The best way to remove harmful plaque, which is a thin, sticky film with bacteria, is to brush teeth regularly and properly. From 6 to 12 months, your child will get that first tooth and successive teeth. This is when a child should begin using a toothbrush and a very small amount of toothpaste. Begin with that very first tooth, brushing gently all around it. Keep going as baby’s teeth keep coming in. Your baby can’t spit yet, but it is all right that a little fluoride remains in the saliva. Usually by 3 years old, children will learn to rinse and spit. Brushing takes more patience now because babies this age don’t sit still long. The fact that you have already been doing this routine will help your baby recognize and accept a toothbrush in the mouth. Many babies also like the texture of a toothbrush and welcome brushing.
1 to 3 years:
Children do not have the necessary eye-hand coordination to properly brush their own teeth until they are about 5 or 6 years old. As the parent, you get to continue the ritual until they reach the appropriate age. This is the time when you help your toddler recognize that brushing is a lifelong habit. Encourage the routine and be enthusiastic about spending this time together. Talk to your toddler about how to brush to get each tooth clean and why it’s important to brush teeth. While toddlers don’t have advanced communication skills, they often understand way more than parents think. As your toddler is able to understand instruction, teach him or her to spit out the toothpaste after brushing.
6 and over:
Once your child has reached the age where hand-eye motor skills have developed enough for your child to begin brushing independently, continue to supervise regular brushing and encourage proper technique. It’s also time to teach the importance of flossing, and its role in good oral hygiene. Recent news reports have raised questions about the value in flossing, but dentists continue to strongly advise flossing as an effective way of cleaning between and around teeth. Media reports questioned the value of flossing because it hasn’t been proven. However, it has not been a priority for research funding, so its value isn’t as clearly established as brushing the teeth. Even when a child is old enough to brush and floss teeth properly, parental supervision helps ensure regularity and consistent technique. With the arrival of permanent teeth and individual growth, teeth are more tightly spaced in the mouth.
The Brush: The toothbrush should be child-sized with soft, rounded bristles. These soft bristles allow for better reach into crevices between the teeth and gums to remove plaque and avoid damage to the gums. An abrasive brush can wear down enamel on teeth. Therefore, medium and hard bristles are not recommended. Excessive pressure can cause children’s gums to recede.
The Toothpaste: The toothpaste you use should have fluoride. All fluoride toothpastes work effectively to fight plaque, avoid cavities and clean and polish the tooth enamel. Look for the American Dental Association (ADA) seal of approval on the container you purchase. This means the toothpaste’s effectiveness and safety have been approved through clinical trials.
The Fluoride: Depending on the water system in your home or community, your child may not get enough fluoride solely from the use of fluoride toothpaste. If you use bottled water or tap water that is not fluorinated for drinking, your child may need additional fluoridation. If your drinking water is fluorinated, a dab of toothpaste is sufficient. You don’t want to overdo fluoride either.
The Technique: Every mouth is different. Deciding the brushing technique most appropriate for your child is dependent on the position of your child’s teeth and the condition of the gums. Consult your child’s dentist for assistance in determining the best brushing technique. Most dentists recommend a circular technique because going back and forth can contribute to receding gums or sensitive root surfaces. Follow these steps at least twice daily and particularly after meals and snacks:
- Try to use a 45-degree angle with the toothbrush.
- Gently brush a small number of teeth at a time, using a circular motion until the entire mouth is covered.
- Brush the inside and outside of the teeth as well as the chewing surfaces.
- Gently brush the tongue to remove bacteria and freshen breath.
As a parent, it’s important you know what normal development is for your child. Babies typically get the first tooth at 6 to 7 months. It is usually, but not always, one of the lower center teeth. By age 3, most children will have all 20 primary or “baby” teeth. Most of them begin losing baby teeth around 5 to 6 years old, and it’s usually the front teeth first. They continue to lose baby teeth until 12 or 13 years old. When all teeth are in place, a child’s mouth will have 28 permanent teeth. Four molars, also known as wisdom teeth, generally appear between the ages of 17 and 21.
Healthy primary teeth improve the likelihood of your child having strong, healthy permanent teeth. When those primary teeth don’t come in properly or grow incorrectly, they can affect spacing for permanent teeth.
It’s important that you also help your child develop healthy teeth and healthy nutritional habits for good oral health. Help your child develop a healthy body and teeth. Begin at baby’s birth and continue healthy nutritional habits as they grow. The American Academy of Pediatrics recommends breast milk for at least six months, preferably for one year. Establish regular feeding habits early, whether you are bottle-feeding and/or breastfeeding. Take precautions to avoid the possibility of baby bottle tooth decay. Don’t allow your baby to nurse on a bottle of milk, formula or juice while going to sleep. Don’t dip pacifiers in sweet substances, such as honey. As early as your child is able, encourage drinking from a cup.
Some basics to remember:
- Prepare balanced meals.
- Limit snack times.
- Choose nutritious snacks.
- Keep sugary, starchy snacks out of sight and allow them for special occasions only.
- If your child chews gum or you allow soda drinks, choose those without sugar.
If your child develops tooth or mouth problems, don’t ignore them. Even though these are primary teeth, toothaches or mouth irritations can indicate a problem more serious than teething.
Sore gums are normal when a baby or child is getting a new tooth. You can help relieve a baby’s discomfort by providing a teething ring or rubbing the gums. For a small child, rinse the mouth with a solution of warm water and table salt. If the pain still doesn’t subside, you can use an appropriate amount of acetaminophen, or Tylenol. Acetaminophen is a different medicine than aspirin. Do not give your baby aspirin. Aspirin can cause Reye’s syndrome, a serious illness that can lead to death in children under 18 years old.
Pacifiers and thumb sucking can contribute to later oral problems. By age 4, a child should no longer use a pacifier because it may impede proper tooth development. Babies who continue to suck their thumbs as toddlers should be discouraged or redirected because ongoing thumb sucking can contribute to malformed teeth. Another possible condition to watch for is baby bottle tooth decay caused by sugary substances in juices and even breast milk. Tooth decay occurs in toddlers when bacteria within the mouth begin to eat away at the primary teeth. If you notice any signs of early tooth decay, call your pediatric dentist.
Dental care basics
In addition to good brushing, professional evaluation is essential to your child’s oral health. Some pediatricians recommend scheduling an exam as soon as your child’s first tooth comes in; overall, there is agreement that every child should see a dentist for the first time by age 1. Generally, dental exams and cleanings are recommended every six months. However, depending on your child’s development and needs, your dentist may recommend a different schedule.
If you do not have a dentist for your child, consider a pediatric dentist. These specialists have additional training and expertise to care for your child’s teeth, gums and mouth. That training and experience also helps increase the odds that your child will look forward to dentist visits and feel positive about them.
Starting early dental care ensures early detection of possible problems and helps keep potential oral disease from worsening. Here’s what you can expect from your dentist:
- Thorough oral exam
- Cleaning to help prevent cavities
- Assessment for potential problems
- Diet recommendations for healthy teeth
- Education to assure healthy gums
- Counseling, if needed, for possible problems, such as thumb sucking
- Possible fluoride varnish
If caring for your child’s mouth and teeth seems more time consuming than you anticipated, consider the benefits. It may surprise you to know that tooth decay is the most common chronic condition among American children. Obviously, there is good reason to make home care and dental care a priority for your growing child.