Brushing a baby's teeth begins as soon as the first tooth appears, twice a day, with fluoride toothpaste. This is the consistent recommendation of the French health authorities, and it still surprises many parents who associate fluoride toothpaste with school age.
This article brings together the official guidelines currently in force: fluoride dosage by age, brushing frequency, covered preventive care, and available public health data.
At what age should you start brushing a baby's teeth?
As soon as the first tooth appears, without waiting. A newly erupted tooth is immediately exposed to the risk of tooth decay, and its enamel is thinner than that of a permanent tooth.
The first tooth most often appears between six and ten months, but the normal range is broad. Some children get their first tooth at three months, others after one year. Brushing should begin when the tooth erupts, not on a specific calendar date.
Before the first tooth
No brushing is necessary. Wiping the gums with a damp gauze pad is sometimes recommended to get the child used to the motion, but it has no proven effect on preventing cavities.
Which fluoride toothpaste, and how much?
The French Union for Oral Health publishes a table of recommendations by age and level of tooth decay risk, updated in May 2020.
For a child at low risk of tooth decay, the guidelines are as follows.
- From ages 0 to 3: toothpaste containing 1000 ppm fluoride, in an amount equivalent to a simple smear on the brush.
- From ages 3 to 6: toothpaste containing 1000 ppm, in an amount equivalent to a pea.
- From age 6: toothpaste containing 1000 to 1450 ppm.
For a child at high risk of tooth decay, identified by a dental surgeon, the thresholds change sooner. The amount increases to a pea-sized quantity from the age of two, and the concentration to 1450 ppm from the age of three.
Two technical details that affect effectiveness
The first concerns the toothbrush. The UFSBD specifies that fluoride toothpaste should be applied to a dry toothbrush. Wetting the brush dilutes the active ingredient even before it comes into contact with the tooth.
The second concerns duration. The recommendation is two brushings a day, two minutes each. For a very young child, two minutes is a goal, not a requirement. Short, regular brushing is better than long, conflict-filled brushing.
Who should brush the teeth, and until what age?
The adult should do it entirely, until the child has mastered the technique. The fine motor coordination needed for effective brushing is not acquired before the age of six to eight.
The transition happens in stages. The child first brushes alone to become familiar with the motion, then the adult takes over and brushes thoroughly afterward. This two-step approach is the most realistic practice between the ages of two and six.
Brushing becomes easier when it is anchored in a consistent evening routine. This is the same mechanism described in our article on routines, rituals, and emotional security. Bath time often serves as an anchor: our guidance on this moment is detailed in our complete guide to bathing your baby.
The often-underestimated role of sugar
Cavities are not caused by the amount of sugar consumed, but by how often the teeth are exposed to it. Each intake of sugar triggers an acidic phase during which the enamel loses minerals.
Two situations are particularly harmful for very young children. A bottle given at bedtime containing anything other than water exposes the teeth throughout the night. Sugary snacking spread throughout the day increases the number of acid attacks.
These milestones align with those for introducing solid foods, which we covered in our article on introducing solid foods according to ANSES. The question of sweet tastes is addressed in our article on babies' taste and sense of smell.
M'T dents: a covered dental examination from age 3
Health Insurance offers the M'T dents program to children and young people aged 3 to 24. It includes a dental examination and any resulting care, with no upfront costs.
The program is now annual, under the name « M'T dents tous les ans ». Invitations are sent each year by email on the child's birthday, and by postal mail at ages 3, 6, 12, and 18. The examination is covered at 60% by mandatory health insurance and 40% by supplementary insurance, or 100% in the absence of supplementary insurance.
Why 3 years old and not later
Because decay in a baby tooth is neither harmless nor without consequences. It can be painful, interfere with eating, and compromise the space for the permanent tooth that follows. Early detection avoids extensive treatment in a very young child.
What do the official figures say?
Data published by Assurance Maladie in December 2022 show a marked social disparity. Among 6-year-old students, the tooth decay rate reaches 48% in priority education areas, compared with 33% outside these areas.
Worldwide, the World Health Organization report published on November 18, 2022, gives an indication of the scale. Approximately 45% of the world's population, or 3.5 billion people, are affected by an oral disease. Untreated tooth decay is the most widespread condition, affecting approximately 2.5 billion people.
These figures put the issue into perspective. Tooth decay remains, worldwide, the most common chronic disease, even though it is largely preventable.
The most common mistakes
- Waiting until starting school to introduce fluoride toothpaste, even though the recommendation applies from the first tooth.
- Choosing fluoride-free toothpaste as a precaution, thereby depriving the child of the main proven preventive agent.
- Wetting the toothbrush before applying the toothpaste.
- Rinsing thoroughly after brushing, which removes the fluoride remaining on the surface. Spitting is sufficient.
- Sharing a toothbrush between children, or storing it in a closed, damp container.
On this last point, the toothbrush should be replaced approximately every three months, and immediately after an infectious episode.
Fluoride and supplementation: do not confuse the two
The fluoride in toothpaste acts locally, on contact with the enamel. This topical action is recommended as the first line of prevention in young children.
Oral fluoride supplementation in the form of medication requires an individual prescription, following an assessment of the risk of tooth decay and existing sources of fluoride. It should not be improvised, for the same reason as any supplementation for an infant. We illustrated this principle with the case of vitamin D and the risk of overdose reported by ANSES.
Frequently asked questions from parents
Should baby teeth be brushed if they are going to fall out?
Yes. Baby teeth are used for chewing and speaking and guide the eruption of permanent teeth. Early tooth decay has lasting consequences.
My child refuses to brush their teeth. What should I do?
Reduce the pressure and maintain consistency. Change positions, let the child hold their own toothbrush, and brush in two very short sessions. Daily conflict does more harm than a few missed seconds of brushing.
Is swallowed toothpaste dangerous?
The recommended amounts for children under three are precisely calibrated to account for ingestion, which is inevitable at this age. Using a trace amount of toothpaste, rather than a pea-sized amount, is what makes the practice safe.
At what age should a child have their first dentist appointment?
The public program starts at age 3. An earlier appointment is still possible and appropriate in case of doubt, a spot on a tooth, or a family history of multiple cavities.
Key points
Brushing your baby's teeth starts with the first tooth, twice a day, using a trace amount of 1000 ppm fluoride toothpaste until age three. An adult should brush until the child is able to do so, around age six to eight. The first covered examination takes place at age 3 and can now be repeated every year.
Other practical questions about caring for young children are compiled on our frequently asked questions page.
Sources
- French Union for Oral Health (UFSBD), “Fluoride toothpaste” fact sheet, fluoride recommendations, updated May 2020.
- Assurance Maladie (ameli.fr), “M'T dents tous les ans !”: annual dental examination for ages 3 to 24, page updated January 19, 2026.
- Assurance Maladie, press release “Our children’s oral health: a public health issue,” December 9, 2022.
- World Health Organization, “Global oral health status report,” press release of November 18, 2022.
