Successful toddler tooth-brushing should win an X Games medal. I’m not kidding when I say that, for me, it was absolutely the most exhausting part of child-rearing—and we had to do it TWICE A DAY! Brushing a young child’s teeth requires tenacity, physical prowess, and an ungodly amount of negotiating skills. Steve Irwin wrestling an alligator had nothing on me as I pinned down my child, while insisting that my shoving a bristled stick into his tiny mouth was good for him.
As you can probably ascertain, I’m traumatized, and I’m guessing a few of you may be too. Which begs the question, is it really worth it to care for primary teeth at all? Why should we put so much effort into something that is only going to fall out anyway? Can’t we just treat baby teeth as a sort of “dry run” and let them fall out if needed? And, if we really do need to take baby teeth seriously, how do I make this unpleasant activity worth it in the end? We spoke to a few experts to get to the answers.
Why starting young matters
If you’ve been dealing with tears over teeth-brushing, take heart: It’s all been worth it. Research shows that the health of primary teeth is an early predictor of how healthy your child’s adult teeth will be.
The dental experts we consulted all say that not only is the care of primary teeth worth it, not caring for them can be far more detrimental than we thought. In fact, tooth decay can lead to—or exacerbate—a host of health problems and baby teeth with decay can infect emerging permanent teeth.
“The bacteria in the mouth can certainly affect the development of primary teeth,” says Gregory W. Olson, professor and chairman of pediatric dentistry at UTHealth School of Dentistry in Houston. “Once decay spreads beyond the teeth and into the bones it can be very, very serious.” Olson says you need to treat any decay in baby teeth in order to halt the progressing decay and maintain an infection-free environment for the permanent teeth to develop. The existing bacteria from a rotting baby tooth—or teeth—can invade developing permanent teeth if not treated thoroughly, leading to a lifetime of cavities.
Ray J. Jurado, division head of dentistry at Ann & Robert H. Lurie Children’s Hospital in Chicago, says it’s important to start good habits as early as when the first baby tooth emerges. He says you can start off by wiping the tooth with gauze or brushing it with a finger bristle. “Just get them feeling comfortable with the feeling and routine at a young age, that way you’ll have less to fight once you introduce a toothbrush,” he says.
Remember that sugar + time = cavities
If you think you can take your kids to a sugar-filled party and let them pass out in bed without a proper tooth-brushing, think again. According to Jurado and Olson, the single most important thing for parents to remember when caring for their children’s’ teeth is that the longer sugary substances remain on the teeth, the more prone those teeth are to decay.
That’s something to think about if you use sticky candy as bribery to get your child out the door. “A sucker, juice, gummy bears—those are the things you want to get off the teeth as soon as possible,” says Jurado. He recommends brushing teeth after breakfast and, if you can, soon after sticky and sugary sweets are consumed.
Jurado says that if you really do rely on sweets to motivate your child (ahem, me), a sugar-free Xylitol lollipop could be your answer. “It has been known to cause stomach upset in some kids, so definitely keep an eye on that. But, if your kid does well with Xylitol, they are a really good option and gaining popularity.”
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Proper brushing technique is key
While many of us may think it’s just fine to let a little one chew on a toothbrush for a few minutes and chalk that up as teeth-cleaning, it’s really not. Teaching kids proper technique, and that they need to pay attention to all surfaces of a tooth, is important.
Olson says to make sure you get a toothbrush that is properly sized for a tiny mouth, as “a too-big toothbrush will be cumbersome and will cause confusion in a small child.” Jurado says you can take it one step further by investing in a kid-sized electric toothbrush. He says it will help a less coordinated child accomplish more in a shorter period of time and will allow a parent to quickly go in to finish up the job.
Both doctors say that kids will fight, but it’s a necessary evil. “Keep at it and they’ll get used to it over time. If you don’t stick with it, it’ll be harder when they are 9 years old and not doing it on their own,” says Jurado. He says that being a good model helps, so make teeth-brushing bonding time and let them mirror what you are doing. “It might take a year or two before they can mimic, but they’ll get there.”
Since kids generally hate brushing, it can be really hard to know at what age they should be adept at it. I was certain that our son wasn’t catching on to the proper technique because he hated brushing his teeth, but it turned out his teeth-brushing skills were only lacking because he wasn’t developmentally ready to brush on his own.
According to Olson and Jurado, you should be brushing your kids’ teeth until they are 6 years old. “As they get older they are going to want independence, but it’s really important for parents to monitor technique and consistency,” says Olson. He recommends that you be with them and watching them brush until at least age 6—for some kids it may be older—and brushing your own teeth along side them until they are at least 8 to 10 years old.
Bring them to the dentist after seeing the first tooth
Jurado and Olson both recommend seeing a dentist within six months after your child’s first tooth emerges. Parents commonly question why they need to bring a child so young when there is very little to be done, but Jurado says it’s not about having a dentist begin work on a small patient, it’s about creating an opportunity for an educational moment between a family and a health care team: “We want to know if the child is on any medications, if there are developmental issues that might make us need to keep an eye on things, we want how brushing is going—if it’s a challenge, often times we can help—and we want to create a personalized prevention plan.”
Jurado says that sometimes dentists can come up with really fun strategies to get kids brushing, “For example, I recommend phone apps with timers. If you give a kid a phone while you are working on their teeth, they will let you do anything to them and it works just as well at home as it does in the dentist chair.”
Some teeth-brushing apps that we like are, Brushing Hero, (available on iOS or Android), and Chomper Chums, (available on iOS or Android).
Are X-rays really important?
Olson says that whether X-rays are important or not really depends on the child. He encourages you to ask about the reason for the X-rays and what information your dentist is hoping to get. “Dental X-rays are less radiation than they ever have been and there is a higher level of safety than ever before, but it’s not out of the question to ask why a child might need them and to make an informed decision on what’s right for your child,” he says.
However, Olson does point out that most kids will need X-rays by age 6 or 7. Whether your child has started losing their baby teeth or not, they are developing below the surface. An X-ray can help a dentist determine whether or not the teeth are developing appropriately. “It gives us one piece of important information in the big picture,” he says.
Yes, your child needs to floss
This was my most disappointing finding while writing this piece—according to our experts and Stanford Children’s Health, flossing should start around age 2 or 3, or when their teeth have filled in enough that two teeth touch. When teeth first come in, if your child mostly eats a healthy diet that is low on candies and gummies, you can probably skip this step. “I’m not endorsing chocolate, but even a chocolate chip here and there won’t be a huge issue. It’s the sticky candy that you really have to look out for,” says Jurado. Think taffy, Twizzlers, gummy bears, and gummy vitamins. “If gummy vitamins are part of your routine, you’re probably going to want to floss.”
It’s important to teach the basics early on: Using a soft toothbrush with fluoride toothpaste made specifically for kids, brush for two minutes or more. Too firm of a toothbrush can make gums recede and, no matter how young the gums are, gums don’t regenerate—once they are gone, they are gone.
Olson notes that maintaining your tooth-brushing tools is important, but often forgotten. “If a brush has been around too long with flared bristles, it’s not going to do a good job and a child might even develop bad brushing habits. An electric toothbrush that isn’t maintained may have bacteria that can cause infections. Aggressive flossing can cause gum recession. Just like having a car, but how you drive the car is what matters.”
Two minutes of brushing is a general rule of thumb but Jurado says that the full duration all depends on what you are using and how good you are at it. “A spin brush or a child’s Oral-B or Sonicare could get the job done in a minute-and-a-half,” says Jurardo.
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