As a parent, you have a big role to play in keeping your child's teeth healthy and clean. You can help prevent cavities. Prevention starts at home, with good eating habits and daily cleaning of the teeth.
This section has important information on how to properly care for primary teeth and new permanent teeth.
Young children are not able to clean their own teeth. As a parent, you must do it for them when they are very young and do it with them, as they get older.
When your child can write (not print) his or her name, your child is ready to do a good job brushing. You should check to make sure your child does a good job.
You should start cleaning your child's mouth even before your child has teeth. It gets both you and your child into the habit of keeping the mouth clean, and it gives baby (or primary) teeth a clean place to come into. The goal is to wipe all parts of the gums and teeth.
Here's how to do it:
- Lie your baby in a comfortable place.
- Make sure you can see into your baby's mouth.
- Use a soft baby brush or wrap your finger in a clean, damp washcloth. Then brush, or wipe, your baby's gums and teeth.
- Do not use toothpaste until your child has teeth.
How to Brush
Hold the toothbrush at a 45 degree angle to the teeth. Point the bristles to where the gums and teeth meet.
Use gentle circles. Do not scrub. Clean every surface of every tooth. For the front teeth, use the "toe" or front part of the brush. The key word is gentle. You can hurt the gums by brushing too hard.
Toothbrushes and Toothpaste
The best kind of brush is soft, with rounded bristles. It should be the right size for your child's mouth. You will need to buy a new toothbrush at least every 3 or 4 months.
Children can be hard on toothbrushes. If the bristles get bent or worn down, they will not do a good job, and may hurt your child's gums.
Make sure the toothpaste has fluoride. Check the box or tube for the symbol of the Canadian Dental Association. This symbol means the toothpaste has fluoride. Use only a bit of toothpaste, about the size of a pea, and make sure your child spits it out.
As excessive swallowing of toothpaste by young children may result in dental fluorosis, children under 6 years of age should be supervised during brushing and only use a small amount (e.g. pea-sized portion) of toothpaste.
Children under 3 years of age should have their teeth brushed by an adult using only a smear of toothpaste.
How to Floss
Take a piece of floss about as long as your child's arm. Wrap it around your middle fingers, leaving about 2 inches between the hands. Use your index fingers to guide the floss between the teeth.
Slide the floss between the teeth and wrap it into a "C" shape. It should wrap around the base of the tooth, where the tooth meets the gum.
Wipe the tooth from bottom to top 2 or 3 times or more, until it is squeaky clean.
Be sure you floss both sides of each tooth, and don't forget the backs of the last molars.
Move to a new part of the floss as you move from tooth to tooth.
Should my child always brush right before bed?
Yes. If you don't get rid of the germs (bacteria) and sugars that cause cavities, they have all night to do their dirty work. Also, when your child is asleep, he or she does not produce as much spit (or saliva). Saliva helps keep the mouth clean, so brushing at bedtime is very important.
Nutrition for Children
When your child eats or drinks sugars, the germs (bacteria) in your child's mouth mix with the sugars to make a mild acid. This acid attacks the hard outer layer of teeth (also called enamel). It can make holes (or cavities) in the teeth.
The damage that sugars do depends on how much sugar goes into the mouth and how long it stays in the mouth.
Any kind of sugar will mix with germs in the mouth. Natural sugars can have the same effect on teeth as white (or refined) sugar out of the bag! Many healthy foods contain natural sugars. Milk contains natural sugar.
If you put your child to bed with a bottle of milk, the milk stays in the mouth for a long time. This may cause cavities. Unsweetened fruit juice may have no added sugar, but fruit juice has natural sugars in it. If your child is always sipping juice between meals, the teeth are being coated in sugars over and over again.
Water is the best drink to have between meals. Starchy foods, like teething biscuits, break down to make sugars. If these kinds of food stay in your child's mouth long enough, they will make the acid that can cause cavities. Your job is to clean your child's teeth, not to stop your child from having milk, juice, bread or noodles. Your child needs these foods to stay healthy.
Read the labels of the packaged food you buy. By law, everything ingredient in packaged food is listed by weight. So if a sugar is listed first, you know that there is more sugar than anything else.
These are sugars you can look for on labels: corn sweeteners; corn syrup; dextrose; fructose; glucose; honey; maple syrup; molasses and sucrose.
Also, check to see if liquid medicines (such as cough syrup) have sugars. Ask your doctor or pharmacist to give you medicines that are sugar-free.
Growing children need and like snacks. Here are some smart ways to give snacks:
Limit the number of times a day your child eats or drinks sugars. If your child sips juice or pop while playing, he or she will have sugars in the mouth over and over again. Water is the best drink to have between meals.
Do not give your child sugar-rich foods that stay in the mouth for a long time like gum with sugar in it, suckers (or lollipops) and other hard candy. Stay away from soft, sticky sweets that get stuck in the mouth such as toffee, raisins and rolled-up fruit snacks or fruit leather.
Keep good snacks handy where your child can get them. Have carrot sticks or cheese cubes on the bottom shelf of the fridge. Children like small things like small boxes of cereal, small fruits and vegetables, and small packs of nuts or seeds (provided they are safe for your child). Keep them in a low cupboard.
To keep your child from asking for sweets, do not buy them. If they are not in the house, you can't give them out. If you do serve sweets, limit them to meals. When your child is eating a meal, there is more saliva in the mouth. This helps to wash away the sugars.
All twenty baby (or primary) teeth come in by the time your child is two or three years old.
If your child is getting his or her teeth and seems to be in pain, you can:
- rub the gums with a clean finger, or
- rub the gums with the back of a small, cool spoon.
- If your child is still unhappy, your dentist, pharmacist or doctor can suggest an over-the-counter medicine to ease the pain.
Here's what you should not do:
- Do not use the kind of painkiller that can be rubbed on your child's gums. Your child may swallow it.
- Do not give your child teething biscuits. They may have sugar added or contain hidden sugars.
- Do not ignore a fever. Getting new teeth does not make babies sick or give them a fever. If your child has a fever, check with your doctor.
At age six or seven, the first adult (or permanent) teeth come in. They are known as the "first molars," or the "six-year molars."
They come in at the back of the mouth, behind the last baby (or primary) teeth. They do not replace any primary teeth.
Also at around age six, children start to lose their primary teeth. The roots slowly get weak, and the tooth falls out. Children lose primary teeth until they are about 12 years old.
It's okay for children to wiggle their primary teeth if they are loose. But it's not okay to use force to pull out a tooth that's not ready to come out. When a tooth comes out at the right time, there will be very little bleeding.
Why do the new permanent teeth look yellow?
Permanent teeth often look more yellow than primary teeth. This is normal. But it could also be caused by medicine your child took, by an accident that hurt a primary tooth, or by too much fluoride. Ask your dentist about this when you go for a check-up.
Cavities are the main problem children have with their teeth. But children can get gum disease too, just like adults. It happens when the gums that hold our teeth in place get infected.
Daily brushing and flossing can stop gum disease. If your child's gums bleed, don't stop brushing. If the gums are always swollen, sore or bleeding, there may be a serious problem. You should take your child to the dentist.
Here are some ways to protect your child's teeth:
- Always use infant car seats and seat belts when you drive.
- Babies will chew on almost anything. Keep them away from hard things that could crack their teeth.
- Children fall a lot when they are learning to walk. Teeth can break, crack, get knocked out or become loose. See your dentist if this happens.
If you have questions about your child's teeth, talk to your dentist.
Early Childhood Tooth Decay
Once your child has teeth, he is susceptible to tooth decay. Mother's milk, formula, cow's milk and fruit juice all contain sugars.
Babies may get early childhood tooth decay from going to bed with a bottle of milk, formula or juice and falling asleep at the breast with milk still in the mouth.
It can happen to children up to age four. Once your child has teeth, lift his or her lips once a month and check the teeth. Look for dull white spots or lines on the teeth. These may be on the necks of the teeth next to the gums. Dark teeth are also a sign of tooth decay.
If you see any signs, go to the dentist right away. Early childhood tooth decay must be treated quickly. If not, your child may have pain and infection.
If you give your child a bottle of milk, formula or juice at bedtime, stopping all at once will not be easy. Here are some tips:
- Put plain water in the bottle.
- If this is turned down, give your child a clean soother, a stuffed toy or a blanket.
- If your child cries, do not give up.
- Comfort him or her, and try again.
- If this does not work, try watering down your child's bottle over a week or two, until there is only plain water left.
Your Child's First Visit
The Canadian Dental Association encourages the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age. The goal is to have your child visit the dentist before there is a problem with his or her teeth. In most cases, a check up every six months will let your child's dentist catch small problems early.
Your child needs to see the dentist by age two or three, when all the baby teeth have come in. Here are 3 reasons to take your child for dental check-ups:
- You can find out if the cleaning you do at home is working.
- Your dentist can find problems right away and fix them.
- Your child can learn that going to the dentist helps prevent problems.
Your dentist may want to take X-rays. X-rays show decay between the teeth. They will also show if teeth are coming in the way they should. Your child's dentist may also talk to you about fluoride.
Once your child has permanent molars, your dentist may suggest sealing them to protect them from cavities. A sealant is a kind of plastic that is put on the chewing surface of the molars. The plastic seals the tooth and makes it less likely to trap food and germs.
When your child goes for a check up, your dentist can tell you if crooked or crowded teeth may cause problems. In many cases, crooked teeth straighten out as the child's jaw grows and the rest of the teeth come in.
If they do not straighten out, your child may have a bite problem (also known as malocclusion). This can cause problems with eating and with teeth cleaning. It can also affect your child's looks and make him or her feel out of place.
Your dentist can suggest ways to treat this, or refer your child to an orthodontist. An orthodontist is a dental specialist with 2 to 3 years of extra university training in this area.
The dentist says my child needs a filling in a baby tooth. Since the tooth is going to fall out, why bother?
Some primary (or baby) teeth will be in your child's mouth until age 12. The tooth that needs to be fixed may be one of those.
Broken teeth or teeth that are infected can hurt your child's health and the way your child feels about him or herself.
To do a filling, the dentist removes the decay and "fills" the hole with metal, plastic or other material. A filling can be a cheap and easy way to fix a problem that could be painful and cost more later because it stops decay from spreading deeper into the tooth.
If a filling is not done and decay spreads, the tooth may need to be pulled out. If this happens, your child may need a space maintainer to hold space for the permanent tooth.
When a baby (or primary) tooth is missing, the teeth on each side may move into the space. They can block the permanent tooth from coming in. To hold the space, your dentist may put a plastic or metal space maintainer on the teeth on each side of the space, to keep the teeth from moving in.
Fluoride & Your Child
Fluoride is a mineral found in nature. It makes the hard outer layer of teeth (called enamel) stronger. When the outer layer is strong, teeth are less likely to get cavities.
Children can get fluoride from four different sources:
- In the water
- In fluoride toothpaste
- In fluoride treatments
- In fluoride supplements (pills or lozenges)
Adding fluoride to the water is the best way to provide fluoride protection to a large number of people at a low cost. That is why many towns and cities put fluoride in the water. Fluoride is also in most toothpaste.
As excessive swallowing of toothpaste by young children may result in dental fluorosis, children under 6 years of age should be supervised during brushing and only use a small amount (e.g. pea-sized portion) of toothpaste. Children under 3 years of age should have their teeth brushed by an adult using only a smear of toothpaste.
If you live somewhere that does not put fluoride in the water and your dentist thinks your child is likely to get cavities, he or she may suggest that your child have a bit of fluoride every day.
This is called a fluoride supplement. The amount your dentist suggests will depend on your child's age and how much fluoride (if any) is in the water naturally.
To give your child even more protection against cavities, your dentist may suggest a fluoride treatment. It is given when your child has a check-up.
Pacifiers & Thumb Sucking
It is normal for babies to suck because it helps them relax.
By the time your child is two or three years of age, he or she has less need to suck. If your child still likes to suck, a soother is better than sucking a thumb. Why? Because you can control when and how your child uses a soother. You can't control a thumb going into the mouth.
Never put sugar, honey or corn syrup on a soother. They can cause cavities. It's best to get your child to stop sucking before permanent teeth come in, at about age five. If a child keeps sucking a soother or thumb after the permanent teeth have come in, it could cause problems with how the jaw and teeth grow.