Kids’ Teeth, Birth to Teens: The Complete Dental Guide for Parents of Black Children

A healthy smile is one of the first things people notice about a child, and it shapes far more than looks. Baby teeth help children chew, speak clearly and hold space for the adult teeth coming in behind them, according to the American Academy of Pediatric Dentistry (AAPD). The good news: a few daily habits and a dentist you trust go a long way.

This guide walks you through every stage, from the first tooth to the teen years, using guidance from the CDC, the AAPD, the American Academy of Pediatrics (AAP) and the American Dental Association (ADA). If you are raising a Black child, you will also find what the national data shows and how to make sure your child gets the care every child deserves.

The first tooth and the first dentist visit

Baby teeth usually start to come in at about 6 months of age, according to the ADA’s MouthHealthy eruption charts. That first tooth is your signal to start a dental routine.

The AAPD recommends that your child see a dentist “when the first tooth appears, or no later than his/her first birthday.” The CDC gives the same advice: visit the dentist by your baby’s first birthday to spot signs of problems early.

HealthyChildren.org, the AAP’s parent site, describes it as a “well baby check” for the teeth that is more about education than treatment. After that, the AAPD recommends a check-up every six months, or on whatever schedule your child’s dentist advises.

Brushing, flossing and fluoride by age

The right amount of fluoride toothpaste changes as your child grows, because young children cannot spit well.

Birth to age 3

• Start brushing as soon as the first tooth comes in, twice a day, with a soft, small toothbrush.
• Use a smear of fluoride toothpaste about the size of a grain of rice. Both the AAP and the ADA recommend this amount for children under 3.
• Ask about fluoride varnish. Your pediatrician can begin applying it around 6 months, usually every 6 months until age 5, or every 3 months for children at higher risk of decay, according to the AAP. The CDC notes that fluoride varnish can prevent about one-third of cavities in baby teeth.

Ages 3 to 6

• Move up to a pea-size amount of fluoride toothpaste.
• Teach your child to spit the toothpaste out rather than swallow it, and supervise every brushing.
• Skip mouthwash for children under 6 unless a dentist recommends it, since young children are more likely to swallow it, per the ADA.

Ages 6 and up

• Keep brushing twice a day with fluoride toothpaste through the teen years.
• Keep helping or watching. The AAP says most children need help brushing until about age 10.

Flossing

Start flossing as soon as two teeth touch each other, according to the AAP. Your child will need your help with this until about age 10, too.

What about tap water?

Community water fluoridation helps prevent cavities. If your local water is not fluoridated, the ADA notes that a dentist may prescribe fluoride supplements for children from 6 months to 16 years old. Ask your child’s dentist or pediatrician what makes sense where you live.

Sealants: the easy win for back teeth

Sealants are “a protective coating that is painted onto the chewing surfaces of the back teeth,” according to the CDC. They fill the deep grooves where food gets trapped, and the AAPD notes that applying them is quick and comfortable.

The results are impressive. Applied soon after the permanent molars come in, sealants can prevent up to 80% of cavities for 2 years and keep protecting against 50% of cavities for up to 4 years. Children ages 6 to 11 without sealants are almost three times more likely to have cavities in their molars than children who have them, the CDC reports.

Ask your child’s dentist about sealants when the first permanent molars arrive, and again when the second set comes in.

Cavities, juice and the bedtime bottle

More than half of children ages 6 to 8 have had a cavity in at least one baby tooth, according to the CDC.

A few habits make a real difference:

• No bedtime bottles of milk or juice. The AAP advises against putting a baby to bed with a bottle at night or nap time. If you do, fill it only with water. The AAPD also advises against nursing children to sleep.
• Do not dip pacifiers in anything sweet, per the AAP.
• Go easy on juice. The AAP says fruit juice should not be given to babies under 12 months. For children ages 1 to 6, the limit is 4 to 6 ounces a day, and juice should not be given at bedtime (AAP).
• Watch the sippy cup. “Fruit juice literally bathes teeth in sugar,” the AAP warns, and it is especially harmful sipped all day from a sippy cup. Water and milk are the better choices.
• Limit sugary and starchy snacks. The AAPD says cutting back on sugars and starches helps protect teeth from decay.

Dental anxiety: how to prepare your child

How grown-ups talk about the dentist shapes how kids feel about it. These steps come from Head Start’s guidance on talking with children about dental visits:

1. Keep it short and positive. Try, “The dentist will see what a good job you do taking care of your teeth.”
2. Leave out shots and pain. If your child asks about a shot, say, “I don’t know, but we can ask the dentist or dental hygienist.”
3. Keep your own worries to yourself. Children pick up on adult anxiety.
4. Play dentist at home. A white shirt becomes a lab coat and a paper napkin becomes a bib. Let your child count everyone’s teeth.
5. Read together. Choose age-appropriate books or videos, and preview them first to skip anything scary.
6. Bring comfort along. A favorite stuffed animal or blanket helps, and so does a fun plan for after the visit.

Choosing a kid-friendly or pediatric dentist

Many general dentists see children. A pediatric dentist is a specialist: the AAPD says pediatric dentists complete two to three years of specialty training after dental school and limit their practice to children, from infancy through the teen years, including children with special health needs.

When you visit or call an office, ask:

• Do you see babies and toddlers for first visits?
• Do you accept my child’s insurance, Medicaid or CHIP?
• How do you help nervous kids feel comfortable?

To search, try the AAPD’s pediatric dentist finder at MyChildrensTeeth.org, which searches by ZIP code. If your child has Medicaid or CHIP, use the dentist locator at InsureKidsNow.gov, which finds dentists who see children and accept those plans.

Paying for care: Medicaid, CHIP and low-cost options

Medicaid and CHIP

Medicaid covers dental services for every enrolled child. Under the program’s children’s benefit, states must cover, at minimum, relief of pain and infections, restoration of teeth and maintenance of dental health, according to Medicaid.gov. The Children’s Health Insurance Program (CHIP) also covers dental care that prevents disease, restores teeth and treats emergencies, and it covers children up to age 19, per the National Institute of Dental and Craniofacial Research (NIDCR).

To check eligibility, visit InsureKidsNow.gov or call 1-877-KIDS-NOW (1-877-543-7669).

Community health centers

Federally funded health centers offer dental care, serve everyone even if they cannot pay and adjust fees based on income and family size, according to HRSA. Find one near you at FindAHealthCenter.hrsa.gov.

Dental schools and local help

Dental school clinics offer reduced-cost care from students supervised by licensed dentists, and dental hygiene schools may offer low-cost cleanings, the NIDCR notes. You can also call your local health department or dial 2-1-1 to find free or reduced-cost dental services in your community.

Oral health and Black children: what the data shows

National data tells a story that is mostly about access to care.

Start with the progress. Among Black children ages 2 to 5, untreated tooth decay in baby teeth fell from 24.3% in 1999 to 2004 to 8.7% in 2017 to March 2020, nearly matching the 8.1% rate for white children in the latest data, according to NIDCR figures from CDC’s national survey. The latest survey was partly disrupted by COVID-19, so the CDC cautions that it may not compare directly with earlier years. Even so, that is a major improvement, and it shows what steady access to prevention can do.

Gaps remain for school-age children. In the CDC’s 2024 Oral Health Surveillance Report, 19.0% of Black children ages 6 to 9 had untreated tooth decay, compared with 14.1% of white children (2017 to March 2020 data).

Income is the clearest dividing line. In that same age group, 24.7% of children from households below 200% of the federal poverty level had untreated decay, compared with 10.0% of children from higher-income households. The CDC points to the reasons: limited access to services where people live, and the fact that more people are unable to afford dental care than other types of health care (CDC, oral health equity).

Sealants show the same pattern. Among children ages 6 to 11, about 32% of Black children had sealants, compared with about 44% of white and Mexican American children (2011 to 2016 data, NIDCR). Sealants are one of the simplest, most effective protections available, which makes this gap one of the easiest to close.

“Untreated” is the key word in these numbers. It measures cavities that have not yet been seen by a dentist, which reflects access, not effort. For parents of Black children, the takeaway is practical: get on a dentist’s schedule early, ask for sealants and fluoride varnish by name and use the coverage your child is entitled to.

Orthodontics basics

The American Association of Orthodontists (AAO) recommends an orthodontic check-up no later than age 7, when children typically have a mix of baby and permanent teeth. You do not need to wait for age 7 or a referral if you notice a problem sooner.

A check-up at 7 does not mean braces at 7. The AAO says only a few problems need correction that early. In many cases, the orthodontist will simply monitor growth and start treatment when the timing is right for your child.

Sports mouthguards

Mouthguards protect teeth, lips, cheeks and gums from sports injuries, according to the AAPD. The ADA notes they matter for contact sports and for non-contact activities like gymnastics and skating, too. There are three main types (ADA MouthHealthy):

• Custom-made: made by your dentist for the best fit and comfort, at a higher cost.
• Boil-and-bite: sold at sporting goods and drug stores, softened in hot water and shaped to the teeth.
• Stock: inexpensive and ready to wear, but often a poor fit that can make breathing and talking harder.

If your child wears braces, a well-fitted mouthguard also protects the braces and the cheeks. Replace it when it no longer fits, since growing kids may need a new one often.

When it’s an emergency: a knocked-out tooth

A knocked-out permanent tooth is a true emergency. It has the best chance of being saved when placed back in the socket within 15 minutes, and may still be saved within the first hour, according to the AAP. Follow these steps:

1. Find the tooth and pick it up by the crown (the part you chew with), never the root.
2. Rinse it gently with milk or saline. Do not use tap water, and do not scrub it.
3. Put it back in the socket if you feel comfortable, then have your child bite gently on gauze or a clean cloth to hold it in place.
4. If you cannot put it back, keep it moist in milk, saline or your child’s saliva. Do not store it in tap water.
5. Go right away to your child’s dentist or the nearest emergency room, and say your child has a knocked-out permanent tooth.

A knocked-out baby tooth is different. The AAP says there is no need to try to put it back, and in most cases no treatment is needed. Call the dentist with any concerns.

Frequently asked questions

When should my baby first see a dentist?

When the first tooth appears, and no later than the first birthday. That is the recommendation from both the AAPD and the CDC.

How much toothpaste should a toddler use?

A smear about the size of a grain of rice until age 3, then a pea-size amount from ages 3 to 6. Use fluoride toothpaste and supervise brushing.

Are dental sealants worth it?

Yes. The CDC says sealants can prevent up to 80% of cavities in the back teeth for 2 years, and children without them are almost three times more likely to get molar cavities.

Does Medicaid cover kids’ dental care?

Yes. Medicaid covers dental services for all enrolled children, and CHIP includes dental coverage too.

What age should a child see an orthodontist?

The American Association of Orthodontists recommends a first check-up no later than age 7.