Dental Health/When to see the Dentist/Toothbrushing Hacks |
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Parents often ask about when their child needs to start seeing a dentist. Those questions are commonly accompanied with follow ups about toothbrushes, toothpaste, brushing hacks etc. I asked my favorite SF pediatric dentist, Dr. David Rothman, to weigh in. When is the best time for your child to establish a relationship with a dentist? The current official recommendation is that your child should have his or her first dental visit by age one or roughly six months after the eruption of that first tooth. Dr. Rothman says that for him, that first early visit is less about the actual exam and more for reviewing the current science of oral hygiene and getting you and your child set for a cavity free future. It’s a great time to ask questions and up your knowledge. Surprising things are often shared! During subsequent visits, along with checking your child for dental decay, the dentist will talk to you about cleaning your baby's teeth. They might also talk to you about tooth friendly diets and proper nutrition for keeping baby teeth healthy. If you have any concerns about the manner in which the teeth are erupting, having a dentist who is familiar with your child will be very useful. One extra perk about routine dental care is that you might walk out of the dentist's office with a new toothbrush! FINDING A DENTIST There are plenty of good general dentists out there, but my preference is to find one that specializes in pediatrics. Often their waiting rooms, offices and equipment are designed to put your child at ease. As you start your search, knowing how they handle after-hours emergencies is important. Kids have accidents! (somehow these things wait until after standard office hours are over for the day.) Over the years I have had countless frantic parents reach out to me about chipped or loose teeth after a fall. I usually suggest that they contact their dentist on those occasions, and the folks that already have an established relationship with one are way ahead of the game. If there is a dental emergency, early intervention can be the difference between saving the tooth or losing it. One more consideration is If you have a child with sensory issues or any special needs, ask about what accommodations they have. What about covid? Having regular dental checkups should not be put off due to COVID or flu season. Good dental offices are on the front lines of practices who deal really well with infection control. They have been using masks, gloves and face shields long before this pandemic. There are still some special requirements for hospitals, medical and dental offices including mask wearing. If your child has a compromising medical condition please let the dentist’s office know before you show up and special accommodations can be made. Why is it so important to have routine dental care? It is much easier to prevent decay in toddlers' teeth than to fill a cavity in a young child. Tooth decay is the most common chronic childhood disease and it can be prevented. People not going in for their routine dental visits corresponds with an increase in cavities and gum disease. This became apparent during the several years of the pandemic when many folks skipped these important appointments. At the same time, many healthy diet routines went down the drain. The number of kids with cavities went way up. The numbers are improving now that we are slowly getting back to normal but 18% of school aged children still have cavities.
As parents, we may think, "baby teeth fall out, so we don't need to worry about them." This sounds logical, but unfortunately is not true. Dental science has found out many new facts about how to prevent dental decay. We now know that bacteria causes tooth decay. This "bad" bacteria can find its way into your babies mouths in many ways. Eating foods high in sugar is one of the most obvious offenders. Germs love sugar to grow and make their colonies in dental plaque on all surfaces including between teeth (here’s winking at you, floss). In order to prevent decay in our adult teeth, baby teeth have to be kept healthy as well. Toothbrush options and considerations Training your child from an early age that teeth get brushed is a good way to create good dental habits that will last a lifetime. For young babies, there are little flavored towelettes specially formulated for wiping baby teeth. Spiffies was the first of these that I was familiar with. Now there are several brands available. You can also use a soft piece of gauze or a wet washcloth. Not only are you cleaning off the teeth, (breast milk does have sugar) but you are getting the baby used to a routine. As a transition to a toothbrush, some parents find success using a soft finger brush. These fit over your finger and if your baby will let you, this option allows you to get in there and do a nice thorough job.
When you graduate to a regular toothbrush, there are lots of choices. I asked Dr David if he has a favorite. His answer? The one that you actually use is the winner, whether powered or not! Make sure the one you pick has soft bristles. When you brush, brush very gently. The bristles should barely bend. Brush in circles to prevent damaging the sensitive gums. Regardless of which brush you use, replace it when it looks like the bristles are getting worn. It is also a good idea to run all the family toothbrushes through the dishwasher every once in a while especially after the child has a cold or strep. Younger children will have an easier time handling a toothbrush with a thicker handle. Perhaps you can let your child be in charge for one brushing a day and the parent be in charge of the other; that way you know you are doing a more thorough job at least once a day. Some people use a two toothbrush approach. Toddler gets to hold one, but so do you. Both of you can be in there at the same time or take turns. Ideally, try to brush twice a day and floss once a day (for teeth that are touching). Brushing is supposed to last 2 minutes. That might feel like a long time, but that is how long it takes for the fluoride to have a real effect. Consider putting a little tune on while you brush. This can act as a timer. Seriously, music makes a big difference. Brushing can be a little more fun and interactive nowadays with some fun toothbrushes and apps. Sonicare-for-kids-sonic-
Some of these apps are pretty high energy. Make sure you don’t let things be too active. Running and jumping around with a toothbrush in the mouth could cause injury. It happens. Focus on positive attention. “Mommy/Daddy are going to help you get rid of those silly tooth germs. Let’s chase them off the teeth with the brush” “Ooh look at how bright and sparkly your teeth look!” On days where they don’t seem to be as cooperative, sometimes a 15 second brushing is going to be all you get. I would try hard NOT to give a lot of negative attention. A small drop of toothpaste with fluoride is better than nothing. In any case, do the best you can. It is quite normal to have good days and bad days. Toothpaste considerations It is important to use a toothpaste that is non abrasive: Most kids' brands are specially formulated to be gentle. Some adult ones are fine. Some toothpastes will have the abrasive rating noted on the package but it isn’t always easy to find. Please remember to use an ADA Seal of Acceptance toothpaste to verify safety and efficacy. Be wary or questioning of ones that don’t. The American Dental Association recommends using a tiny amount (just a little dab) of fluoride toothpaste. It is important to note that too much can be harmful so keep the amount as small as a grain of rice. Once kids get to be over two and can spit it out after brushing, you can increase to a pea sized amount. While there may be some discussion over whether or not fluoride is safe, the Centers for Disease Control and Prevention clarifies that fluoride is a naturally occurring mineral. When applied to teeth, fluoride strengthens enamel and prevents cavities that can form after eating sugar and other refined carbohydrates. It has been added to some toothpastes and water systems since the 1950s and has tested and proven benefits. Be aware that most water filters remove fluoride to some degree. Bottled waters have little or no fluoride. Xylitol is another recommended ingredient for dental health. It is found in some toothpastes. While it does not have the same positive impact on the enamel that fluoride does, this natural sweetener is found to help reduce bacteria and strengthen tooth enamel. It is also toxic for pets, so make sure your dogs and cats don’t have access to any xylitol products Flossing is important too Once your kids have teeth that are close together, flossing is an important part of dental hygiene. This may not actually be an issue until they are 2-3 years old. Just as an aside, our grandson Elliot is delighted by floss. If you aren’t watching him carefully he can pull out yards and yards of it in the blink of an eye. However once he has a piece, he actually lets me get in there and do a little flossing. Elliot also likes to use the little hand held flosser picks. Is he actually accurately flossing in between every tooth? Probably not, but again, it's about habits. I hope he keeps it going! What can you do to keep your child's teeth healthy right from the start? Pay attention to habits that may or may not be good for your teeth. Children who are “grazers” tend to have more cavities than those who eat less frequently. Saliva neutralizes the acids in the mouth and actually ‘washes’ the teeth, but it needs about 2 hours in between meals to work. If someone is constantly snacking, the saliva isn’t getting a chance to do its job.
It will come as no surprise to anyone that foods that are high in carbohydrates and sugar are not healthy for our teeth or general health. A daily intake of 60 grams of carbs or higher more than doubles your chance of getting caries (and all that sugar can lead to type II diabetes in kids!) Carbonated, acidic drinks can be hard on the enamel even if they aren’t sugary.
Regular dental care can actually save you money Some parents avoid taking children to the dentist to save money, yet studies show that the dental costs for children who have their first dental visit before the age of one are 40 percent lower in the first five years of life than for those who do not see a dentist before their first birthday. Consider this when deciding whether or not to add your child to your dental plan (if you are lucky enough to have one.) Is your child one of the many who has never seen a dentist? Don't waste your time feeling shame or guilt. You can’t manage the past. Do your best starting now to change that. If you are overdue for a dental check up, or realize that your family tooth hygiene regimen could use some improvement, take a step in the right direction. Identify one little baby step that you can take to change that and start today!
Extra tips from the Oath community Andrea shared, What I started when my little one was 2 months old was running a wet washcloth on my son's gums once a day, then when he got teeth I just started brushing them with baby friendly toothpaste. After I brush his teeth, I then let him "brush" his teeth as well Amina likes the Frida Baby toothbrush. She also thinks that having her little one watch the parents brush every night helped establish a solid habit. Being a good example doesn’t stop when they are toddlers. Lindsay says that her 5 year old watches and imitates his parents when they are brushing. This is a great way to show them the right angles and directions. Don’t forget to brush the tongue. Arianna shared: My 19 month old was fighting tooth brushing for a bit. Firstly I made sure to brush her teeth even if she cried or complained about it. She stopped fighting it after a few days. Second, we’ve been practicing words and sounds so we both go “Aaaaahhh” and I brush sections at a time. I give her lots of high fives and positive reinforcement when we’re done. Then I let her suck on it and play with the toothbrush if she wants. Jody V, Oaths speech and language specialist shared At our home we do 2 brushes, one that my son gets to do, and then I get to "double check" and sing the ABC's while brushing his teeth. It allows for some independence while also making sure those chompers get the right scrubbing. He's absolutely loved it since he was a little one...plus side is learning his ABC's while brushing his teeth :). Megan added When my kids were little and had a hard time reaching the sink - it was most fun to let them spit in the tub! They thought it was silly and I could spray the tub down easily! Sometimes adding something novel and fun will help keep the tooth brushing habit easier to maintain. Pauline added We love Hello Toothpaste for kids! My little one likes to play pretend with me being the “dentist” when she is having a hard time with brushing. I make all the sound effects possible to entertain her (when I'm not tired of course) . We also alternate between two different colored brushes and toothpaste flavors so that I can give her a choice of what color and flavor she would like…it keeps it much more interesting for her. Oath’s Pediatric Nurse Alice really likes the Thanks So much to Dr. David Rothman for being my go-to pediatric dentist! |
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