Should a 4-month-old infant's teeth be brushed?

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Last updated: February 26, 2025View editorial policy

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From the Guidelines

Yes, a 4-month-old infant's teeth should be cleaned, even before they appear, to prevent bacteria buildup and reduce the risk of early childhood cavities. Start by wiping the gums gently with a clean, damp washcloth or a silicone finger brush once daily, typically during bath time or before bedtime 1. Once the first tooth emerges (usually between 4-7 months), begin using a tiny smear of fluoride toothpaste (about the size of a grain of rice) on an infant-sized, soft-bristled toothbrush.

Key Points to Consider

  • Brush gently twice daily - in the morning and before bed to establish a routine and prevent decay
  • The small amount of fluoride toothpaste is safe and helps strengthen developing teeth, as recommended by the Centers for Disease Control and Prevention 1
  • Avoid putting your baby to bed with a bottle containing anything other than water, as milk, formula, or juice sitting on teeth overnight can lead to decay
  • It is essential to consult a dentist or other health-care provider before introducing a child aged <2 years to fluoride toothpaste, as they can provide personalized guidance on oral hygiene and fluoride use 1
  • The American Academy of Pediatric Dentistry recommends that the first oral examination occur within six months of the eruption of the first primary tooth but by no later than 12 months of age, highlighting the importance of early oral health care 1

From the Research

Oral Hygiene for Infants

  • The American Dental Association recommends cleaning an infant's gums with a soft cloth after feedings, even before the first tooth erupts 2.
  • Infants begin teething around four to seven months of age, and their gums are highly susceptible to bacterial build-up, causing problems long before oral hygiene comes to mind 3.
  • There is no specific evidence that a 4-month-old infant's teeth should be brushed, but it is essential to clean their gums and any erupted teeth gently with a soft cloth or toothbrush to prevent bacterial build-up.

Importance of Early Oral Hygiene

  • Early detection and treatment of oral health problems in infants can prevent more severe issues later in life, such as gingivitis and periodontitis 3, 2.
  • Educating parents about oral hygiene and the importance of taking care of their newborn's oral health can help prevent oral health problems 2.
  • Poor dental hygiene can result in tooth decay, gingivitis, periodontitis, tooth loss, bad breath, fungal infection, and gum diseases 4.

Cleaning Infants' Teeth and Gums

  • The use of a toothbrush is the most important measure for oral hygiene, and toothbrushes with soft bristles can help remove plaque and avoid mucosal trauma 4.
  • A soft cloth or gauze pad can be used to gently clean an infant's teeth, gums, and tongue, especially if they have limited motor skills or are sensitive to toothbrushes 4.
  • Fluoride toothpaste is essential for daily oral hygiene, but detergents and flavoring agents should be avoided in infants and young children 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Caring for baby's teeth starts before birth.

European journal of paediatric dentistry, 2017

Research

Oral care.

Current problems in dermatology, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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