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It's an exciting moment when a parent notices that first tooth peeking through in a baby's mouth.

What many parents don't realize is that long before the tooth arrives, they should be working diligently to keep their baby's mouth clean.

And by the time little one celebrates birthday number one, a visit to the dentist is in order.

That's the message the Arizona Department of Health Services is trying to spread around the state to reduce oral disease in infants, children and adults.

About 34 percent of Arizona's children experience tooth decay by age 3, the department says.

Cavities in the teeth of infants and toddlers can easily lead to cavities in permanent teeth later, said RaNee Tuscano, preschool prevention manager in the department's oral-health office. Tuscano is urging pediatricians to tell parents about the importance of early dental care.

"We want their teeth looked at very early because decay starts much earlier than people are aware of," she said. "We now know that decay early in life is a predictor of decay later in life."

An infant's gums should be cleaned daily with a clean, damp washcloth. Once a tooth appears, a baby toothbrush should be used each morning and evening.

If the amount of bacteria on the gums is diminished, Tuscano said there's less risk of the baby getting cavities as teeth come in. Wiping the gums also gets the child used to oral care.

Babies often have bacteria transmitted to their mouths by their mothers or caregivers, who sometimes share spoons or cups with a baby and spread bacteria that way.

"When we're born, we don't have bacteria in our mouths. A parent or caregiver who has a high level of bacteria in their mouths can pass it on to their children," Tuscano said.

Katie Flanders didn't take her oldest daughter to the dentist before she turned 3, but her younger daughter, 14-month-old McKenna, went for the first time Wednesday.

"I didn't know when I had Elenna. I had read somewhere that you were supposed to start when they turned 3," said Flanders.

When Flanders took Elenna, now 4, to Dr. Laila Hishaw's clinic a year ago, she saw a sign on the wall urging parents to bring in babies by age 1.

At Wednesday's visit, Hishaw counted 12 teeth in McKenna's little mouth. The dentist also cleaned her teeth and checked on spacing.

"She did OK. A little bit better than I expected," said Flanders, 31, of her toddler daughter.

Hishaw said if parents wait to visit until a child is nearing pre-school age, cavities may have already moved deep into the tooth. Then a root canal or extraction may be necessary.

"If we see them early enough, we can do a simple little light filling," she said.

Dr. Jerry Caniglia, health services' chief dental officer, said problems with chewing food and talking are only two of the outcomes of tooth loss. When a child prematurely loses what's considered a "baby tooth," he said, permanent teeth often do not grow in properly.

Caniglia said parents should consider that a baby's front teeth are usually not lost until age 7 to 9, and back teeth usually aren't lost until a child is at least 10.

Tuscano said people should choose sweets for their children wisely. Hard candy and lollypops mean more sugar on the teeth for longer periods of time.

Other ways of preventing tooth decay include avoiding fluids that are high in sugar, such as sports drinks and soda. Fruit juice should be limited and given only when it's been diluted, she said.