Winning Smiles
You can read part one of this blog looking at WHEN to start brushing baby’s teeth as well as part two on WHICH toothpaste and toothbrushes to use for small children.
Today’s post talks all about HOW to brush baby’s teeth and why this matters – I hope you find it useful!
HOW:
How can I brush my child’s teeth effectively?
The million dollar question! Yes some children love brushing, yet for others it’s a battle. Like with most areas of child development and parenting it’s somewhat trial and error and often you will go through phases of behaviour change. The basic principle of good brushing is to brush all 4 corners of the mouth (top, bottom, left and right) and all surfaces of the teeth (outside, inside, chewing side and in between).
For adults there are specific techniques which can be demonstrated. For young children it is really a case of trying to reach these areas as best you can. Be patient and don’t apply too much pressure with the brush in an attempt to be thorough. This can actually damage tooth enamel and gums – so a gentle side-to-side action is best. As young children often don’t have the dexterity to brush all the tooth surfaces effectively we recommend supervising toothbrushing until at least age 7. This can transition over time from the adult being the main brusher, to the child learning for themselves – it’s all about teamwork!
What if it isn’t happening?
Toothbrushing regression can be a real struggle but if you’re in the throes of the terrible twos or dealing with a threenager there are various things that may help (see top tips). When babies are teething it can be difficult to know what’s best to do to help. Especially as they can’t tell you how they feel or where it hurts. Ideally you should continue to brush the teeth even when teething. This will remove plaque which can cause gum inflammation and makes even gums sorer. Also the gentle bristles on a tooth brush or bobbles on a teething toy act as a massage on the gums and can distract from teething pain.
If you don’t want to use a toothbrush when the teeth are coming in then for a few days you could always apply a smear of paste to a cooled teether instead or consider using the baby dental wipes. Charlotte has also done a fabulous instagram post before about feeding teething babies with advice such as frozen yoghurt pops or frozen fruit to help soothe sore gums. You’ll find helpful hints plus plenty more toothy tips and mum life over on my Instagram @themummydentist
Rinsing…
Another key message is after brushing, encouraging your child to “spit out, don’t rinse” as soon as they can understand this message. You don’t want to be rinsing away the lovely toothpaste that you’ve just brushed with. It needs to stay on the teeth for longer to have a topical effect. So the advice is not to rinse out with water or mouthwash straight after brushing. You don’t want kids to be swallowing lots of excess paste either. So just encourage them to gently spit out into the sink (hopefully accurately!) the foamy paste in the saliva. Also regarding mouthwash it’s generally not advised for toddlers or young children as it’s likely to end up being swallowed and is not really necessary. Children from age 6 upwards may benefit from a mouthrinse. However 3 important points apply;
- It should be one that is child appropriate & this means alcohol-free.
- The child must spit it out. Don’t use it as a quick solution instead of brushing – it should be as an extra not a substitute.
- It should be done at a separate time to toothbrushing (so it doesn’t remove all the toothpaste)
WHY:
Why brush twice a day?
Yes there is some science behind this! Brushing in the evening, just before going to sleep, is so so important as when we sleep our saliva production is reduced. The saliva acts as a ‘buffer’ in your mouth to coat and protect your teeth. If you go to sleep without brushing then food debris particles and plaque may be left on the tooth surface enamel. With less saliva to protect your teeth then during the night is when a lot of decay activity happens.
This is also why it is recommended not to be feeding too much during the night. Ideally for toddlers only water at bedtimes. Also brushing with a fluoridated toothpaste ensures the teeth are given an extra boost of overnight protection. It helps to ingrain good habits from an early age for both yourself and baby. An association with routine such as bath-time, toothbrush, storytime then bed can be useful too.
The morning clean is then to ensure that after a (hopefully) good night’s sleep you remove any plaque that has built up during the night before you eat breakfast. Plus your mouth feels nice and fresh for the day ahead. It’s worth mentioning here that you shouldn’t brush teeth immediately after a meal as when you eat it takes the environment inside your mouth at least 30 minutes to recover a neutral state.
In summary:
So the Simple & Realistic advice for teeth is;
- Start brushing as soon as first tooth erupts
- Use a fluoridated toothpaste
- Use the correct amount of toothpaste according to child’s age
- Brush twice daily – including just before bedtime
- Use an age-appropriate toothbrush (and replace it every 3 months)
- Take your child to see the family dentist regularly (and ideally before baby’s first birthday)
- Supervise & assist with brushing until at least age 7
All beautifully summarised in the image below from Public Health England;
This post was written by Jemma Hook BDS (Hons), MFDS RSC (Ed), PGCert with support from SR Nutrition.
Jemma is a NHS family dentist and clinical teacher in Paediatric Dentistry. She started the instagram @themummydentist whilst on maternity leave last year to promote oral health for mums & babies. And also to find support in the breastfeeding/weaning/sleep deprivation chat!
Toothbrushing tips for toddlers and beyond –
🔹CONSISTENCY – between all caregivers. Even if there’s strong rebellion really try to stick brushing 2 x every day as part of a routine regardless of who is supervising it – children shouldn’t see not brushing as a ‘treat’.
🔹POSITIVITY – verbally praise the good behaviour, try and ignore the bad
🔹REWARDS – (aka bribery!) offering incentives can be a good idea, some people use a sticker chart or points system.
🔹COPYCAT – let them see yourself or older siblings giving your teeth a clean and lots of big happy smiles. My baby sat in his bouncer in the bathroom and watched my brushing my teeth from a very young age – it was also the only way I could get 2 hands free!
🔹SHARING – let them have a go at independent brushing & then you can give a helping hand afterwards as a team effort. Or even have 2 toothbrushes so that you can both hold one, this is the current situ in my house.
🔹TECHNOLOGY – there are some fun toothbrushing apps available that can help engagement with brushing.
🔹MULTITASKING – little ones often like playing at bathtime so brushing teeth as a game whilst they’re in the tub can be a good evening routine. Or have a special silly song you brush along to like the Hey Duggee toothbrushing song. Make it fun!
🔹NOVELTY – such as a new brush that the child has chosen themselves. Larger supermarkets & pharmacies generally have good selections of appealing age-appropriate brushes. Get one with a theme there are some great designs for little ones.
🔹POSITION – a good idea is to stand behind your child so that they can see themselves in the bathroom mirror. They can learn what to do by watching, plus with their head tipped back you can get a better access (this is the position us dentists view teeth best in!) And for babies we say try on your knee or the changing mat”.
Breast feeding and baby teeth
The British Society for Paediatric Dentistry is fully supportive of breast feeding, where possible, and in fact there is research that suggests breastfeeding up to 12 months of age is associated with a lower risk of tooth decay. It is known that breast milk has many wonderful features including passing antibodies between mum and baby. And during breast feeding a baby must actively suck to get milk, this means they will also be swallowing and milk is less likely to pool around the teeth.
However tooth decay issues in young children’s front teeth can be associated with on demand night time feeds. Adding sugary drinks to bottles and using a bottle over 18 months of age. Obviously babies require night time feeding. But once teeth start to erupt we have to be conscious that breast milk contains lots of ‘lactose’ or milk sugars. Current guidelines from the World Health Organisation (WHO) recommend exclusive breast-feeding up to six months (where possible). Then introducing complementary foods ‘weaning’ alongside continued breastfeeding up to two years. As dental professionals we just want to highlight the importance of minimizing the risk to teeth by encouraging regular effective toothbrushing, with fluoridated toothpaste and other good dietary choices.
I’ve written a separate post about the topic of baby and toddler drinking habits from weaning age and upwards. You can also see Charlotte’s other blogs about cow’s milk and plant based milks too!