Children aged 4 years and older

Childrens oral health needs vary greatly as they grow and develop. This guide has been written to walk you through each stage of their journey from three years old and above.

Baby teeth

By the age of three, most children will have a full set of 20 baby teeth. More information about your child's teeth can be found in babies and toddler oral health.

Baby teeth eventually fall out to make way for the permanent adult teeth, but that does not mean dental care and cleaning them is not important. If baby teeth are lost or removed much earlier than intended, this may lead to future problems such as crowding of your child's teeth when the permanent teeth push through.

Losing baby teeth

Baby teeth will start to become loose and wiggly from around the age of six. This often starts with the lower front teeth.

It is important to remember that all children develop in different time frames. Some children may lose their first tooth earlier than six years, and others may be a little late. This is absolutely normal.

Once the first tooth becomes loose, it is important it is not left loose for long as it may cause the child to avoid this tooth when brushing their teeth.

Permanent teeth eruption

Permanent teeth, often called adult teeth, start to develop in the jaw from birth and continue to grow after the child is born. From six years of age, the four first permanent molar teeth will appear in the mouth. These teeth push into the mouth behind your child's teeth that are already present in the mouth. As your child continues to get older, more adult teeth will push out the baby teeth creating space for the adult teeth to move into the mouth.

The timing of when permanent teeth push into the mouth is different between children. However, the rough timeline of when the adult teeth appear in the mouth is below.

Around the age of 21, most people have a full set of 32 permanent teeth. This includes 16 teeth in the upper jaw and 16 teeth in the lower jaw. It is common for wisdom teeth (3^rd molar teeth) to not develop or be able to push through to fit in the mouth. Therefore, many people will only have 28 teeth in their mouth.

Brushing and flossing

It is recommended everyone brush their teeth twice a day, ideally in the morning and then at night as the last thing that is done before bed with no food or drinks after. This brushes away the plaque and bacteria from the teeth to help to prevent tooth decay and gum disease. Brushing should go for 2 minutes each time. This can be made more fun by playing a song or using a phone app that has a 2-minute timer to ensure the correct length of brushing and provide positive reinforcement.

Toothbrush and low-fluoride toothpaste

Flossing and interdental cleaning

Flossing is recommended for children once they have at least two teeth touching side-by-side. This cleans the surfaces between the teeth that the toothbrush bristles cannot reach. Your dentist can show you and your children techniques and items that can make this process easier. Some children naturally have larger spaces between their teeth which means flossing may not be needed between all of the teeth. Flossettes can be useful for parents cleaning between their child's teeth or for children to use themselves.

Getty Images.

Parental Assistance

Children should be helped by their parents when brushing teeth twice a day and flossing until around the age of 8 or 9. At this age, their physical dexterity is more developed. This means they can hold and control their toothbrush or floss better for good dental care. A good reference for this time is when your child starts using a pen at school instead of a pencil.
 

Visiting the dentist

The Australian Dental Association recommends children have their first dental visit when their first teeth appear in the mouth or by the age of one, whichever comes first. Therefore, by 3 years of age, your child should have had their first dental visit and hopefully are starting to understand how to keep their teeth and gums healthy.

Families with private health insurance may prefer private dental clinics. In most cases children will be eligible for public dental clinics.
What is important is that children see their dentist regularly and understand that visiting the dentist is an important part of growing up. Visiting the dentist as a child is not only important to ensure the teeth are being cleaned well and that no tooth decay is present but to also monitor development, such as whether the teeth are appearing in the mouth at the correct time.

Young children may be recommended to attend every 6 months as they continue to grow and their teeth appear in the mouth. Once children are older and take good care of their teeth, their dentist may suggest moving to 12 monthly appointments.
 

The Child Dental Benefits Schedule

If you receive a Government benefit, such as Family Tax Benefit A payments, your child may be eligible for the Child Dental Benefits Schedule.
This is a national program that provides children ages 1 to 17 access to dental care. Examinations, x-rays, professional dental cleans, fissure sealants, fillings, root canal treatments, and tooth extractions are all covered under the CDBS.
Eligible children can access $1,013 of dental treatment over a two-year period. Children can access this treatment at both public dental clinics and private dental clinics.

Eating and drinking habits

As well as maintaining good oral hygiene by brushing and flossing every day, it is important to limit your child's sugary food and drink intake. Added sugar is the largest contributor to the development of tooth decay. Beware though - it is not just well-known sugary foods such as lollies, cakes and biscuits. Foods such as breakfast cereal, muesli bars and flavoured yoghurts can include a lot of added sugar.

When it comes to drinks, water and milk are the best options for healthy teeth. Soft drink, cordial, sports drinks, energy drinks and fruit juice can be high in sugar which can increase your child's risk of developing tooth decay.

Sugar-free drink options are also not recommended. These drinks can also affect the teeth by dissolving the tooth structure (known as tooth erosion). Fresh fruit and a drink of water makes a great tooth-friendly snack to replace fruit juice.

Tooth-friendly snacks include carrot and celery sticks, hard cheese and fresh fruit. Making your child's meals and snacks from scratch can help to decrease the amount of added sugar. It also allows for the use of fresh ingredients.

If you give your child a sweet treat, try to do so as part of main mealtimes and decrease snacking between meals. These eating behaviours can increase the risk of tooth decay developing.

If you are struggling for time, have fussy eaters or looking for healthier options, this podcast featuring Paediatric Dietician Dr Kyla Smith gives a great insight into how to get your kids to try anything.

Snoring and tooth grinding

If you notice that your child grinds their teeth or snores whilst sleeping, it is recommended that they have an examination with a dentist. These habits may be a sign of issues that need to be investigated further.

Dental trauma

A knock to the mouth can cause a tooth to come out of the mouth completely. If this is a baby tooth, it should not be put back into the mouth. Only adult teeth should be placed back in the mouth if knocked out.

If you are sure the tooth is a permanent adult tooth, push the tooth into the space in the gums that it came from inside the mouth. If you are not confident in doing this or are unsure whether it is a baby or adult tooth, place the tooth in saliva or milk and take it with you to the dentist as soon as possible. Your dentist will review the knocked-out tooth and check that there has been no other damage to any other teeth, the jawbone, lips or cheeks.

For more information on dealing with a knocked-out tooth, see dental trauma.

Sports mouthguards

Mouthguards can help to protect teeth and keep dental trauma to a minimum. Mouthguards are particularly important for contact sports, even for primary school-aged children.

Avoid the do-it-yourself 'boil and fit' type mouthguards bought from sports stores or pharmacies. These mouthguards are unlikely to provide effective protection, are often uncomfortable and can make it hard to breathe. See your child's dentist for a professionally made custom mouthguard. Professionally made mouthguards are comfortable, and don’t make it hard to breath or speak while wearing them.

It is important that your child wears their mouthguard at training as well as games. Have the mouthguard checked by your child’s dentist at their regular appointments. They will check that it still fits and is still providing the best protection. Store the mouthguard in a hard case away from the heat so that it does not lose its shape.