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April 18, 2019

Parents, dental hygiene should begin at the first tooth

Cavities are the top chronic disease affecting children

Children's Health Baby Teeth
Tooth Brushing Toddler 04162019 Brian/via Flickr Creative Commons, CC BY-SA 2.0

The American Academy of Pediatrics says children should see a dentist by their first birthday or within six months of cutting their first tooth.

Childhood cavities are the number-one chronic disease affecting children. More than 40 percent of kids have tooth decay by the time they reach kindergarten and 50 percent of children have gingivitis. Too many little ones have poor oral health, due to an unhealthy diet and insufficient dental hygiene. Many parents do not realize how prevalent childhood tooth decay is until their kids are affected.

Little ones lose their baby teeth, so does it really matter if they get cavities? Absolutely. Cavities at a young age are a major indicator of tooth decay later in life and can have serious and lasting complications, including chronic pain, chewing problems, weight loss or nutritional problems resulting from difficulty with eating, tooth loss, and infections. Not to mention that children with dental issues can suffer from intense pain and miss a lot of important school time for appointments to remedy their oral health issues.

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The American Academy of Pediatrics (AAP) says that children should see a dentist by their first birthday or within six months of cutting their first tooth. Since pediatricians are involved in our children’s lives starting at birth, they are usually the ones to refer parents to pediatric dentists. My son’s doctor advised holding off on taking Killian to see a pediatric dentist until he turned three. I usually defer to our pediatrician, but this advice seemed wrong. My son had a mouth full of teeth. Why delay his first dental visit?

So, I took Killian in to get an exam when he turned two and I am so glad I did. His oral health is part of his overall wellness, and not something I’m going to mess around with. I wish I had known to take him when he was a year old. Thankfully since we have been diligent about brushing, his teeth were in great condition. At that first check-up, his new pediatric dentist gave us good advice to ensure his teeth continue to stay healthy.


When should your child begin? As soon as your little one has a tooth! Adjusting your baby to teeth brushing as soon as that first pearly white pops through will make it any easy, normal part of their routine as they grow older. Pediatric dentists recommend that kids brush twice a day: once after breakfast and at night before bed. For children under age 3, use a grain of rice size amount of toothpaste and brush their teeth for them. For children three to six years old, use a pea-size amount of toothpaste, encouraging them to brush on their own while helping to ensure their entire mouth is properly cleaned. For kids under 6 years old, adults should apply the toothpaste so too much isn’t used.

Kids who are 6 and older should be supervised to the extent that you can confirm that they have properly brushed twice daily. Children’s teeth should be brushed for two minutes (same as adults), which can seem like a long time. For your little ones, sing a song or play a game to help distract and pass the time. For your older kids, set a timer to help keep track.


Choose a soft-bristled toothbrush designed to fit the size of your child’s mouth and replace it every six months. The AAP, the American Association of Pediatric Dentistry and the American Dental Association all recommend using a fluoride toothpaste. Though Killian received a fluoride treatment at his first dental visit, and will receive additional ones at his subsequent check-ups per his dentist’s recommendation, while he is little I prefer an all-natural children’s toothpaste made by my favorite EWG Verified brand, Attitude Living. Fluoride can help strengthen teeth and prevent tooth decay – I think it is a great advancement for oral health – but if consumed in large doses (far more than any child should brush with) it can be poisonous.

Until Killian can rinse and spit after brushing, I am going to stick to the non-toxic, fluoride-free toothpaste for his daily brushing just to play it safe. He gets fluoride through drinking water, his diet and topical treatments at his dental visits, which I think is plenty for his age. If you use a toothpaste with fluoride, make sure your child does not swallow it. Tilt your toddler’s head down so the toothpaste dribbles out and tell older children to spit out the toothpaste after brushing. In addition to a good toothbrush and your preferred toothpaste, have something for your little one to floss with, if necessary.

Most children have spaces between their baby teeth to allow the room for their adult teeth to grow in but if their teeth are close together and prone to getting food stuck, use flossers or a waterpik.


In addition to daily oral hygiene and visiting a pediatric dentist for check-ups, limiting your little one’s sugar intake will benefit their dental ( and overall ) health. Introduce healthy foods like fresh fruit and vegetables into your baby’s diet at a young age and do not use sweets as bribery or rewards. Be especially careful of sticky sweets – even dried fruit – which can really get into the grooves in their teeth.

Drink choices are just as important for tooth decay prevention. Killian rarely drinks juice and when he does, I cut it with water. Little ones never need soda and older kids should only have it in moderation. Avoid giving your baby or toddler a bottle of milk, formula or juice when they go down for nap or bedtime as it can cause Baby Bottle Tooth Decay. Even milk contains a lot of sugar and having that liquid sit in their mouths while they sleep can cause cavities. If your baby is used to a bottle when they go down, fill it with water instead.

Making some of these changes may result in difficult period of transition, but your children will adjust, and their health will benefit. If your little one has a lot of sugar, say at a birthday party, give them water and an apple on the ride home. Per our dental hygienist, this combo will help clean their teeth until they are able to brush properly.

Teeth brushing seems to be one of those things that kids are always resisting and parents are always harping on. Having a twice daily argument about it can be draining. But if you introduce good dental hygiene at a young age when your little ones are babies, they will grow up understanding that teeth brushing, flossing and regular dental check-ups are a normal part of life, like bathing and eating and going to the pediatrician.

Does your little one like brushing his teeth or is it a struggle? How do you feel about fluoride? Share with me and other parents in the comments section, below, or tweet me at @ThePhillyVoice and @KathleenEGagnon.

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