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Pediatric Dental Hygiene

Many parents have a tough time judging how much dental care their children need. They know they want to prevent cavities, but they don’t always know the best way to do so. Here are some tips and guidelines.

When Should Kids Start Brushing Their Teeth?

Good dental care begins before a baby’s first tooth appears. Just because you can’t see the teeth doesn’t mean they aren’t there. Teeth actually begin to form in the second trimester of pregnancy. At birth, your baby has 20 primary teeth, some of which are fully developed in the jaw.

Here’s when and how to care for your child’s teeth:

  • Before your baby starts teething, run a clean, damp washcloth over the gums to clear away harmful bacteria.
  • Once your baby gets teeth, brush them with an infant toothbrush. Use water and a tiny bit of fluoride toothpaste (about the size of a grain of rice). Use fluoride toothpaste that carries the American Dental Association’s (ADA) seal of acceptance. (If you are using baby toothpaste without the fluoride, keep it to the same amount because you still want to minimize any toothpaste that is swallowed.)
  • Once your baby’s teeth touch, you can begin flossing in between them.
  • Around age 2, your child should learn to spit while brushing. Avoid giving your child water to swish and spit because this might make swallowing toothpaste more likely.
  • Kids ages 3 and up should use only a pea-sized amount of fluoride toothpaste.
  • Always supervise kids younger than 6 while brushing, as they are more likely to swallow toothpaste.

Even babies can develop tooth decay if good feeding habits aren’t practiced. Putting a baby to sleep with a bottle might be convenient, but can harm the baby’s teeth. When the sugars from juice or milk remain on a baby’s teeth for hours, they can eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted, or discolored front teeth are signs of bottle mouth. Kids with severe cases might develop cavities and need all of their front teeth pulled (permanent teeth will grow in later).

When Should Kids See a Dentist?

The ADA recommends that children see a dentist by their first birthday. At this first visit, the dentist will explain proper brushing and flossing techniques and do a modified exam while your baby sits on your lap.

These visits can help find problems early and help kids get used to visiting the dentist so they’ll have less fear about going as they get older. Consider taking your child to a dentist who specializes in treating kids. Pediatric dentists are trained to handle the wide range of issues associated with kids’ dental health. They also know when to refer you to a different type of specialist, such as an orthodontist to correct an overbite or an oral surgeon for jaw realignment.

If a child seems to be at risk for cavities or other problems, the dentist may start applying topical fluoride even before all teeth come in (this also can be done in the pediatrician’s office). Fluoride hardens the tooth enamel, helping to ward off the most common childhood oral disease — dental cavities (also called dental caries).

How Can We Prevent Cavities?

Cavities happen when bacteria and food left on the teeth after eating are not brushed away. Acid collects on a tooth, softening its enamel until a hole — or cavity — forms.

Here’s how to keep cavities away:

  • Start good oral habits early. Teach kids to brush at least twice a day with fluoride toothpaste and to floss regularly.
  • Get enough fluoride. Regular use of fluoride toughens the enamel, making it harder for acid to penetrate. Although many towns require tap water to be fluoridated, others don’t. If your water supply is not fluoridated or if your family uses purified water, ask your dentist for fluoride supplements. Most toothpastes contain fluoride but toothpaste alone will not fully protect a child’s teeth. Be careful, however, since too much fluoride can cause tooth discoloration. Check with your dentist before supplementing.
  • Limit or avoid certain foods. Sugary foods, juices, candy (especially sticky gummy candy, gummy vitamins, or fruit leather or “roll-ups”) can erode enamel and cause cavities. If your kids eat these foods, have them rinse their mouth or brush their teeth after eating to wash away the sugar. The same goes for taking sweetened liquid medicines: always have kids rinse or brush afterward.

Looking Ahead

As children grow, plan on routine dental checkups anywhere from once every 3 months to once a year, depending on your dentist’s recommendations. Keeping sugary foods in check, encouraging regular brushing and flossing, and working with your dentist will lead to good dental health.

Reviewed by: Rupal Christine Gupta, MD

Date reviewed: May 2015

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