How to care for your kid’s teeth

Untreated cavities in children can lead to serious tooth infections and can even harm incoming adult teeth. Photo / Scott Suchman for The New York Times

When that first tooth emerges, start brushing - and other advice from paediatric dentists.

Pop quiz: At what age should kids first see a dentist? In a USrepresentative survey conducted in 2017 on behalf of C.S. Mott Children’s Hospital, roughly half of parents who responded said they believed they could wait until children were 2 or 3 before going to the dentist.

In fact, the American Academy of Paediatric Dentistry recommends that children first see a dentist within six months of the eruption of their first tooth, or by age 1. After that, the organisation suggests children see a paediatric or general dentist every six months for cleanings and checkups.

Although fewer children in America suffer from cavities now than they did a decade ago, more than 12 per cent of children between the ages of 2 and 11 had cavities in their baby teeth between 2017 and 2020, according to Centres for Disease Control and Prevention surveys. Because kids retain some of those teeth until the age of 12 or 13, it’s important to keep them healthy, said Dr Judy Yip, a pediatric dentist in Garden Grove, California. Untreated cavities can lead to serious tooth infections, she said, and can even harm incoming adult teeth.

Here’s what parents need to know about caring for children’s teeth.

Start early

Parents may not see a baby’s first tooth until months after birth, but teeth start developing in utero, said Dr Erin Issac, a paediatric dentist in Pittsburgh. Some research suggests that vitamin D deficiencies during pregnancy increase the risk that children will develop cavities down the road, so it’s important that pregnant women get the recommended 600 IU of vitamin D per day, she said.

You can start getting your baby used to oral hygiene by wiping down their gums with a damp washcloth twice a day, even before the first teeth arise, said Dr Jonelle Anamelechi, a pediatric dentist in Washington, DC. “The earlier we’re inside that kid’s mouth, the more likely they are to take it as a part of their routine,” she said.

Once that first tooth appears, gently brush it twice a day with a small toothbrush and a rice-grain-sized amount of fluoride toothpaste, Dr Yip said. Doing so keeps the teeth healthy — milk can wreak havoc on them. Some parents are nervous about using fluoride toothpaste with young kids, she said, but it’s safe as long as kids don’t swallow more than that tiny amount each time. Still, non-fluoride options are also available.

As soon as teeth appear that are close together, floss between them using disposable flossers, Dr Issac said. Once your child is adept at spitting, you can switch to a pea-sized amount of toothpaste, Dr Anamelechi said, and have them start using a fluoride rinse once a day, too.

As for when to start letting kids brush their own teeth, experts had different opinions. Dr Yip said they are often ready once they can tie their own shoes, at around the age of 7 or 8, but Dr Anamelechi recommended that parents keep brushing their children’s teeth — at least at night — until the age of 10.

Make brushing easy and fun

What if your kid hates brushing? “My first child was not a fan,” Dr Anamelechi said, “so I used to brush his teeth while he was asleep.”

If oral hygiene is a struggle, do your best to at least brush at night, she said — that’s when the teeth most need cleaning.

Dr Yip agreed: “My philosophy is, anything is better than nothing.”

Dr Yip recommended manual toothbrushes for children under 3 for safety reasons. But after that — as long as kids enjoy them — electric toothbrushes are often more effective, Dr Anamelechi said.

You don’t have to brush at the sink, either — you can do it while kids are lying down, or in the bath or a highchair, Dr Issac said. “Sing a song, do a little silly dance,” she suggested.

YouTube has lots of fun tooth-brushing videos for kids, she added.

Give your child agency, as well. “Having kids pick out the toothbrush with their favourite character is usually a good start,” said Dr Olga Krikunenko, a dentist in Franklin, Mass. Let them try different toothpaste flavours and pick the one they like best.

If brushing remains a struggle, try to problem-solve, Dr Yip suggested. “It’s important to pinpoint exactly what the issue is: Are their gums sensitive? Is the electric toothbrush too stimulating? Do they not like the texture or taste of the toothpaste?” Sometimes, a simple change can make all the difference, she said.

Stay vigilant

Beyond brushing, you can keep kids’ teeth healthy in other ways — such as by limiting their consumption of gummy candies and vitamins, Dr Anamelechi said. She suggested giving kids snacks of apple slices, which she called “nature’s toothbrush.”

As kids get older and are able to brush and floss on their own, the burden on parents typically eases, Dr Anamelechi said. But it’s important to monitor that they’re brushing twice daily — and check supplies regularly, because children don’t always speak up when they should.

“Sometimes I talk to kids and they’re like, ‘Oh, I ran out of toothpaste months ago,’” she said.

Written by: Melinda Wenner Moyer

Photographs by: Scott Suchman

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