Care of Your Child’s Teeth

Begin daily brushing as soon as the child’s first tooth erupts with non-fluoridated toothpaste. A rice size amount of fluoride toothpaste can be used after the child is 18 months old and a smear of fluoride toothpaste once a child can spit. Children who are able to brush their own teeth should be able to tie their own shoes or cut food with a fork and knife as a guide line. However, each child is different. Your dentist can help you determine whether the child has the skill level to brush properly.

Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.

Flossing removes plaque between the teeth where a toothbrush can’t reach. Flossing should begin when any two teeth touch. You should floss the child’s teeth until he or she can do it alone. Use regular floss or try Plackers which are hand held flossers. Use a gentle, back-and-forth motion to guide the floss between the teeth. Curve the floss into a C-shape and gently scrape the floss against the side of the tooth. Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth.

Good Diet = Healthy Teeth

Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet.

Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel.

When planning snacks, choose nutritious foods such as vegetables, low-fat yogurt, peanut butter and low-fat cheese which are healthier and better for children’s teeth.

Sugar, high fructose corn syrup, sucrose, glucose and lactose are all sugars in foods that feed the bacteria, allowing them to produce more acid which breaks down the enamel and causes cavities.  Limiting sugars is the #1 way to prevent cavities.

Preventing Cavities

Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water.

For older children, brush their teeth at least twice a day. Use the ADA Mouth slogan of “2X2” to teach children to brush two times a day, for two minutes each time. Help your child floss at least once daily until they can continue to do so on their own. As mentioned above, limit the number of snacks and drinks containing sugar that you give your children.  “Sipping” sugary drinks including fruit juice throughout the day has been found to be extremely harmful to teeth and to overall health.

The American Academy of Pediatricians recommends no juice before the age of 1 year (AAP, 2017), and 100% juice products should be 4 ounces or less for 1 – 3 year olds and 4-6 ounces for 4 – 6 year olds.  For more information, visit

The American Academy of Pediatric Dentistry recommends six month visits to the dentist beginning at your child’s first birthday, or from the time they have their first tooth. Routine visits will start your child on a lifetime of good dental health.

Your dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars and premolars to prevent decay on hard to clean surfaces, such as pits and fissures.

Seal Out Decay

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.


Fluoride is an element which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to brown discoloration. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

  • Too much fluoridated toothpaste at an early age.
  • The inappropriate use of fluoride supplements.
  • Hidden sources of fluoride in the child’s diet.

Two and three year olds may not be able to spit out fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of  tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Despite these precautions, the significant role that fluoride plays in preventing tooth decay is proven and real.  Talk with your dentist about specific recommendations for your child.