Crooked teeth are usually genetic, but not in the way you might think. Sometimes, a child inherits their father’s larger teeth and their mother’s smaller jaw—which may cause some trouble. If that’s the case, when the teeth begin to grow in, they start fighting for position because there isn’t enough space for them in the arch of the mouth. That can lead to crowding.

Another reason for crooked teeth might be baby’s habit of sticking his or her fingers in his or her mouth. If baby’s a thumb-sucker, he or she will put his or her thumb tightly between the upper and lower teeth when his or her mouth is closed. That places pressure on the upper front teeth and pushes them out. At the same time, the lower teeth are pushed back into the mouth, which can cause crowding. In some other cases, extra teeth develop, and crowding occurs because there isn’t enough room.

If you’re seeing spaces between baby’s teeth, know that that’s a good thing. If the teeth are all crowded, then it’s very likely that when baby gets permanent teeth, they’ll be crowded too, and then benefit from getting braces. You don’t have to wait for the adult teeth to come in to do something about crowding. Even at a young age, baby’s teeth can be analyzed for deficiencies in arch length so treatment can be started. Children as young as 4 years old could get a removable retainer-like appliance that helps guide the growth of the arches in the mouth so that they can better accommodate the teeth size. Early arch expansion can make orthodontic treatment of the permanent teeth easier and more stable, if it’s even needed at all.

Want to know about caring for baby’s teeth? Get baby used to dental hygiene even before he or she gets his or her first teeth. Once a day, you can gently and carefully swab the inside of his or her mouth with a moistened gauze square or a small washcloth wrapped around your index finger. That way, once the first tooth comes in, baby will already be used to this routine. You can continue to clean the brand-new tooth this way until baby has a few more teeth—that’s when you can introduce the toothbrush. As for using toothpaste, most people believe that baby can’t use it because he or she won’t be able to spit it out. You can actually use a tiny amount of mildly flavored toothpaste with fluoride—a small amount of toothpaste won’t be a problem to ingest. More families are using a xylitol gel to swab baby’s mouth and to brush with—you can use it instead of toothpaste. When he or she gets older, make sure xylitol is one of the ingredients in the toothpaste for extra bacteria protection. Xylitol is a natural sugar that’s good for teeth because it can reduce cavity-causing bacteria by 95 percent with correct usage.

Until he or she is old enough to brush solo, be sure to do it for him or her twice each day. Make sure to gently brush the inside and outside of each of baby’s teeth, and try to also brush the tongue where bacteria collect. If baby’s teeth are crowded or are contacting one another, it’s also important to floss the teeth to make sure bacteria doesn’t get stuck. Try floss picks—they’re surprisingly easy to use on babies.

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