Oral Health›Life stages

Children's Teeth: From First Tooth to Adult Teeth

When teeth come through, how to handle teething, when to see a dentist, and how much toothpaste to use at each age. The toothpaste advice differs between the UK, Australia and the US, so each is set out separately.

Updated September 2026·By the OHA editorial team·9 min read·How we write
Key takeaways
  • Start cleaning teeth as soon as the first one appears, usually at around 6 months, and brush twice a day, including last thing at night.
  • Toothpaste advice depends on where you live: UK and US guidance use fluoride toothpaste from the first tooth, while Australian guidance uses water only until 18 months.
  • Use only a smear or a pea-sized amount, and help your child spit it out rather than swallow it. Do not rinse with water afterwards.
  • Take your child to a dentist when the first teeth appear, or by their first birthday.
  • Keep bottles for milk or water, never sugary drinks, and help your child brush until they are about 7 to 9 years old.

Baby teeth matter even though they fall out. healthdirect Australia explains that they help guide the adult teeth into place, and that tooth decay is the main reason children lose them early. Where health services in different countries give different advice, we give each one separately.

When do baby teeth come through?

Babies are born with 20 baby teeth (milk or primary teeth) already in the jaw, say healthdirect and the American Dental Association. Sources give slightly different typical ages for the first tooth:

  • The NHS says most babies start teething at around 6 months, but some start before 4 months and some after 12 months. healthdirect, the Better Health Channel and the American Dental Association also say around 6 months.
  • The Australian Dental Association says baby teeth often appear around 9 months, with a range of 3 to 12 months, and suggests a dental check-up if your child has no teeth by 12 months.

The NHS gives a rough order: front teeth at around 6 months, the teeth beside them at 8 months, first back teeth (molars) at 12 months, canines at 18 months and second molars at 24 months. Most children have all their baby teeth by 2 to 3 years old. The Australian Dental Association says baby teeth start to loosen at around 6 and most children have all their adult teeth at around 13.

How can you help a teething baby?

Some teeth come through without discomfort. The NHS lists possible signs of teething as a sore, red gum, a slightly raised temperature below 38C, one flushed cheek, a rash on the face, rubbing the ear, dribbling, gnawing, being more fretful and sleeping poorly. It says there is no evidence that teething causes diarrhoea, and to call NHS 111 or a GP if any symptom worries you.

The Australian Dental Association is more cautious: it says symptoms such as poor sleep, loss of appetite, rashes, diarrhoea, vomiting or a very high fever should not be put down to teething straight away, and advises seeing a doctor to rule out other illness.

What may help, according to the NHS and the Australian Dental Association:

  • A teething ring, cooled in the fridge but never frozen, and never tied around the neck.
  • Gently rubbing the gums with a clean finger or the back of a cold spoon, plus comfort and cuddles.
  • For babies over 6 months, raw fruit and vegetables to chew, always watched in case of choking. The NHS advises avoiding rusks, as nearly all contain some sugar.
  • A sugar-free children's painkiller if your baby is in pain. The NHS says paracetamol can be given from 2 months and ibuprofen from 3 months. Follow the instructions, and never give aspirin to anyone under 16.

The NHS says there is a lack of evidence that teething gels work and suggests trying teething rings or sugar-free painkillers first. The Australian Dental Association notes that a swallowed gel can numb the throat, and warns that amber and other beaded necklaces are a choking hazard and unlikely to help.

When should a child first see a dentist?

The advice is broadly the same everywhere: when the first teeth appear, or by the first birthday. That is the gist of guidance from the NHS, healthdirect, the Better Health Channel, the Australian Dental Association and the American Dental Association, though the exact wording varies. Our guide to your child's first dental visit sets out each body's advice.

An early visit helps your child get used to the dentist and lets problems be spotted early. NHS dental care for children is free in the UK. In Australia, healthdirect explains that eligible children can get help with costs through the Child Dental Benefits Schedule, which is based on financial need.

How much toothpaste, and what strength?

Fluoride in toothpaste protects against decay, but young children tend to swallow toothpaste, so guidance limits the amount. This is where countries differ. The fluoride content is shown in parts per million (ppm) on the tube or box.

United Kingdom (NHS)

  • First tooth to 3 years: a smear of toothpaste containing no less than 1,000ppm fluoride, with a parent or carer doing the brushing. A dentist may advise a family toothpaste of 1,350–1,500ppm.
  • 3 to 6 years: a pea-sized amount of toothpaste containing 1,000–1,500ppm fluoride. Supervise your child's brushing.
  • 7 and over: toothpaste containing 1,350–1,500ppm fluoride.

Australia

All three Australian sources say water only (no toothpaste) until 18 months, but they differ on what comes next.

  • Australian Dental Association: from 18 months to 6 years, a children's fluoride toothpaste, which it says contains 500ppm, using only a smear. Over 6, a pea-sized amount of standard fluoride toothpaste (1,000–1,450ppm).
  • Better Health Channel (Victoria): from 18 months until the child turns 6, a pea-sized amount of children's fluoride toothpaste, which is lower in fluoride. From 6, a pea-sized amount of standard toothpaste.
  • healthdirect: from 18 months to 5 years, a small pea-sized amount of fluoride toothpaste (strength not specified). By 9 years, adult-strength toothpaste. Before 18 months, it says only to use toothpaste if a dentist advises it because your baby is at high risk of decay.

So the Australian Dental Association says a smear, while healthdirect and the Better Health Channel say pea-sized. If unsure, ask your child's dentist, especially if your child is at higher risk of decay or your tap water is not fluoridated.

United States (American Dental Association)

  • First tooth to 3 years: a smear of fluoride toothpaste, about the size of a grain of rice.
  • 3 to 6 years: a pea-sized amount.
  • An adult should supervise so the child spits rather than swallows.

In all three countries, the advice is to spit out the toothpaste after brushing and not rinse with water, so the fluoride keeps working.

How to brush a young child's teeth

Brush twice a day, including last thing before bed, with a small, soft toothbrush made for children, as the NHS and the Better Health Channel advise.

  • The NHS suggests sitting your child on your knee with their head resting against your chest.
  • Brush gently in small circles, covering the outside, inside and chewing surfaces of every tooth and along the gumline.
  • Aim for about 2 minutes. The Australian Dental Association says babies with only a few teeth do not need that long, as long as every surface is reached.
  • Once two teeth touch, start cleaning between them. The Australian Dental Association says this is often around age 2.

How long should you help?

Sources give slightly different ages. The NHS says to keep helping until you are sure they can do it well, normally until at least 7. The Better Health Channel says around 8, the Australian Dental Association around 8 or 9, and healthdirect by 9. The American Dental Association says to supervise until your child can be relied on to spit and not swallow toothpaste, usually not before 6 or 7.

Bottles, sugary drinks and decay

The NHS says sugar causes tooth decay, and that how often teeth are in contact with sugar matters, not just how much. Sweet drinks in a bottle are especially harmful because they flow slowly through the teat and stay on the teeth longer.

  • Only put breast milk, formula or water in a bottle. The NHS, healthdirect and the American Dental Association all warn against juice, squash, flavoured milk and fizzy drinks in bottles.
  • Introduce a cup from around 6 months. The NHS recommends an open cup or a free-flow cup without a valve, and says bottle feeding should be discouraged from age 1.
  • The NHS says babies under 12 months do not need fruit juice, and plain milk and water are the best drinks.
  • Never dip a dummy in honey, sugar or jam.

Advice on night-time bottles differs slightly. The NHS says that at bedtime or during the night, only give breast milk, formula or cooled boiled water. healthdirect advises against letting your child fall asleep with a bottle of milk, formula or any sweet liquid, and the American Dental Association says bedtime bottles should be finished before going to bed.

Fissure sealants and fluoride varnish

  • Fissure sealants are a thin plastic coating painted onto the grooves of the back teeth to keep food and germs out. The NHS says they can be applied when the adult back teeth come through (usually at around 6 or 7) and again between 11 and 14, and last up to 4 years.
  • Fluoride varnish is a high-fluoride coating painted onto the teeth. The NHS says children should be offered it at least twice a year from age 3, and younger children may be offered it if their dentist thinks they need it.
When to see a dentist
  • Your child has no teeth by 12 months, which the Australian Dental Association says is worth a check-up.
  • You see white, brown or black spots on the teeth that do not brush off, which can be a sign of decay.
  • You suspect a problem such as toothache (healthdirect advises going as soon as you do).
  • Your child has sore or bleeding gums.
  • The top and bottom teeth do not meet properly when your child bites together.
Get help urgently
  • A tooth has been knocked out: the NHS says to ask for an emergency dental appointment. For an adult tooth, hold it by the crown (not the root), rinse it in milk if dirty, and try to put it back in, or keep it in milk or saliva. Never put a baby tooth back in, as it could damage the adult tooth underneath.
  • Your child's face or jaw is swollen, or they have toothache with a high temperature, which the NHS lists among the signs of a dental abscess. Ask for an urgent dental appointment or call NHS 111 (or your local equivalent).
  • Call 999 (or your local emergency number) if your child is finding it hard to breathe, speak or swallow, or has a lot of swelling in the mouth.

Frequently asked questions

Should I use toothpaste on my baby's first tooth?

In the UK and US, yes: a smear of fluoride toothpaste from the first tooth. Australian guidance is water only until 18 months, unless a dentist advises otherwise.

Is it a problem if my child swallows some toothpaste?

Some swallowing is expected, which is why the amount is kept small. The American Dental Association says the recommended smear and pea-sized amounts help keep the fluoride a child swallows below the levels suggested by US health experts. Supervise brushing and encourage your child to spit.

Do baby teeth really need treatment if they will fall out?

Yes. The Australian Dental Association says that losing baby teeth early can cause problems later, such as crowding when the adult teeth come through. Your dentist will advise on the right treatment.

Sources

  1. Children's teeth, NHS, accessed September 2026
  2. Looking after your baby's teeth, NHS, accessed September 2026
  3. Baby teething symptoms, NHS, accessed September 2026
  4. Tips for helping your teething baby, NHS, accessed September 2026
  5. Drinks and cups for babies and young children, NHS, accessed September 2026
  6. Knocked-out tooth, NHS, accessed September 2026
  7. Dental abscess, NHS, accessed September 2026
  8. Gum disease, NHS, accessed September 2026
  9. Looking after your baby or child's teeth, healthdirect Australia, accessed September 2026
  10. Toothbrushing: children 0–6 years, Better Health Channel (Victoria), accessed September 2026
  11. Baby and toddler oral health, Australian Dental Association, accessed September 2026
  12. Dental care for kids, Australian Dental Association, accessed September 2026
  13. Tips for choosing toothpaste, Australian Dental Association, accessed September 2026
  14. Toothpastes, American Dental Association, accessed September 2026
  15. Baby teeth, American Dental Association (MouthHealthy), accessed September 2026
  16. Tooth decay with baby bottles, American Dental Association (MouthHealthy), accessed September 2026
  17. Your baby's first dental visit, American Dental Association (MouthHealthy), accessed September 2026
  18. Sealants, American Dental Association (MouthHealthy), accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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