A baby born early can have teeth that come through later, look a little different, or be more likely to have weak spots in the enamel. Most premature babies grow healthy teeth, and the care is the same as for any baby: clean the gums and teeth twice a day, use fluoride toothpaste in the right amount, and see a pediatric dentist by the first birthday. Because early birth can affect how teeth form, a dental check in the first year is worth doing, and the dentist can tell you whether anything needs watching.

Why can being born early affect teeth?

Baby teeth begin to form before birth, and the permanent teeth start forming around the time of birth. Enamel, the hard outer layer, is laid down in stages. When a baby is born early, or needs intensive care, some of that work happens in unusual conditions. Research on children born preterm points to a few things worth knowing:

Enamel can be thinner or marked.
Defects in the enamel, such as chalky white or yellow-brown patches, are reported more often in children who were born early or were very unwell as newborns. Weak enamel can decay more easily.
Teeth can come through later.
First teeth often appear around 6 months in full-term babies. In premature babies, the timing may follow the due date more closely than the birth date, so a few months’ delay can be normal.
A long period with a breathing tube
can occasionally leave a groove in the roof of the mouth or a mark on the front baby teeth. This is not common, and it is usually seen early by the dentist.
Tooth size may differ.
A systematic review of studies on this topic, co-authored by Dr. Shaima Buhamer, found that permanent teeth tended to be slightly smaller in children born extremely preterm. The authors rated the evidence as moderate, based on a small number of studies, and said the findings should be read with care. It does not mean every preterm child will have small teeth. You can read the review in PLOS ONE.

When will my premature baby’s first tooth come?

For a full-term baby, the first tooth usually appears between about 4 and 12 months. For a premature baby, count from the due date rather than the birth date when you wonder whether teething is late. A baby born 8 weeks early may reasonably get a first tooth about two months later than the usual range.

Talk to your doctor or dentist if there are no teeth at all by around 18 months. Delay is often just a variation, but it is worth a check.

How do I clean my premature baby’s teeth and gums?

The routine is simple, and it starts before teeth appear:

Before teeth
wipe the gums gently after feeds with a soft, clean, damp cloth or gauze.
From the first tooth
brush twice a day, morning and just before bed, with a soft baby toothbrush.
Toothpaste
use fluoride toothpaste in a smear about the size of a grain of rice for children under 3. From 3 to 6 years, use a pea-sized amount. Our guide on fluoride for kids explains the amounts and what to do if your child swallows some.
Night feeds
if your baby still feeds at night, clean the teeth afterward once they have come through. Milk and sugary drinks left on the teeth overnight raise the risk of decay. Our guide on early childhood tooth decay explains why.
Medicines
some liquid medicines for babies contain sugar. If your child takes one regularly, brush afterward or rinse with a little water, and ask your doctor whether a sugar-free version exists.

Babies who spent time in intensive care sometimes dislike having their mouths touched, because they had tubes and tapes on the face. Go slowly, keep it gentle and short, and let your baby get used to it over days. This is something a pediatric dentist can help with.

When should a premature baby see a pediatric dentist?

The advice for every baby is a first dental visit when the first tooth appears and no later than the first birthday. For a premature baby, we are glad to see you at that point or sooner if you have a concern. At the first visit, the dentist will:

  • look at the teeth, gums, tongue and the roof of the mouth,
  • check the enamel for any marks or weak areas,
  • show you how to clean the teeth and how much toothpaste to use,
  • talk about feeding and sugar, and
  • plan how often to see you, which depends on your child’s needs.

Our guide to your child’s first dental visit walks through what to expect.

What should I watch for at home?

Look at your baby’s front teeth now and then, in good light. Tell the dentist if you see:

  • chalky white, yellow or brown patches or lines on a tooth,
  • a tooth that looks pitted, rough or softer than the others,
  • a dark spot or hole,
  • teeth that look very small, or an unusual shape, or
  • a tooth that hurts when your baby eats or drinks something cold or sweet.

These are not emergencies, and they are easier to look after when found early.

When to see a doctor

Book a dental check if you notice any of the signs above, if no teeth have come through by around 18 months, or if brushing is a struggle because your baby is sensitive to touch around the mouth. Go to the emergency department or call 998 if your child has swelling of the face or neck, a fever together with a painful swollen gum, trouble breathing or swallowing, or an injury to the mouth with bleeding that does not stop.

How we can help at myPediaclinic

Dr. Shaima Buhamer, Specialist Pediatric Dentist, and Dr. Mustafa Abdalla, Specialist Pediatric Dentist and Director of the Dental Department, see babies and children for first visits, enamel checks, cleaning and fluoride through our routine cleaning, fluoride and sealants service. Dr. Shaima completed her Master’s in Pediatric Dentistry at Mohammed Bin Rashid University and also carries out research there. You can read more about her work, parent guides and published studies on her personal website, drshaimabuhamer.com. Consultations at our clinic in Dubai Healthcare City are available in English and Arabic.

Frequently asked questions

Do premature babies get their teeth later?

Often a little later by birth date, but usually on time when you count from the due date. A baby born 8 weeks early may get a first tooth about two months after the usual range. If there are no teeth by around 18 months, ask your doctor or dentist to check.

Are premature babies more likely to get cavities?

Some are, mainly because the enamel is more likely to be weak or marked, and because feeding routines, medicines and long hospital stays can make cleaning harder. Good cleaning, fluoride toothpaste and early dental visits lower the risk.

What are the white or brown marks on my baby’s teeth?

They can be enamel defects, where the enamel did not form fully, or early signs of decay. A pediatric dentist can tell which, and can advise on protecting the tooth. Do not try to scrub the marks off.

Will my child’s permanent teeth be smaller if they were born early?

Maybe slightly in some children, especially those born extremely early, according to a systematic review of a small number of studies. The evidence is moderate and the difference is usually small. The dentist will watch tooth development at your visits, and most children need nothing beyond routine care.

When should my premature baby first see a dentist?

When the first tooth appears and by the first birthday at the latest. If you are worried about your baby’s teeth or enamel, you can come sooner.

To book, message us on WhatsApp at 052 218 1662 or call reception on 04 430 5926.