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There is so much going on when you are taking care of a new baby, that it is easy to forget about oral hygiene considerations. I didn’t even start thinking about my son’s oral health until he started eating solid foods around 7 months old and already had a number of baby teeth. So I was inspired to write this post for new parents to provide some practical information about when and how to brush baby teeth.
Please note that this post is based on recommendations from professional associations and other trusted online resources, but parents should discuss their child’s individual dental needs with their pediatrician and dentist.
When to Start Brushing Baby Teeth
ABQ Pediatric Dentistry explains that the time to start brushing is as soon as the first baby teeth emerge, usually sometime around 6 months old (this timeline varies of course from baby to baby).
Even before baby teeth emerge though, the AAPD recommends cleaning newborn’s gums with a soft, damp, clean cloth or an infant toothbrush with water. And The CDC recommends cleaning gums once in the morning and once before bedtime to prevent bacteria buildup.
Toothpaste for Baby Teeth
As soon as the first baby teeth appear, the ADA recommends using a smear of fluoride toothpaste about the size of a grain of rice to brush. And depending on where you live, your pediatrician may also prescribe supplemental fluoride drops. This was the case for my baby, since fluoride is not added to our local public drinking water supply.
Dentistry for Children & Adolescents explains that fluorideplays an important role in preventing tooth decay in children. They explain that mouth bacterias feed on sugars and starches from remaining food after eating and then produce acids. These acids then breaks down protective tooth enamel, leaving the inner part of teeth exposed. This is when tooth decay occurs. Fluoride helps prevent decay by strengthening enamel, as well as inhibiting mouth bacteria from producing acid. It also helps remineralize enamel.
Historically, the official recommendation was to use fluoride-free toothpaste on baby teeth until a child turned 2. Today though, the ADA recommends using fluoride toothpaste as soon as baby teeth emerge. And since they recommend using such a small amount of fluoride toothpaste (a rice grain sized smear), they say it isn’t harmful if a child swallows it.
As I was considering the ADA’s recommendation on fluoride toothpaste, I wondered why I have heard so much controversy floating around about fluoride. Some saying it has detrimental health effects, and others saying it is essential for oral health. I never knew the details behind these opposing points of view, so I looked into it.
WebMD states that too much fluoride before the age of 8 can cause fluorosis, but that this is usually just a cosmetic issue (stains and changes to teeth’s surface). They also state that less than 1% of fluorosis cases are considered severe.
The big problem with fluoride occurs when intake is excessive and is ingested from multiple sources; such as drinking fluoridated water, taking supplemental fluoride, and swallowing a lot of fluoride toothpaste.
Healthline explains that problems from excessive fluoride intake usually occur in countries where there are very high levels of fluoride in the drinking water. In these countries, a bone disease called skeletal fluorisis may occur. Fluroide can be found in the groundwater in these countries at levels greater than 8 ppm. This is double the amount of fluoride that is federally regulated and allowed in drinking water in the US. Healthline says that there is inconclusive evidence regarding other illnesses and their potential link to fluoride.
Toothbrushes for Baby Teeth
There are so many different types of toothbrushes marketed for kids out there that it can be hard to know where to begin. What I think is more important than getting too caught up in the specifics of types of toothbrushes, is just making sure you are getting those twice daily brushings in and being gentle to the teeth and gums in the process. And because every kid is different, there may be some trial and error involved in finding out what type of brush works best for your child.
Silicone Finger Toothbrushes
I use a silicone finger toothbrush with my son.The most helpful thing about this brush for me is that I can feel exactly where I am on his teeth and gums. Since I can feel where I am making contact, I know when I have done a thorough brushing.
Silicone finger toothbrushes are also very gentle on sore gums from emerging teeth. Because they are gentle, brushing with a silicone brush doesn’t cause my son discomfort and he generally stays mostly still while we brush.
Dentaly explains another benefit of silicone toothbrushes is that they are nonporous. This means they are easy to clean and they do not have as much bacteria buildup as regular toothbrushes. They are also a more eco-friendly option, since they do not need replaced as often as regular brushes.
As we continue to rely on a silicone toothbrush though, I have wondered if they are less effective than regular bristled toothbrushes. They are so much softer, so do they do as good of a job?
According to a 2019 Romper article, more research is needed on silicone toothbrushes, but reputable sources say that they seem to do as good of a job as regular nylon bristled toothbrushes. These sources come from interviews with AAPD (American Academy of Pediatric Dentistry) leaders and pediatric dentists.
Traditional Nylon Toothbrushes
We also got a cute kid toothbrush with a small brush head and soft nylon bristles to try out. My son likes to gnaw on it and play with it, but at this stage I do not know how much it is actually cleaning his teeth. We can get a quick brush in with it, but it never feels very thorough. I think the bristles are still a little uncomfortable for his sore gums.
Silicone Finger Brush and Kid’s Toothbrush
How to Brush Baby Teeth: Strategies and Routine
Even with all the right tools, it can be hard to know exactly how to brush baby teeth. Most parents I talk to say that brushing their babies’ teeth is challenging, if not impossible. There is a lot of squirming, thrashing and general refusal. I would tend to agree, so below are some of the strategies I use to brush my son’s teeth.
I often play Elmo’s Brushy Brush video on my phone as I brush my son’s teeth. It is a fun song and video of Elmo and other adults and children brushing their teeth. For whatever reason, my son is captivated by it and will sit still long enough for me to get a good brush in. We also use other distraction tactics like books, singing, and toys. We hope that over time he will realize that brushing teeth is just a part of daily life and we won’t need to rely on these distractions. And while this never worked for us, I have heard that holding a handheld mirror up to a baby’s face while brushing can keep them happily occupied while brushing.
Modeling Good Teeth Brushing Habits
I also try to make sure my son is seeing me brush my teeth regularly. I make a point to show him how I am moving the toothbrush, then spitting and rinsing. Children are naturally inclined to model the behavior they see around them, so this can be an easy way to encourage your child to jump on board with brushing his teeth.
Developing a Teeth Brushing Routine
Getting on a consistent schedule has helped my son become more comfortable with brushing his teeth. We brush everyday, once after breakfast and once after dinner, and he knows to expect this. I think that once kids know that something is routine, they actually start to like it or at least find it comforting. When it comes to learning how to brush baby teeth, there is no substitute for sticking with it and remaining diligent.