With dental disease continuing to be a significant public health problem in children, brushing with fluoride toothpaste and flossing are still effective preventive measures to reduce cavities in children. But for something that sounds so straightforward to do, it isn’t. As if brushing itself isn’t a large enough hurdle to get over, let’s not forget about flossing to get in between your child’s teeth.
Before discussing some tips on helping with your child’s oral health care, there are many reasons children’s teeth may not be cleaned well. Some reasons include:
- Your child may be highly active and unwilling to stay still long enough for brushing and flossing to be done.
- Your child may have oral discomfort because they are teething, or they may have soreness because their teeth may be very loose and are going to fall out soon.
- Your child may push you away from brushing their teeth because they have sore teeth from cavities or a broken tooth that’s getting irritated when their teeth are brushed.
- Your child may be disinterested or uncooperative in the process.
- Your child may have a medical condition, making the process difficult.
- Your child may have an oral infection.
- There may be a combination of any of the above, where there is more than one reason why brushing and flossing is difficult.
As such, a first visit to a dentist should occur within six months of your child’s first tooth coming in. This way, an evaluation can be done to learn if there are any underlying reasons for the challenges you are facing in regard to your child’s home oral health care.
Although it is ideally recommended to brush and floss teeth twice a day, a minimum of once a day is necessary.
As a specialist in pediatric dentistry, many parents approach me to learn better ways to clean their child’s teeth. I have put together several tips to share:
Brushing your young child’s teeth may be a two-person job. Certainly, there are parents who are able to brush their child’s teeth by themselves without any help. For those who have difficulty doing this alone, consider using a two-person approach. This method is based on an infant oral exam done at a dentist’s office. In this method, one person (Person A) is going to do the cleaning while the other person (Person B) is going to help hold the child safely during the cleaning.
Here’s how it works: Person A and Person B sit on their own chairs with their knees facing each other, ensuring a short distance is present, separating both parties. Person B holds the child up so the child is facing them first and then gently lays the child down on their back, so the child’s head is now on Person A’s lap. The right leg of the child is then positioned to the left side of Person B while the left leg of the child is then positioned to the right side of Person B. This is important to ensure your child doesn’t kick off the stomach of Person B.
The hands of your child are then held gently by Person B, so the child knows they are safe.
In this position, Person A can focus on brushing the teeth without having to also focus on the child’s behavior – the latter being the focus of Person B. During each session of brushing and flossing, it is encouraged that both parties give lots of positive feedback and reinforcement to the child.
While brushing, it is important to ensure that excess fluoride is not swallowed and, as such, care needs to be taken to ensure that children under three years old use a small amount of toothpaste – only about a rice-size amount. Although studies have shown that plaque on teeth is not a barrier to the uptake of fluoride in enamel, it is an irritant and causes the gums to bleed (gingivitis) if left on teeth.
If you do see bleeding gums when you are brushing your child’s teeth, it’s always important to see your dentist to determine the reason why.
Brushing technique. With regard to brushing technique, although it is recommended to use a circular motion, often parents find more success initially brushing their child’s teeth up and down and side to side. The important thing is getting the teeth clean the best you can while using a soft toothbrush.
For infants with very few teeth, consider using 2×2 gauze to wipe the teeth clean rather than using a toothbrush. Sometimes using gauze on an infant is better tolerated than using an age-appropriate toothbrush.
For some kids, brushing all of the teeth, top and bottom, in one session won’t happen. Don’t give up! Split it up! Consider brushing only the top teeth during your first session and then during the next session that day, only brush the bottom teeth. In time, as your child warms up to the routine, you may very well be able to brush both the top and bottom teeth in a single session.
Introducing flossing to your child. When first starting flossing, you may find your child is a natural born flosser and will let you floss between all of their teeth without issue, or you may find your child won’t let On day three, attempt to floss three times between four teeth in the morning and then three times between four teeth before bed, and so on. Continue this slow introductory approach over several days until you are successful at flossing between all of your child’s teeth. If there is a struggle, step back and floss less teeth the next time and try again, adding more teeth to floss during your next session.
The nice thing with an early introduction to flossing when your child is an infant is there are very few teeth in the mouth to floss between, so you will be doing this approach naturally and only adding more teeth to floss between as more teeth erupt in the mouth; this allows time for you and your child to get used to the routine of daily home care with brushing and flossing.
Supervision. As children age, many desire to be self- sufficient and brush and floss on their own; encouraging independent oral health care is important. Until children are eight (and some children even longer than that), it is recommended that you help brush your kid’s teeth as they may not have the manual dexterity to do a good job. Consider having your child brush their teeth first and then go over their ‘work’ after to ensure it is a job well done. When your child brushes their teeth, supervision is important.
Success in having a healthy mouth and a healthy smile comes from being open to trying different techniques with oral health care. What works for one child may not work for another. What works for your child one day may not work for them another day. Brushing can be tough to do for children. For some kids an electric toothbrush really helps. For others, not so much. Brushing and flossing isn’t a one-time show, it’s a lifelong journey. The goal is to find what works best for your child and keep their teeth cleaned, consistently.
If you have any specific questions or concerns about your child’s oral health, contact a member of your dental team.
Written by Dr. Rory Vinsky
Published in Calgary’s Child