Oral Health: Children

Tooth decay, or cavities, is the most common dental problem among children, yet it is preventable. Tooth decay can begin as soon as a baby’s first tooth comes in.

Nationally, more than half of children ages 6 to 19 have experienced tooth decay. In NYC, more than one in three third-grade students have untreated tooth decay.

Once tooth decay develops, it must be treated by a dental professional or it will worsen. Signs of tooth decay are white or brown spots on the teeth.

If left untreated, tooth decay can cause a variety of health problems, including:

  • Pain
  • Infection
  • Difficulty eating and speaking
  • Reduced self-esteem

Infancy and Early Childhood

Brush Teeth Twice a Day

  • Wipe the gums. Before your baby has teeth, wipe the gums with a clean washcloth after feedings and at bedtime.

  • Brush twice a day. As soon as the first tooth comes in, start brushing twice a day with a soft child-sized toothbrush.

  • Use fluoride toothpaste. For children younger than three, use a smear of fluoride toothpase, the size of a grain of rice. For children ages three to six, use a pea-sized amount of fluoride toothpaste.

  • Help with brushing. Make sure to supervise children and help them brush until they can brush well on their own, at around age seven or eight.

  • Teach children how to brush their teeth. Here are a few steps to show them proper toothbrushing techniques:
    • Place the toothbrush at a 45 degree angle to the gums.
    • Gently brush back and forth in short strokes.
    • Make sure to brush all three surfaces of the teeth: inner, outer, and chewing surfaces.

  • Floss. Begin flossing when the teeth start to touch each other.

Avoid Sugary Snacks and Drinks

Sugary foods and drinks, such as cookies, candy and soda can cause tooth decay.

  • Avoid sugary snacks. Limit the number of snacks to three a day. Offer healthy snacks that are low in sugar, such as cheese, yogurt and fruit.

  • Avoid sugary drinks. Give your child milk or water, instead of sugary drinks such as soda, juice with added sugar or flavored milk.

  • Limit fruit juice. If you give your child fruit juice, make sure it is 100% juice with no added sugar. Give your child no more than six ounces of juice per day, and have your child drink it in one sitting.

Avoid Sipping of Non-Water Drinks in Bottles and Sippy Cups

Milk and formula have sugar too. The sugars in drinks other than water can cause tooth decay when they stay on the teeth for too long.

  • Limit sipping. Limit sipping of drinks other than water from bottles or sippy cups, especially between meals.

  • Do not let your child sleep with a bottle or a sippy cup. Sleeping with a bottle or sippy cup filled with with any drink other than water can cause tooth decay.

  • Do not use a bottle as a pacifier. Bottles should only be given when a baby is hungry or thirsty.

  • Drink from a cup. Help your child drink from a regular cup by age one.

  • Give your child tap water. The fluoride in New York City’s tap water helps prevent tooth decay.

Do Not Share Utensils or Bites of Food

Babies are born without the germs that cause tooth decay. They get these germs from saliva that is passed from the mouths of adults to their mouth.

Some of the ways that saliva might be shared with a baby are by sharing a spoon or piece of food, or by cleaning off a pacifier with saliva instead of water. As soon as germs are in a child’s mouth, the process that causes tooth decay can start, even before the child has teeth.

  • Do not share saliva. To avoid spreading germs, do not put a spoon or a piece of food from your mouth into your child’s mouth. Use water, not your mouth, to clean off a pacifier.

  • Take care of your own teeth. Brush, floss and visit the dentist regularly to reduce germs in your mouth.

Visit the Dentist

  • Start seeing the dentist by age one. Children should see a dentist by their first birthday. They should then visit a dentist every six months to prevent cavities and treat oral health problems.

  • Speak to your child’s dentist or doctor about fluoride varnish. Fluoride varnish is a coating that is painted on the teeth to prevent tooth decay.
    Frequently Asked Questions About Fluoride Varnish (PDF)
    Other Languages: عربي | বাংলা | 繁體中文 | Kreyòl ayisyen | Français | 한국어 | Русский | Español | اردو

  • Ask about sealants. Speak to your child’s dentist about dental sealants, a thin white coating that is put on the chewing sides of the back teeth to protect them from tooth decay. Sealants are usually placed on the adult molar teeth, which come into the mouth at around ages six and 12.

Middle Childhood and Adolescence

Brush and Floss

  • Brush twice a day. Brush twice a day with a soft toothbrush and fluoride toothpaste.

  • Floss. Floss between the teeth daily.

Avoid Sugary Snacks and Drinks

Sugary foods and drinks, such as cookies, candy and soda can cause tooth decay.

  • Avoid sugary snacks. Limit the number of snacks to three a day. Eat healthy snacks that are low in sugar, such as cheese, yogurt and fruit.

  • Avoid sugary drinks. Drink water or milk instead of sugary drinks such as soda and sports drinks.

Visit the Dentist

  • Visit the dentist regularly. Children and adolescents should see a dentist every six months to prevent cavities and treat oral health problems.

  • Speak to the dentist or doctor about fluoride treatments. Fluoride varnish is a coating that is painted on the teeth to prevent tooth decay, and may be placed by either a medical or dental professional. Your dentist can also advise on additional types of fluoride that may be appropriate.

  • Ask about dental sealants. Speak to the dentist about dental sealants, a thin white coating that is put on the chewing sides of the back teeth to protect them from cavities. Sealants are usually placed on the adult molar teeth, which come into the mouth at around ages 6 and 12.
    Keep Your Child's Teeth Healthy with Sealants (PDF)
    Other Languages: العربية | Español | Français | 繁體中文 | Русский | Kreyòl ayisyen | اردو | বাংলা | 한국어

  • Ask about silver diamine fluoride. Silver diamine fluoride (SDF) is a non-invasive treatment that stops cavities from getting worse. SDF is a good option for children who cannot tolerate or do not have access to regular dental treatment.

Utilize School Based Dental Services

  • No-cost dental services are available to students in many NYC schools, regardless of insurance status. This includes examinations, dental sealants and fluoride treatment among other preventive and restorative care.

  • To find out whether your local school offers dental services, contact the school directly.

  • Consent from a parent or guardian is required to participate. Look for this form in your child’s back-to-school packets or at other times during the year, and be sure to complete and return the consent form. It can also be requested from the school directly.

Abstain from Tobacco and Vaping

Do not Abuse Alcohol or Recreational Drugs

Be Aware of Oral Side Effects from Common Medications

  • Liquid medications often include sugar, which can leave a sticky residue on the teeth. Oral inhalers for asthma can cause fungal infections in the mouth. Rinse with water after using these medications and brush the teeth well. If your medications cause dry mouth, drink water frequently and avoid sugary drinks like juice, soda, or sports drinks.

Avoid Mouth Piercings

  • The American Dental Association advises against oral piercings because of the many health risks, which include pain, infection, and damage to teeth or gums.

  • When one has a mouth piercing, it is important to keep the piercing site clean. See a dentist or doctor if there is pain or infection.

Take Precautions when Playing Sports

  • When playing contact sports, a mouth guard should be worn to protect the teeth, jaw, and mouth from injury.

  • Dentists can make customized mouth guards, which provide an ideal fit. Other options are ready-to-wear mouth guards and boil-and-bite mouth guards, which are less expensive than custom mouth guards but do not fit as well.

Stay up to Date on HPV Vaccination

  • Human papilloma virus (HPV) is a very common virus that can cause many types of cancer. The most common HPV-related cancer is oropharyngeal (mouth and throat) cancer.

  • The HPV vaccine is safe and can prevent 90% of cancers caused by HPV.

  • Children should be vaccinated for HPV along with other routine immunizations at age 11-12.

Additional Resources

Oral Health Campaign Ads

Posters and Brochures

Find a Low-cost Dentist


  • Find low-cost dental treatment near you on the NYC Health Map.
  • Other Resources


    More Information