In this article
Start cleaning your baby's mouth before the first tooth, and start brushing as soon as it comes in. The harder question is toothpaste. For children under 3, Health Canada, HealthLink BC and Ottawa Public Health give slightly different advice, so we've laid out what each one says, and the one thing they all agree on: ask at your baby's first dental visit, by age 1.
Before the first tooth: clean the gums
After feeds, wipe your baby's upper and lower gums with a clean, soft, damp cloth. Tooth and gum wipes are handy when you're out. Most babies start teething around 6 months, according to HealthLink BC, though every baby is different. Our guide to teether materials covers what to give them to chew.
From the first tooth: a small, soft brush
When the first tooth comes in, switch to a small, soft-bristled toothbrush. The Public Health Agency of Canada says to brush the teeth, tongue and gums for two minutes, twice a day, and that the bedtime brush matters most.
How much toothpaste, by age
Here's what each source says. All three recommend fluoride toothpaste in small amounts. Health Canada notes that very young children may not be able to spit yet, so they can swallow toothpaste.
| Source | Under 3 | 3 to 6 |
|---|---|---|
| Health Canada | If your child is at risk of tooth decay, an adult brushes with a rice-sized grain of fluoride toothpaste. Ask a health professional whether your child is at risk. | A small pea-sized amount, 5 mm at most |
| HealthLink BC | A smear the size of a grain of rice of fluoride toothpaste, from the first tooth | A pea-sized amount |
| Ottawa Public Health | No toothpaste, just water, unless a dental professional finds your child is at risk. Then no more than a grain of rice, twice a day. | No more than a green pea-sized amount, twice a day |
So the difference is only before age 3: BC advises a rice-grain smear for every child, while Health Canada and Ottawa tie it to your child's risk of decay. Whichever you follow, the amount is tiny. A rice grain is a smear, not a strip along the bristles. From age 3, everyone agrees on a pea-sized amount.
Health Canada says fluoride helps prevent tooth decay. It also links swallowing too much fluoride while adult teeth are forming to dental fluorosis, small white lines or flecks on the adult teeth. The mild form is cosmetic.
Fluoride or fluoride-free?
A fluoride-free training toothpaste lets a toddler get used to the taste and the routine of brushing. It has no fluoride, and the official advice above is all about fluoride toothpaste, so ask your dentist or public health dental team which suits your child. If they recommend fluoride, follow that.
Brushing tips that come from the guidelines
- You do the brushing. Health Canada says an adult should always help children under 6. The Public Health Agency of Canada puts it this way: if your child can't write their name yet, they can't clean their teeth properly on their own. Ottawa Public Health suggests helping until age 8. Let your toddler have a turn, then finish the job yourself.
- Spit, don't rinse. Once your child can, teach them to spit out the extra toothpaste. The Public Health Agency of Canada says not to rinse with water afterward, so the fluoride keeps working.
- Lift the lip. Every so often, lift your child's lip and look along the gum line. White chalky spots or brown spots can be early decay and mean a visit to a dental professional.
- Water only in bedtime bottles. Going to bed with a bottle of anything but water is a decay risk. When your baby is ready for a cup, our guide to straw cups and spout cups may help.
- Don't share. Avoid sharing spoons or toothbrushes with your baby, or blowing on their food. Never dip a soother in honey or anything sweet.
- Floss when teeth touch. Once two teeth touch, floss them daily. Most children can't floss on their own until about 9.
The first dental visit
Book it within 6 months of the first tooth, or by your baby's first birthday. That's the visit to ask about your child's risk of decay and which toothpaste to use. In Ottawa, Ottawa Public Health runs free dental screenings, and Healthy Smiles Ontario covers dental care for eligible children 17 and under, based on family income.
Brushes and toothpaste for each stage
- Gums, newborn and up: Aleva Naturals Bamboo Tooth and Gum Wipes, $5.99, for cleaning after feeds or on the go.
- First teeth, 0 to 3 years: the Dr. Brown's Infant-to-Toddler Toothbrush, $6.99, has super-soft bristles and a shield that stops it going too far into the mouth. It also comes in a 4-pack.
- 12 to 24 months: the Jack N Jill Stage 2 Silicone Toothbrush, $11.99, also has a safety shield.
- 18 months and up: the Radius Totz, $8.99, has extra-soft bristles and a handle sized for small hands, for the "my turn" part of brushing.
- Fluoride toothpaste: Attitude Kids Toothpaste With Fluoride, $8.95. Use the amount for your child's age from the table above.
- Fluoride-free training toothpaste: Attitude Baby Toothpaste, $9.95, labelled for children 3 and under, or Jack N Jill Natural Toothpaste, $11.99.
Prices are in CAD and were current when we wrote this. Teething at the same time? See our teething toy picks. You'll find all of these online, or call our Richmond, Burnaby or Ottawa store ahead of your visit to ask what's on the shelf.
