Chapter 7 – Oral Health and Baby Teeth

A baby’s oral health is deeply influenced by that of the mother, both before and after birth. Recent studies have shown that the more cavities a future mother has, the greater the likelihood that her child will develop the same issues (22). Therefore, expectant mothers are advised to book a dental visit as soon as pregnancy is confirmed, or ideally before conception, to schedule regular hygiene check-ups and resolve any existing problems.
During pregnancy, numerous changes occur in the mother’s body, including in the oral cavity (23). Hormonal shifts may weaken and inflame the gums, leading to “pregnancy gingivitis”, with redness, pain, and bleeding. Progesterone encourages bacterial growth in the mouth and weakens immune defenses, increasing the risk of cavities and undermining oral health overall.

For the baby, bacterial colonization of the oral cavity begins in utero and continues through maternal saliva, even via simple gestures like a kiss. However, tooth decay cannot yet occur, as the bacteria responsible require teeth to survive.

Deciduous teeth (commonly called baby teeth) typically start to erupt between 3 and 6 months of age (24). There are 20 teeth total, per arch: 2 central incisors, 2 lateral incisors, 2 canines, 4 molars. The lower central incisors usually appear first, followed by the upper incisors between 5–7 months. The full eruption of central and lateral incisors in both arches generally completes by 12 months. Then follow: First molars: 12–18 months, Canines: 18–24 months, Second molars: 24–30 months.

As with all developmental milestones, teething varies widely. Some children don’t get their first tooth until age one.

When teeth begin to emerge, babies may experience: Swollen, inflamed gums, Increased drooling, Sleep disturbances. Sometimes accompanied by: Fever, Diarrhea, Loss of appetite. These symptoms are typically mild, though molars may cause more discomfort. To ease symptoms: Use soothing creams on the gums, Massage gently with a cool, damp sterile gauze, Offer teething rings, especially chilled ones for a cooling, numbing effect.

Herbal remedies such as chamomile, catnip, thyme, and calendula may also help. Additionally, parental affection and soothing (songs, books, cuddles) greatly contribute to the child’s well-being.

Oral hygiene should start before teeth appear, by gently wiping gums with warm, damp sterile gauze. Special fun microfiber finger gloves make the process playful. Between 12 and 36 months, the child should begin learning to use a toothbrush, always under parental supervision.

Ideally: Brush after every meal, or at least morning and bedtime. Avoid sugary drinks after brushing at night, as saliva production drops during sleep, making sugar more damaging.

A first dental check-up is recommended within 6 months of the first tooth eruption. The goals: Acclimate the child to the dental environment, Begin preventive care, Even though baby teeth will eventually fall out, they must be treated—they are crucial for future oral health.

Canker sores (aphthae): small white/red blisters inside the mouth or under the tongue. They may stem from oral bacteria, tonsil infections, or vitamin deficiencies (iron, B12, folic acid). These can cause discomfort, especially during feedings. The pediatrician may recommend antiseptic solutions and paracetamol for relief.
Thrush: white patches in the mouth that resemble milk residue. This is a fungal infection (Candida albicans), common in early weeks of life, and can make feeding painful.

Mild oral thrush usually resolves in two weeks without medication. However, always consult the pediatrician. Severe cases may lead to systemic infection.
Treatment typically involves: Cleaning the baby’s mouth with bicarbonate-water-soaked gauze, Breast hygiene: wash with acidic soap, dry, and apply antifungal cream after feedings, Disinfect bottles and pacifiers carefully.