Taking care of your child’s teeth

What you need to know about dental care from infancy onward

Thanks to advancements in pediatric dentistry, my children have yet to have a cavity or a filling. They are likely to be among 55 percent of American children, ages five to 17, who have no cavities in their permanent teeth, so says a recent Journal of the American Dental Association study.

But cavity-free teeth don’t occur without some work on your part. Here are age-by-age guidelines for taking care of your child’s teeth.

The baby years

Good oral care begins before your child even sprouts her first tooth. Try to wean your child from a bottle by age one—sucking on a bottle for extended periods of time is a top cause of tooth decay in children under three. Milk and juice contain sugar, so the longer a bottle is in your child’s mouth, the longer his teeth are bathing in sugar.

Once teething begins, you should begin cleaning your baby’s mouth. Hold off on a toothbrush just yet. You can use a wet washcloth or piece of gauze wrapped around your finger to gently wipe down gums and teeth after feedings.

When your child has teeth on top and bottom, switch from wiping to brushing. Use a toothbrush designed for the smallest mouths. These have very soft bristles and a tiny head. Dental experts say that these smaller heads allow parents to reach farther into a child’s mouth to clean molars, which are the first place cavities appear.

How to brush a young child’s teeth

Dentists recommend parents do the brushing for their child and do it while she’s lying down. Place the child’s head in your lap so you can see what you’re doing. You can use kid-friendly toothpaste if you’d like but use only a pea-size drop of it. Kids tend to swallow toothpaste and too much fluoride in their tiny systems could lead to tooth discoloration down the road.

Once your child is mobile, he can stand at the bathroom sink to brush but don’t let him try it alone—you’ll continue to have to supervise and step in to get his teeth properly brushed for quite some time.

It’s important to ensure that your child brushes all of the surfaces of his teeth and for a long enough time. Dentists recommend you brush for about two minutes. I found that most of my kids’ favorite songs were about two minutes long so at toothbrushing time, we’d put on a CD and brush for the duration of a song. New Tooth Tune electric toothbrushes also play music for two minutes, and your kids can’t hear the tunes unless they’ve got the toothbrush in their mouth. A timer in the bathroom works, too.

You should also get your child into the habit of flossing between his teeth. I found that the Reach Access Flosser, which has a removable flossing head on the end of a toothbrush-like stick, was the best way to successfully floss my children’s teeth and avoid having them inadvertently bite down on my fingers during the process.

The first dental visit

While your child’s pediatrician will be keeping an eye on tooth development during well-child visits, it’s a good idea to schedule your child’s first dentist appointment by age three—assuming your doctor hasn’t found any evidence of early tooth decay. You can bring your child to the dentist you see, or you can make an appointment with a pediatric dentist who, like a pediatrician, specializes in younger patients. (Visit the website of the American Academy of Pediatric Dentists at aapd.org to find a pediatric dentist near you.)

Like adults, children should see the dentist every six months for a cleaning. Once your child cuts his six-year molars (usually well before age six), the dentist will likely recommend sealants. Sort of like clear nail polish for the teeth, dentists paint on this harmless substance on the biting surface of teeth (it takes about 30 minutes to dry) to fill in any nooks and crannies where cavities might take hold. Studies have shown that sealants reduce the development of cavities by 90 percent. Expect a second sealant coating on teeth once your child’s 12-year molars come in, too.

Graduating to solo brushing

Doctors say that successful use of a toothbrush requires specific motor development, something your child probably won’t acquire until he’s six to eight. How do you know when your child is ready to brush his own teeth? When he can tie his shoes, write his name, and use eating utensils.

No more cavities ever?

Researchers at the Forsyth Institute in Boston are working on a vaccine that will prevent cavities. This vaccine will create an immune response in the mouth to prevent the bacteria that causes cavities from attaching to the tooth or accumulating on the tooth surface. The vaccine already has been shown to be effective in rats. Who knows? The cavity-free vaccine could be coming to a dentist’s office near you in the not-so-distant future.

As long as you take an active role in teaching your children good dental hygiene, they may never have to experience the eerie whine of the dental drill.