How many teeth does a toddler have?
Most children have a full set of 20 primary teeth (also called baby teeth or milk teeth) by the age of 2½ to 3 years. This set includes the second molars, which will probably erupt when your toddler is between 20 and 30 months of age.

When will my child get her permanent teeth?
The primary teeth will be replaced by a set of 32 secondary (permanent) teeth over a span of years, generally from 6 or 7 to 12 or 14 years of age.

How common is tooth decay among toddlers?
Unfortunately, tooth decay is a common problem for toddlers. According to one recent estimate, about 8% of 2-year-olds, and nearly 60% of 3-year-olds, have had at least one cavity.

What causes tooth decay?
Tooth decay occurs when bacteria normally present in the mouth combine with food residue and saliva to form a substance called plaque that sticks to the teeth. The acids in plaque can gradually wear down the enamel (hard outer covering) of the teeth and create cavities, also known as dental caries.

Does sugar cause cavities?
From the time you started weaning your child, her diet has included an increasing variety of foods. Sugars are naturally present in many foods, particularly fruits and fruit juices, and also milk, dairy products, and certain vegetables. Some foods, such as processed breakfast cereals and sweets (for example, cookies, cake, and ice cream), contain added sugar.

It is important to remember that all types of dietary sugar, including sugars produced by the breakdown of other carbohydrates (for example, from breads and cereals) in the mouth, can promote decay. The more frequently these substances come into contact with the teeth, and the longer they remain on the teeth, the greater the risk of decay.

Do cavities in baby teeth really matter?
Cavities, which can be recognized by black or brown spots, and eventually pain, in teeth, should be repaired promptly. An untreated cavity will enlarge until the internal parts of the tooth are involved, possibly leading to infection and tooth loss.

It is important to protect baby teeth to prepare for reception of the permanent teeth. If primary teeth are lost through decay or infection before the secondary teeth are ready to erupt, the other primary teeth shift, filling space that should have been reserved for the secondary teeth.

How should I care for my toddler's teeth?
Select a child's brush with a small head and soft, rounded bristles. While you can use toothpaste to brush your toddler's teeth, it is not essential. The cleaning process relies largely on the actions of brushing and rinsing with water.

If you do use toothpaste, it may be best to choose one without fluoride until your child is able to rinse and spit. Although fluoride offers benefits for teeth, it can be harmful when taken in excess. (Consult your dentist or other health care advisor about the appropriate use of fluoride toothpaste.)

Brush your toddler's teeth at least twice a day. Experts have given various recommendations on the correct brushing motions-up and down, back and forth, or in circles-but they agree that it is important to clean thoroughly all surfaces and between the teeth.

Where the teeth have not erupted, gently brush the gums or wipe them with a soft, clean cloth or cotton pad.

Can my toddler brush her teeth by herself?
Although you should encourage your toddler's interest in participating in brushing, remember that she lacks the control and focus to brush without help.

At about 2 years of age, your child should be capable of learning to rinse and spit after brushing. Rinsing removes food residue that has been loosened by brushing. Rinsing also helps prevent the child from swallowing toothpaste, which is particularly important if it is fluoridated. But keep in mind that your toddler may not yet have developed adequate control of the swallowing reflex.

Even when your child is able to do most of the brushing, you should continue to help until she is at least 7 years old.

Do I have to floss my toddler's teeth?
Experts differ as to whether it is best to start flossing your toddler's teeth as soon as there is a full primary set, or rather to wait until a child can manage with her own small hands. In any case, you will need to supervise for a few years.

What should I feed my toddler to protect her dental health?
To give your toddler the best possible start, provide a well-balanced and varied diet, including dairy and other sources of calcium to encourage dental mineralization for strong teeth.

To help ensure appropriate intake of calcium, you may wish to complement your toddler's solid food diet with a quality growing-up milk formula. Good-tasting PROGRESS* GOLD is an excellent source of calcium, vitamin D, and other at-risk nutrients for children 1 to 3 years of age.

Follow these guidelines to help minimize the risk of tooth decay:

• Limit foods and drinks that have added sugar. Be particularly careful to avoid sticky foods that are high in sugar.
  
  
• Restrict foods and drinks containing sugars to structured mealtimes. If sweets are given as dessert, they should immediately follow the meal.
  
  
• Snacks should be low in sugar and eaten at scheduled times. Snacking throughout the day on foods and drinks containing sugars and other carbohydrates (a habit known as "grazing") increases the risk of tooth decay.
  
  
• Do not have your child drink from a bottle after 12 months of age unless advised otherwise by your pediatrician.
  
  
• Do not let your toddler sip juice or milk for extended periods. Doing so prolongs the exposure of the teeth to sugar.

Is fluoride important? Can it actually harm teeth?
Fluoride, a mineral present in the teeth, helps prevent tooth decay by making the tooth enamel more resistant to the acid in dental plaque. Exposure to a small amount of fluoride can help make tooth enamel stronger and prevent cavities.

Fluoride is naturally present in all water, and some water supplies are fortified so that their fluoride concentration is optimal for dental health. In fact, your health care professional may recommend a fluoride supplement if the fluoride content of your drinking water is low.

Fluoride is also present in some toothpastes, mouthwashes, and beverages. Some dentists may apply topical fluoride solution to the teeth as an additional preventative measure.

Although adequate fluoride intake is beneficial, too much fluoride can cause fluorosis, a permanent staining of the tooth enamel. To help prevent fluorosis, authorities recommend that children younger than 2 years of age not use fluoride toothpaste and that children 2 years and older use only a pea-sized dab of toothpaste.

Consult a dentist or other health care advisor about the appropriate use of fluoride for your child.

When should my toddler go for her first dental checkup?
Experts agree that toddlers should have their teeth checked regularly, although they differ about the age at which the examination should be performed by a dentist rather than by your pediatrician. In any case, if your pediatrician finds abnormalities, such as discoloration of teeth, misaligned teeth, or an unaligned bite, prompt evaluation by a dentist is necessary.

Once regular dental visits have been established, and your toddler has a full set of primary teeth, a professional cleaning twice annually is recommended.