The Best Baby Toothbrushes and Toothpastes

Congratulations! After months of teething symptoms, your baby’s first little razor-sharp teeth are here! You’re hoping for some reprieve from teething symptoms, but you might also be curious, what do I need to do to keep these new teeth healthy?

The good news is that baby teeth are a lot like adult teeth, and we want to take care of them in much the same way:

• Brushing in the morning and before sleep.
• Focus on the gumline and lift the upper lip to brush under it.
• Floss wherever teeth are touching each other.
• Avoid grazing and snacking throughout the day.
• No eating after brushing at night.

Baby’s First Dentist Appointment

Just like grownups, children benefit from going to the dentist every six months. The American Academy of Pediatrics and American Academy of Pediatric Dentistry recommend the first visit by 12 months of age (or as soon as the first teeth show up).

This visit is generally a conversation with the caregivers to determine what the child’s risk for decay is, and to encourage you to modify behaviors if necessary for a better oral hygiene routine and diet. The discussion is followed by an oral exam, cleaning and preventive fluoride treatment.

And don’t worry if your baby cries! That means their mouth is open and we can check their teeth very quickly (wink). If your baby cries during their dental exam, it’s perfectly age-appropriate behavior and does not reflect on you as a parent or caregiver. Many babies are scared of strangers, and our protective equipment (mask, face shield, goggles) doesn’t help!

Many babies right around age one are also worried about getting shots in healthcare settings. All this is 100% normal! Rest assured that your child is safe and cared for, and we are helping you keep their teeth healthy. In general, once kids turn four years old or start preschool, they are fine with all our stuff—and if they’ve been coming twice a year, they have learned they don’t get shots and nothing hurts.

Do babies need their teeth brushed?

Why do we even brush babies’ teeth? The goal of brushing is to remove the biofilm that builds up on teeth made of bacteria, food and the metabolic byproducts of bacteria. This biofilm is called plaque, and if it stays in one spot long enough, it becomes more organized, more complex, more acidic and will slowly melt the minerals out of a tooth.

Eventually the tooth gets so soft that it crumbles away and is left with a hole. We call this hole a “cavity” and the process of “tooth decay.” If the decay isn’t removed and filled up, the bacteria can make their way further and further into the tooth and eventually into the bone and bloodstream where they can cause an infection. In the United States, tooth decay affects about 37% of children ages two to eight years old.

Pediatric dentists are big fans of preventing cavities from a young age, because it can be quite tricky to do fillings for younger children. Dental decay is a preventable disease, but once you have the symptoms (holes in your teeth) it can be very costly to treat.

Let’s start with the basics and talk a little about brushing and toothpaste. There are some great tools to brush efficiently and effectively. I have three kids, and I am not a fan of wasting time with products that don’t work!

The Best Toothbrushes for Babies

There are a few things to look for and a few things to skip when you’re buying oral healthcare products for your baby.

PICK: Any soft bristled toothbrush, including manual brushes and electric brushes.

PICK: A product with the American Dental Association seal of approval.

SKIP: A silicone brush or finger brush, unless you’re using it as a teether. They are fun for teething toys or playing with because they feel good on gums, but once teeth erupt, our goal is to remove the sticky biofilm. The silicone bristles on finger toothbrushes are so soft, I always picture them as gently petting the germs on the head, saying “Nice little germ, you can keep living here.” Would you brush your own teeth with a silicone toothbrush? Probably not. So stick with a traditional toothbrush for your kiddos.

SKIP: The U-shaped retainer-style brushes that advertise exceptional cleaning of all your teeth at the same time just by biting on a mouthpiece. A randomized controlled trial (RCT) is considered one of the highest levels of research evidence, and an RCT from June 2020 showed that there was no statistically significant difference between not brushing your teeth and using the U-shaped brush. There was a significant statistical difference between using a regular manual toothbrush or an electric toothbrushbrush and the U-shaped brush.

If you are ever curious about how much plaque you are removing, you can always try this experiment for yourself or your child: chew up a disclosing tablet that stains the plaque on your teeth pink, and see what it takes to make your teeth white again.

So here are some of my favorites:

Do babies need toothpaste?

Now that you know why you should be brushing your baby’s teeth, what about toothpaste? And what type of toothpaste is best for babies?

The actual purpose of toothpaste may not be exactly what you think. We know cavities are caused by the biofilm sitting on the teeth too long, but does toothpaste by itself help disrupt the biofilm? Nope. Brushing and flossing disrupt the biofilm.

The active ingredient in toothpaste is actually a naturally-occurring mineral that strengthens the teeth on a microscopic level. Toothpaste with the mineral fluoride is allowed to market as “Anti-Cavity” toothpaste because it makes teeth stronger and restores enamel. Fluoride has been used in toothpaste since 1890 for its anti-cavity properties. Fluoride ion is present in roughly the same concentration for anticavity toothpastes available over the counter.

But consuming too much fluoride can cause abdominal pain, nausea and vomiting, so fluoride toothpaste should be treated like a medicine (especially since it has a tendency to taste pretty good). You don’t want your child to eat too much toothpaste, but a tiny amount is beneficial for children of all ages with teeth. Keep it out of reach, and make sure the grownup is in charge of its dispensing and application.

How much toothpaste should my child use?

The main thing to consider is whether or not your child can spit every time. For children ages three years old and younger, or any age child who doesn’t spit predictably, a rice grain amount of fluoride toothpaste is recommended twice a day.

(I will admit I did not really push spitting with my three boys. We mostly brush their teeth in the bedroom while they lay on their bed or on the floor, so I used a rice grain amount until they got good at holding their spit in their mouth, and now I bring a cup with me for them to spit into.)

If your child spits predictably every time, you can use up to a pea sized amount.

You don’t need more than that, even as a grownup. But toothpaste companies like to sell more toothpaste, so they encourage you to use more!

What to look for in a baby toothpaste

The best way to pick a toothpaste is to look for that ADA seal of acceptance—this means the toothpaste has achieved a special certification that it is effective against cavities.

So why are there so many options for baby and toddler toothpaste? Training toothpastes don’t have fluoride, so your child can safely eat more of it. There are a few reasons fluoride-free toothpaste can still be valuable, even though it won’t prevent cavities:

• It gets you more time with the brush in their mouth because they love that flavor.
• Your child who doesn’t spit yet wants to brush their own teeth, so you give them the non-fluoride toothpaste when it’s their turn.
• Your child just sucks out the toothpaste before it even touches their teeth.

Even with a training toothpaste, I still recommend a parent brush with a rice grain amount of fluoride toothpaste afterwards.

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If you are choosing a non-fluoride toothpaste there are two types that I recommend: toothpaste with baking soda or with hydroxyapatite. Baking soda works by counteracting the harmful acidity created by the bacteria and snacks. This helps neutralize the pH of mouth. When the mouth is less acidic, the teeth minerals melt less. So baking soda toothpaste won’t make the teeth stronger, but it can help reduce enamel loss.

The other type is a hydroxyapatite-containing toothpaste like Risewell or Apakids. This is a relatively new type of toothpaste for the American market, so more research is needed to determine its efficacy. Hydroxyapatite is a form of the minerals that teeth are made of, so this might also help restore some of the lost tooth enamel after a day of eating.

All of these are personal and professional recommendations, however if you have any concerns, schedule a visit with your child’s pediatric dentist. Remember, first visit by age one or first tooth. We love seeing babies (even if they don’t always love seeing us)!