Dental Care A Lesson Best Learned Early In Life 

February Is National Children's Dental Health Month 

The teeth in a young child's mouth may not be permanent, but they require as much care as an adult's - and neglecting them can have lifelong consequences.

That is why dentists recommend brushing a child's teeth from the minute the first one comes in, and maybe even before that.

February is National Children's Dental Health Month, and dentists are taking the opportunity to promote a strong dental cleanliness routine from infancy onward.

About 20 percent of children have tooth decay by age 3, says Dr. Mary Hayes, a Chicago dentist and a spokeswoman for the American Dental Association (ADA). And just because the teeth are temporary does not preclude a child from suffering the pain of cavities.

"The primary molars in the back that children get between ages 2 or 3 are in the mouth until the child is 11 to 14," Dr. Hayes says. "Temporary is a long time. It's not just a few months."

Those baby teeth also help guide the permanent teeth into position, explains Dr. Jeff Phillips, a pediatric dentist in Salem, Ore. Any disease in the baby teeth, including mouth or tooth infections, can lead to expensive orthodonture later in life, he says.

Cleaning, Flossing Begins at an Early Age

Parents might want to consider getting their infants used to having their teeth cleaned by running a wet washcloth around their mouths before the first tooth comes in, Dr. Hayes says.

"You can clean their gum pads," she says. "You want to get the child used to the idea that manipulation of the mouth is part of their cleaning routine."

If not then, parents should definitely start cleaning their child's teeth from the very first one.

"As soon as a tooth comes into the mouth, it needs to be cleansed," Dr. Phillips says.

The ADA states parents should clean their infant child's teeth with a child-sized toothbrush and a little water.

Dr. Phillips says a cloth can be used as well. "A lot of pediatricians are telling people to get in the habit of using a wet washcloth at bath time, prior to bathing," he says.

Parents might find it easier to clean a young child's teeth if they do it in a more comfortable setting than the bathroom, Dr. Phillips says.

He suggests cleaning their teeth on a couch or bed if it helps settle them down. Parents also can sing a song or count while they are cleaning their child's teeth to help keep them distracted.

Flossing should begin when two of the child's teeth begin to touch.

There is more parents can - and must - do. They should encourage their children to drink from a cup by their first birthday. Research has shown that extended use of a baby bottle can increase a child's risk of tooth decay.

Once a child is 2 years old, parents can begin using a pea-sized amount of toothpaste on the toothbrush. At that age, they are able to spit out the toothpaste and not swallow it.

Children have to be as old as age 6 or 7 before they can take over their own brushing chores. That is when they will have the fine motor skills necessary to do an adequate job.

"When they can write an entire page of cursive, they have the motor skills to brush their own teeth," Dr. Phillips says.

Visit the Dentist in Baby's First Year

The ADA recommends a child's first visit to the dentist take place within six months of the eruption of the first tooth, and no later than their first birthday.

"You want to get good advice as soon as possible," Dr. Hayes says. "If I give good advice to parents early, I'm less likely to see problems in their children later on."

After the first visit, parents should schedule regular cleanings on six-month intervals.

Besides brushing, parents can also ensure their children's dental health by watching what they eat. Breads, pastas, and sugary snacks or drinks, in particular, should be avoided as often as possible, with brushings as soon as possible after these foods have been eaten, Dr. Hayes says.

"While you're satisfying your child's taste buds, you are allowing the bacteria that causes tooth decay in your child's mouth to flourish," she says.

Dr. Phillips says parents should check to see if the water in their home is fluoridated. If it is not, they should ask their physician or dentist to prescribe a fluoride supplement for their young child. After age 5, children can use off-the-shelf fluoride mouth rinses.

Parents also might want to ask their child's dentist about sealants, which provide a thin protective barrier that shields the chewing surface of back teeth against tooth decay, Dr. Phillips says.

Always consult your child's dentist for more information.

Online Resources

American Academy of Pediatrics

American Dental Association

Centers for Disease Control and Prevention (CDC)

National Institutes of Health (NIH)

National Library of Medicine, at NIH

February 2004

Dental Care A Lesson Best Learned Early In Life

Cleaning, Flossing Begins at an Early Age

Visit the Dentist in Baby's First Year

Proper Technique for Teeth Brushing

What Toothbrush Is Best?

How Often Should a Child Brush?

Online Resources

Other Resources:

Find a St. John's Mercy Physician

Children's Services at St. John's Mercy

Children's Health Information

St. John's Mercy Classes and Programs

Proper Technique for Teeth Brushing

Because every mouth is different, there is more than one technique of brushing that has proven to be effective.

Deciding which technique is most appropriate for your child depends largely on your child's teeth positions and gum condition.

Consult your child's pediatric dentist to determine which brushing technique is most appropriate for your child's mouth.

Generally, most dentists recommend a circular technique for brushing. This includes brushing only a small group of teeth at a time and gradually covering the entire mouth.

The importance of maintaining a circular or elliptical motion is emphasized as using a back and forth motion may cause a receded gum surface, an exposed and tender root surface, or a wearing down of the gum line.

Instead, dentists recommend the following method: 

• Step 1: Place the toothbrush beside the teeth at a 45-degree angle.
  
  
• Step 2: Gently brush teeth, only a small group of teeth at a time (in a circular or elliptical motion), until the entire mouth is covered.
  
  
• Step 3: Brush the outside of the teeth, inside of the teeth, the chewing surfaces, and in between each tooth.
  
  
• Step 4: Gently brush the tongue to remove bacteria and freshen breath.
  
  
• Step 5: Repeat steps one through four at least twice daily, especially after meals and snacks.
  

What Toothbrush Is Best?

A toothbrush head should be small - about 1 inch by 1/2 inch - and should have a handle suitable for firm grasping.

The bristles of the brush should be soft, nylon, and rounded at the ends.

This helps ensure that the brush bristles are reaching the spaces between the teeth as well as the surface. Some brushes are too abrasive and can wear down the enamel on teeth.

Thus, in most cases, medium and hard bristles are not recommended.

How Often Should a Child Brush?

Generally, brushing is recommended twice a day for at least three to four minutes each time. People generally think they are brushing long enough, when, in fact, most people spend less than one minute brushing.

In addition, it is generally better to brush three to four minutes, twice a day, instead of brushing quickly five or more times throughout the day.

Dentists advise brushing teeth during the day while at school or play. Keeping a toothbrush handy in a backpack  increases the chances that a child will brush during the day.

Always consult your child's dentist for more information.