Good oral hygiene in childhood starts from the time a baby is born. Although in the first months of life the teeth have not yet come in, it is advisable to clean the gums after each feeding with a gauze moistened with drinking water or chamomile; there is also a kind of thimble for babies that is designed to stimulate the gum when the baby teeth start to come in and serves in turn to clean the gum after each feeding.
Until the first tooth appears, at approximately 6 months, the gauze and thimble, above all, help us to introduce the habit of future brushing.
Brushing teeth in childhood
Brushing should be done by parents until the children are able to do it themselves, at approximately 6-7 years of age. The brush is just another toy.
When we brush their teeth we do it in front of the mirror and tilting their head back. Of course, when we brush our teeth we do it in front of them so they can see that it is a common practice in our lives. Also, as the teeth come out we will adapt the brush according to the needs of the child.
It is advisable to follow an order to clean all the teeth without forgetting any part of the mouth. Brushing should last at least 2 minutes, and we will do it after each of the three main meals of the day.
The most important thing is to make sure that a good dragging of the “biofilm” or “plaque” that remains stuck to the teeth is done after each meal. Therefore, although in adults a medium or soft brush is always recommended, in childhood a very soft one might not be enough.
Once the first teeth appear, the brushing technique should be quick and simple. It is advisable to lay the baby down on the sofa or bed and approach him from behind to better control his head movements.
Make quick, repetitive horizontal movements. The brush should cover some of the gums, since it is in that area of the tooth where more plaque tends to accumulate. It is important to separate the cheek and lip well.
Breast or bottle tooth decay
We often overlook cavities in babies and young children because they are baby teeth. Rampant caries, also called baby bottle or nursing caries, can affect young children from the time their first teeth appear.
It is very aggressive and causes very rapid destruction of the baby tooth. It is one of the first dental problems of the little ones and detecting it in time helps us to treat it more easily.
There are many factors that can cause the appearance of a cavity. Some of the most frequent causes are:
- Prolonged and frequent exposure of the child’s teeth to drinks containing sugar (juices, soft drinks…)
- Letting the baby/child fall asleep with the bottle in his/her mouth or using it when he/she is nervous as a pacifier
- Soak the pacifier in sweet products (honey, sugar…)
- Vertical transmission, occurs when the bacteria that cause tooth decay are transmitted from the mother to the baby through saliva, kissing on the mouth, sucking on her pacifier to clean it, sucking on the teaspoon when we feed it…
- If an infant or young child does not receive enough fluoride, he or she may be at increased risk for cavities.
The good news is that cavities are preventable. There is a new fashionable slogan that says “Lift the lip” so that children’s mouths can be detected for those white spot lesions that indicate early decay. The diagnosis of rampant or baby bottle tooth decay should always be made by the paediatric dentist.
What kind of toothpaste should children use?
From the first tooth at 2 years of age, scientific evidence supports the use of a 1000 ppm fluoride toothpaste. Therefore it is recommended to brush twice a day (we recommend morning and evening) with a dry brush and lightly staining (the brush = scraping).
When the child reaches the age of 2, he or she can use a 1450 ppm toothpaste, and the amount of paste will be increased to that of a dry grain of rice. Parents should apply the toothpaste and supervise brushing.
In all cases, the toothbrush should be dry. There are several types of toothpaste on the market for children. If you do not know which one to use, consult your paediatric dentist, who can tell you which one is best for your child.
Should mouthwashes be used in childhood?
Introducing mouthwash into the ritual of children’s dental hygiene brings great benefits to their oral health, helping to prevent the appearance of cavities and bacterial plaque. It is good to acquire this habit from an early age.
The use of the mouthwash is usually recommended from the age of 6, since at that age children are sufficiently prepared not to ingest it.
The mouth should be rinsed after brushing with 5-10 ml of mouthwash for about 1 minute. Once a day is sufficient and you should avoid eating or drinking 30 minutes after using the mouthwash.
There are many brands of children’s mouthwashes on the market. Your paediatric dentist will be able to indicate the most suitable one for your child.
Pediatricians do not usually advise this, although paediatric dentists do recommend it when there is a tendency to suffer from cavities. If you have any doubts, the best thing to do is to consult the paediatric dentist directly, who will give the most appropriate recommendation according to the child.
Flossing should start to be used independently from the age of 8 or 10. Until then, it should always be used under the supervision of an adult, as the floss could break when inserted and remain between the teeth.
Nowadays it is possible to buy very practical floss holders that facilitate this function, there are even some decorated with children’s motifs.
What is the difference between floss, silk and dental tape?
This is a very common question my patients ask me at the cabinet. It is true that the type of floss to be used depends on each mouth, not all mouths are the same, there are people with teeth very far apart and others with teeth very aligned and clenched. If you have any doubts, it is advisable to consult your dentist or hygienist.