Primary teeth come in when babies are about six months old. However, parents can take action on their little one’s oral health before their first teeth even pop up.

“Newborn infants typically produce less saliva,” said Kyle Dosch, DDS, Delta Dental of Washington’s dental director and member dentist. “Saliva helps us wash away food debris and bacteria buildup in our mouth. For a newborn with less saliva, this process just doesn’t work as well.”

For babies, the bacteria in their mouths feed on the sugar and carbs found in breast milk and formula. The bacteria create an acid which wears away tooth enamel. When breast milk or formula stays in a baby’s mouth for too long, over time, this acid can lead to cavities and tooth decay. These small tips can make a big difference for your baby’s health long-term.

• Feeding and teething items, like bottles, pacifiers and toys, are best used when cleaned and sterilized. Cavity-causing bacteria can be passed from caregiver to child through saliva. Avoid sharing utensils and don’t test the temperature of a bottle with your mouth to avoid transmitting bacteria from your own mouth to your baby’s.
• Don’t put your child to bed with a bottle of breast milk or formula. When your child sips on breast milk or formula throughout the night, the sugars stay in their mouths, exposing their teeth to long periods of acid buildup from their mouth bacteria.
• When baby’s teeth start to come in, have some clean, chilled teething rings on hand to soothe their gums.
• Begin their brushing routine once a baby tooth comes in by brushing with a soft-bristled toothbrush with a smear of fluoride toothpaste until age two, and then a pea-sized dot of toothpaste after age two.
• Visit a dentist by your baby’s first birthday to spot early dental health problems and to get your child used to visiting the dentist.

Breastfeeding, also known as chestfeeding, can help with baby’s oral health as well as their overall health. Several studies found that babies who were only breastfed for their first six months had fewer teeth alignment issues in comparison with those who breastfed for less time or didn’t breastfeed at all. This is not to say breastfeeding is a guarantee for perfectly straight teeth—every child is different, and factors like genetics and pacifier use may affect alignment as well.

Another healthy option is bottle feeding. However, it is important that children eat in one feeding. Don’t leave children with bottles for extended periods of time, as this can feed bacteria that create cavity-causing acid. Never give a child a bottle with juice unless recommended by a doctor.

Formula comes in three different types in the U.S., each with varying levels of fluoride, a natural mineral extremely important in maintaining a healthy smile. Fluoride strengthens and protects teeth, but too much fluoride can cause dental fluorosis—changing the tooth enamel and appearing as faint white streaks on the teeth.

The American Dental Association recommends if liquid concentrate or powdered infant formula is the primary source of nutrition, it can be mixed with water that is fluoride-free or contains low levels of fluoride to reduce the risk of fluorosis.

Ready-to-feed formula has very little fluoride in it and will not cause dental fluorosis. Powdered and liquid concentrate may increase the chance of cosmetic dental fluorosis when mixed with fluoridated water.

Consult your pediatric dentist or medical care provider if you have questions or to help determine the right amount of fluoride for your child and what formula will work best or your needs.