Discussion Points

Effectively brushing and flossing teeth is essential for good oral health.

• The longer plaque stays in contact with the teeth, the more time acid demineralizes the enamel.
• Teeth should be brushed twice per day with fluoride toothpaste. The optimal duration of brushing is 2 minutes. Spitting excess toothpaste is encouraged but “swishing” to rinse the mouth should be discouraged, along with drinking anything, even water, after brushing.
• After the nighttime brushing, the child should not be allowed to drink anything. Plain water (no additives or flavorings) can be offered during the night if the child is thirsty.
• Before teeth are present, families should clean the mouth after feeding using a damp cloth. Once teeth are present, a small, soft toothbrush can be used. A tiny smear of toothpaste is safe to use with children under 3 years of age. After age 3 and the child learns to spit, a pea-sized smear can be used.
• Children need supervision during brushing to ensure that only a tiny smear or pea-sized amount of toothpaste (depending on age) is applied to the brush, that it is not swallowed, and to make sure that all surfaces of the teeth are thoroughly cleaned. Families should continue to assist with brushing until the child demonstrates adequate coordination and motivation to brush effectively. This may be until age 8 years or older, typically when the child can tie their own shoes.
• Similarly, children need supervision during flossing. Floss aids such as disposable dental floss holders can be helpful.
• Brushing teeth with fluoridated toothpaste provides the additional benefit of applying topical fluoride. When children are older, fluoride also can be topically delivered to the tooth in fluoride rinses and mouthwashes if advised by the dentist.
• Find creative ways to motivate young children to brush and floss. Here are some tips:
  • Sing a song throughout the brushing process.
  • Brush in various parts of house/car that are convenient.
  • Model brushing by brushing as a family.
  • Let the child pick out their favorite toothbrush in the store.
  • Have the parent get behind the child while brushing so that if the child is squirming, the parent can hold the child’s hands with 1 hand and use the other to brush the child’s teeth.
  • Electric toothbrushes can be used adequately before 4 years of age, but some children may object to the vibration and noise produced. There is no difference in the effectiveness of electric toothbrush or manual toothbrush if children are taught how to brush properly. The optimal brushing time is 2 minutes.
  • Introduce floss aids and keep them available when on the go.
  • Encourage brushing of the tongue, being careful not to cause gagging.