Parents commonly ask when they should begin to take care of their children’s teeth, and the simple answer is before the child is born.

Dental decay and gingivitis are infectious diseases that are passed from person to person. The bacteria that cause these conditions are often passed from parent to child by hand-to-mouth contact. Research has shown that when the parents have no decay, the child is less likely to experience decay. By restoring their own cavities and practicing good oral hygiene, parents reduce or eliminate the bacteria and decrease the chances of passing disease on to the child.

Primary teeth contribute to the development of speech, nutrition and facial form. They maintain the space for the permanent teeth and guide the permanent teeth in their eruption. Premature loss of the primary teeth can cause short-term and long-term problems. The early loss of primary teeth may contribute to incorrect tongue positioning, speech problems or self-consciousness when smiling. Even in supportive environments, there may be a sense of sounding and looking different from other children. This requires sensitivity and encouragement from the adults responsible for the child.

The most basic need for proper development is good nutrition. The primary molars are essential for proper chewing of fibrous foods. Vegetables and fruits that are high in fiber content may be difficult to chew if there are several missing primary teeth. The essential vitamins contained in these foods may be missed if they are left out of the diet or if the food is overcooked to make it soft enough to be eaten without teeth.

The most obvious problem that results from premature loss of primary teeth is lack of space for the permanent teeth. This does not mean that every person with crowding had missing primary teeth. Crowding is often hereditary. However, there are many instances where crowding and expensive orthodontic treatment could have been avoided if the primary teeth had been maintained in a healthy state. This is most critical in the case of primary molars.

Primary molars generally are lost between 10 and 12 years of age. When a primary molar is lost prematurely, the tooth behind will drift forward into the empty space. This drifting shortens the length of the dental arch and crowds the erupting permanent teeth. The lost space can only be regained by orthodontic intervention. Sometimes, space loss can be minimized by the use of a space-maintaining device. However, the device does not replace the chewing function of the teeth.

Prevention of these problems must start at birth. Breast milk is essential for the newborn child, and exclusive breastfeeding is advocated for at least six months. Breast milk by itself is unlikely to cause decay. However, if a child is receiving other foods or beverages (other than water) and is frequently being breastfed on demand, the likelihood of decay increases dramatically. Therefore, the introduction of a breastfeeding schedule is recommended once other foods and beverages have been introduced.

The use of a bottle for sleep or frequent sipping from a bottle or sippy cup during the day is the most common cause of early primary-tooth loss. Even the natural sugars in milk and juice can create an environment where bacteria can flourish and decay can develop at a rapid rate. Frequent snacking and drinking between meals can cause the same problem in primary or permanent teeth. The recommended between-meal beverage for the bottle or sippy cup is water.

Developing proper nutrition and oral-hygiene habits from the start will help prevent premature loss of primary teeth. Clean your baby’s teeth and gums after feeding and before bed. Regular dental checkups can start at twelve months or six months after the first tooth appears. If there are problems, a child should be seen sooner. The dentist can provide oral-hygiene instruction and other dental health information on cleaning your infant’s or toddler’s mouth, the effects of diet on oral health, teething and dental development, the proper use of fluoride, oral thumb or finger habits and preventing accidents to the teeth and face.