Almost half of the three year olds whom I see
for a first dental examination have one or more cavities. Primary (baby) teeth
do not have the enamel-strengthening advantage of fluoride during their
development, because only trace amounts of fluoride pass through the placenta to
the fetus. The primary teeth begin to develop during the sixth week and are
calcifying at twenty weeks during pregnancy. Infants may be infected with the
bacteria that cause tooth decay as early as ten months of age. This occurs when
the caretaker tastes or blows on baby's food or by kissing. The decay-causing
bacteria are transferred in saliva. Constant exposure of the teeth to juices,
milk, or other sweetened drinks, either in a baby bottle or sippie cup, may also
cause decay. Early childhood decay may result in a tendency to experience decay
for the rest of your child's life. Good oral hygiene is just as important for
the primary teeth as it is for the permanent teeth.
Toothpaste should not be used until after two years of age. A match head-sized amount
should be dispensed. Some toothbrushes have a colored area on the brush head to
indicate how much toothpaste to use. Do not permit your toddler to eat
toothpaste from the tube. If your little one does not like toothpaste, do not
use any. The fluoride in toothpaste does help to decrease decay, but sometimes
brushing without toothpaste is necessary. Do not use tartar control toothpaste
until the teen years. There are too many additives.
Toddler's teeth should be brushed at least once each day. Bedtime is always
the most important time to brush the teeth. During the day, saliva flows over
the teeth to aid in removing any food residues. Brushing should be done only by
the parents, not the toddler or pre-schooler. A serious injury can result from
permitting your child to run with a toothbrush in his or her mouth. Once all
20 primary teeth have erupted (come in), begin to brush after breakfast too.
Do not permit your little one to brush first. The benefit of the fluoride in the
toothpaste will be lost. Brushing the toothpaste directly onto the tooth's
enamel surface will add to fluoride's strengthening effect. The toothbrush is
not a toy. Chewing on the bristles will bend them. The brush must be replaced if
this occurs, because it can no longer properly remove plaque. The brush should
have a small, rounded head with soft bristles.
Most parents find brushing in a seated position to be easiest. Sit on the
floor, the bed, or the couch and place your child's head on your lap. If your
toddler is not cooperating, wrap one of your legs around both of his/her legs.
Use your free hand to hold his/her hands. Your child will probably be protesting
with the mouth wide open. Take advantage of the moment and brush! Brushing does
not have to take two minutes. Thirty seconds may be enough time to cover all
tooth surfaces. Do not think about time, just be sure to brush all surfaces.
A back and forth or small circular motion may be used for brushing primary
teeth. Covering every tooth surface is most important. If you brush with the
same pattern every time, you will be more efficient. Begin with the upper right
or left primary molars. Brush from one side of the mouth to the other. Include
the chewing surfaces and the side of the teeth next to the roof of the mouth.
Move on to the bottom primary molars. Brush in the same manner as the upper
teeth, moving from right to left, or vice versa, including the chewing surfaces
and the side of the teeth next to the tongue. Ask your little one to close his
or her mouth and brush the sides of the teeth all the way around next to the
cheeks. Gently pull the bottom lip away from the bottom incisors (front teeth)
and brush upward and away from the gum line. You may notice some light staining
on these teeth when your little one is taking an oral antibiotic.
If there are no spaces between the primary teeth, flossing should begin. The
same reclined position used for brushing should be used for flossing. Pretend
like you are the dentist. This can become a time for not only cleaning teeth,
but a time for desensitizing your child. Each time you brush or floss, he/she
will become more accustomed to being in a reclined position with this activity
occurring in his/her mouth. There are so many varieties of floss. If the teeth
are tight together, use waxed floss. Your child may like the flavored floss,
which also is easy to use with tight teeth. Use a piece of floss the length of
your wrist to your elbow. Wrap the floss around your middle fingers on each
hand. Palms will face upward for the top teeth and downward for the bottom
teeth. Use your thumbs and index fingers to gently slide the floss between the
teeth. In this case, begin with the front teeth first because they are easier to
reach. Wrap the floss in a C-shape around each tooth and use an up and down
motion (not back and forth) to floss. After a short time, you will be a pro! If
you can manage to floss each day, that would be great, but two to three times a
week is adequate.
No matter how much your child prefers to delay
or avoid brushing, do it! It is much better for you to have a battle at home
than for your child to experience early decay and have to undergo dental
treatment at age two or three. In most cases, decay is preventable. Here's to a
cavity-free future!
