By Chris Woolston, M.S.
When should my child start brushing?
Clean your child's very first teeth by rubbing them gently with a damp piece of gauze. But when the first molars come in, usually by the age of ten months, it's time to start daily brushing. Use a soft-bristled brush and water. Move the brush back and forth gently in short strokes, making sure you reach the front, back, and chewing surfaces of all teeth. Be extra careful around her tender gums.
The American Dental Association and the American Academy of Pediatric Dentistry don't recommend using fluoride toothpaste until your child is two to three-years-old, and then you should only use a pea-sized amount, making sure your child spits it out and doesn't swallow it. When choosing a toothpaste, be sure to check the label -- some are not recommended for children under six years old.
How can I help my older child brush?
Until your child is old enough to handle a toothbrush on her own -- probably when she's around six --you'll need to do the actual brushing. Again, use a soft-bristled toothbrush and a pea-sized dab of fluoride toothpaste. When the child turns three, start brushing twice a day, once after breakfast and once before bed. Even when she starts brushing her own teeth, she still needs a parent to supervise until she's seven or eight. As long as you're standing there, why not pick up a brush and join her? Foaming at the mouth together is fun, and your child will pick up on your good habits.
Will my child be getting too much fluoride?
Young children who swallow large amounts of fluoride toothpaste can develop fluorosis, which leaves harmless but unsightly white patches on teeth. Fluorosis only strikes teeth that are still forming under the gums, so it doesn't affect older children or adults. If you're conscientious about using only a pea-sized portion of toothpaste and make sure she doesn't swallow, there's little likelihood your child will ever develop fluorosis.
Usually the greater risk is that a child will get too little fluoride. If you live in an area where fluoride isn't added to the water, your child's dentist may recommend giving her fluoride drops or lozenges to help prevent cavities.
Can my child get an overdose of fluoride toothpaste by eating it out of the tube?
Yes. The candy-flavored varieties may be tempting for some toddlers (and even older kids), so be sure to keep it high out of reach. Ingesting a large tube of fluoride toothpaste can be dangerous, so call a poison control center or get emergency help immediately if you suspect your child has ingested too much toothpaste.
Does my child need to floss?
Children need flossing as soon as they have two teeth that touch together. Many children under six will need help, of course. After your child's teeth are brushed, wrap a length of floss tightly around two of your fingers, and guide it between your child's teeth using a gentle rubbing motion. Slide the floss up and down along the side of each tooth, and clean the gumline by carefully sliding the floss under the gum in the space between the gum and tooth.
When should my child first see a dentist?
The American Dental Association recommends taking children to the dentist as soon as the first tooth erupts, or by their first birthday whichever comes first. This gives dentists an opportunity to spot the beginnings of tooth decay and teach parents how to care for their child's teeth. The American Academy of Pediatrics agrees that children should make their first trip to the dentist no later than their first birthday.
What foods cause cavities?
Anything sweet, starchy, or extra sticky can promote cavities, especially if your child grazes on these foods throughout the day. Try to limit your child to two or three snacks a day, and encourage her to eat raw fruit, vegetables, nuts, and nonsugary drinks. If the child still drinks from a bottle, it's crucial to avoid letting her spend hours sipping sweet liquids such as juice, soda, or even milk. (Letting a child suck on a bottle in bed is really asking for trouble, both for dental reasons and because it could also cause choking.)
Could sucking on a thumb or pacifier hurt my child's teeth?
For children under four, these behaviors are harmless. But those children who keep on sucking into their kindergarten years can end up with permanent teeth that are misaligned. A dentist can tell you if your child's habit is likely to cause trouble.
American Dental Association. Babys first teeth. http://www.ada.org/prof/resources/pubs/jada/patient/patient_11.pdf
American Academy of Pediatrics. Dental care for your baby. http://www.aapd.org/publications/brochures/babycare.asp
American Dental Association. Quick Tips for Parents and Caregivers of Young Children. http://www.ada.org/public/topics/parents/parentips.html
American Academy of Pediatric Dentistry. Parent Information. http://www.aapd.org/parents/faqs.html
American Academy of Pediatrics, A Guide to Your Child's Dental Health
American Academy of Pediatrics, Tooth Development
American Academy of Pediatric Dentistry. Frequently Asked Questions. http://www.aapd.org/pediatricinformation/faq.asp