 years of age. The way your child cares for their primary teeth plays a critical role in how they will treat their permanent teeth. Children and adults are equally susceptible to plaque and gum problems, therefore there is a continuous need for regular preventive care and dental checkups.

Setting a Good Example

As part of the natural learning process, children are expert mimics, and you can take advantage of this talent. Brush and floss daily while your child is watching, and they will learn at an early age the importance of good habits. As soon as your child shows interest, give them a toothbrush of their own and encourage them to "brush" with you. (You'll find toothbrushes with chunky, short handles that are easy for your child to grip.) Most children do not have the dexterity necessary to thoroughly clean their own teeth until they're about six or seven, so you'll have to do that part of the job for them. Try different techniques to make brushing fun: flavored toothpaste, a toothbrush with a favorite character on it, or sing songs about brushing. The primary goal is to instill healthy oral habits at an early age to prepare your child for a lifetime of healthy, cavity-free teeth!

Caries Management by Risk Assessment (CAMBRA)

As part of our routine evaluation and teeth cleaning, we will assess caries risk factors associated with each patient. An individual treatment plan will be discussed as to how to decrease the risk of caries. This is another preventive tool to help keep our patient’s teeth healthy and free from decay.


Dental x-rays are utilized to help diagnose dental decay and pathology, evaluate growth and development, monitor tooth and bony injuries, and assist in orthodontic treatment planning.  X-rays are needed to make a complete diagnosis and treatment plan. The frequency of x-rays is determined based on individualized needs and pediatric dentists are particularly concerned about limiting the exposure of your child to radiation.

Next page: Common Pediatric Dental Problems