Dr. Helen Mo with pediatric patient

Dr. Helen Mo

Recent discussions by the federal administration about increased regulation of fluoride use—such as in public water—have left many parents wondering how best to protect their children’s oral health. A 2025 JAMA Health Forum study estimates that removing fluoride from water systems could lead to 25.4 million additional decayed teeth and $10 billion in extra dental care costs over the next five years. This potential change highlights the importance of revisiting oral health strategies parents can take to safeguard their children’s teeth.

I spoke with a pediatric dentist, Dr. Helen Mo, about the knowledge gaps and myths she addresses most often in clinic. From sensory desensitization to breastfeeding myths, here’s what every parent should know.

Early Oral Health Builds Comfort and Confidence at the Dentist

“Oral care can start before your baby even has teeth,” says Mo. Early routines aren’t about removing plaque yet; they’re about helping babies become comfortable with sensations in and around the mouth. This reduces oral hypersensitivity and sets the stage for smoother brushing once teeth emerge. “Starting early also builds a routine for both your baby and yourself,” she adds. Using a clean cloth, gauze, or a silicone finger brush along the gums is a gentle way to begin. The goal is simply to help your child feel comfortable with someone else in their mouth before a toothbrush enters the picture.

This early comfort matters long-term. A 2016 study found that parents who feel confident and positive about their infant’s oral-care routine are far more likely to maintain consistent, healthy mouth-cleaning habits as their child grows.

That same idea, comfort through familiarity, applies to dental visits. “The American Academy of Pediatrics and American Academy of Pediatric Dentistry recommend a first dental visit by age 1 or within six months after the first tooth,” Mo notes. Many families delay, assuming toddlers won’t tolerate the experience, but pediatric dentists emphasize that the earlier a child is introduced to the dental setting, the easier and less intimidating it becomes. Early visits build confidence, reduce fear, and allow clinicians to catch issues before they escalate.

For children with autism or sensory sensitivities, these early “sensory visits” are especially valuable. Progress may be incremental, and consistency is key. Sometimes Mo begins by having a child simply enter the waiting room; the next visit may focus on letting the dentist look at their teeth. The goal is to build trust, predictability, and a relationship with each patient, especially those more prone to overstimulation.

Bottles, Breastfeeding, and Thumb-Sucking: What Actually Matters

Infants soothe themselves through sucking, thumbs, fingers, pacifiers, or breastfeeding, and none of these habits are inherently harmful. An infant’s sucking need is completely natural. Mo shared with me that her children started sucking their thumbs in utero. As a dentist who recognizes her duty to eventually recommend discontinuing oral habits, she still understands the weaning process can have large impact on the patient and the family.

“Not every child who uses a pacifier or thumb will have bad teeth,” Mo says, “and there are many benefits to help your baby soothe.” However, depending on the intensity and duration of this habit, the shape of the jaws can shift. “Persistent sucking can apply unfavorable forces to the teeth and jaws,” she adds. For the teeth, this can lead to an anterior open bite, posterior crossbite, misalignment of the teeth, and protruding front teeth. For the jaw, patients can have restriction of proper growth, which can affect a child’s swallowing pattern and overall tongue positioning.

Few topics spark more confusion and controversy than the relationship between breastfeeding and dental decay. Mo understands the complexity of guiding breastfeeding parents on oral health and habits. “Breastmilk alone does not cause cavities, and parents of exclusively breastfed infants should not feel alarmed,” Mo reassures.

“A baby’s health and nutrition are important and nighttime feeding is necessary for some.” That being said, she still notes the risk of children developing cavities, especially if teeth are not cleaned at bedtime and a baby has overnight feedings.

How Genetics Influence Oral Health

Parents often assume cavities are predetermined by family history. Genetics do influence enamel quality, saliva composition, teeth alignment, and microbiome—but they don’t override daily habits, such as flossing and brushing teeth.

“Cavities are a multifactorial disease,” says Mo. She recommends brushing, flossing, increasing water intake, limiting sugar and sticky-food exposure, and reducing the frequency of snacking. Dentists like Mo caution against snacking allows, “more opportunity for the teeth to be bathed in an acidic environment,” a major driver of tooth decay.

Why Baby Teeth Are Not Disposable

Many parents believe cavities in baby teeth are inconsequential because those teeth will eventually fall out. “But some baby teeth remain until age 12 or beyond,” Mo reminds us. And studies show that dental disease in early childhood can cause pain, infection, speech challenges, and missed school days.

She also wants parents to know that crowded baby teeth may signal limited space for future adult teeth, though mild cases often resolve naturally. If parents or general dentists are concerned, she recommends an evaluation with an orthodontist around age seven, “not to apply braces immediately, but to assess jaw growth and catch issues while early intervention is still possible.”

In addition to cavities, young children are susceptible to dental trauma. Dental injuries can look frightening because they often bleed heavily, but staying calm helps parents assess what’s truly happening. “Comfort your child, clean the area, and determine whether the injured tooth is baby or adult,” says Mo, “since knocked-out baby teeth should not be replaced, while adult teeth must be placed back in the socket or stored in milk or saliva and taken to the dentist immediately.”

The Takeaway about Oral Health for Parents

Most pediatric dental issues are preventable, though evidence-based education for parents can support a child’s oral development. As more decisions are being considered about oral health and fluoride, parents should remember that early routines at home and visits to the dentists will always remain critical to healthy smiles.