Young children have ever-changing mouths that require frequent attention. The dental needs of the child change along with them. So how do parents receive the best possible advice on how to care for their kids’ teeth and gums, and how can they encourage and foster good oral hygiene that their children will carry with them for the rest of their lives?
Your dentist is the very best source of information, but we’ve put together a common-sense guide on dental care for families with infants, toddlers and growing kids.
The Mouths of Babes
Your little one may not have visible teeth yet, but oral care is important from their earliest days. Their baby teeth, more formally known as primary teeth, begin to grow in the jawbone prior to birth. The very first primary tooth will usually appear (or ‘erupt’) at around six months of age, but teeth can also be visible from birth, or they may not emerge until the child is close to twelve months.
The period in which the first teeth appear is known as ‘teething’. Babies often experience discomfort during this process, and some become quite distressed from the tenderness in the gums. Your baby can show their irritability in the following ways:
- Crying often, and taking a long time to settle
- A mild fever
- Rosy cheeks
- Changes in appetite and digestion
- A tendency to chew or suck on toys
- Touching or pulling on one ear
There are a number of ways you can help your baby through the teething process. The Australian Dental Association recommends using your freshly washed hands to gently rub baby’s gums with a clean finger until the child is soothed. Another option is to provide baby with a teething ring, a dummy or a wet cloth. These objects can be bitten to provide relief. A teething ring can also be cooled in the refrigerator (not the freezer) if your child seems to take comfort from the chilling effects. Never tie a teething ring around a baby’ neck, and wash all chewable objects thoroughly between uses.
If a baby is avoiding food while they teethe, try cooling the food. Heat may increase sensitivity in the gums and cause additional discomfort. Fruits and sugar-free yoghurts are an ideal food to chill.
It may have been common practice to provide teething gel or powder to a distressed child, but since reactions and adverse outcomes are not uncommon, they are no longer considered safe. Aspirin and alcohol-based products should not be given either. If your baby’s distress is prolonged or unmanageable, see your family doctor or dentist for information about safe and effective pain management.
Although your baby may not yet have visible teeth, an oral hygiene routine is still important. Gently wiping their gums with a clean, wet cloth each day will help to move on any bacteria and sugars from the crevices, and will help get your little one used to the sensation.
When the primary teeth begin to erupt, the cloth can still be used to wipe them until the surface allows for a special baby’s toothbrush to be used. The brush should have very soft, rounded bristles and should be small enough to comfortably move around your baby’s gums. The packaging should specify that the brush is designed to care for baby teeth. At the very early stages is it fine to use warm water for brushing, at least until several teeth appear.
At this point, which will likely be beyond the first birthday, toothpaste can be used very sparingly on the brush – a thin film on the very tips of the bristles is fine. Find a toothpaste variety that is low fluoride and formulated for milk teeth. Your pharmacist can help you choose an appropriate product for your young child’s growing mouth. Fluoride is important for growing mouths, but children are sensitive to amounts that adults require. Too much at a young age can upset baby’s stomach and can even damage the teeth be causing a mottled effect. Once the brushing is complete, encourage baby to spit out the remaining toothpaste, or if they are too young, use a wet cloth to absorb the excess.
Once baby is at the brushing stage, a twice-daily routine is the best for their developing mouths. Before the first and after the last feeds of the day is ideal, and you can do this with your child sitting on your lap with their head tipped back towards you gently. If squirming and wriggling is an issue, seek additional advice. Getting into good habits now will pay off – dentists recommend brushing your child’s teeth until they are at least seven years of age.
The first trip to the dentist should either be before their first birthday, or within six months of the first tooth erupting – whichever is sooner. Your child’s individual dental needs will depend on the heath and development of their teeth and gums. At the first visit, talk to your dentist about your child’s check-up schedule, which may be every six to twelve months. If you have concerns about the development or timing of your child’s primary teeth, it’s safer to seek medical advice sooner rather than wait for a scheduled visit.
Beyond the First Year
Most children will have all 20 of their primary teeth before they are three years old, and paying close attention to how they are developing is crucial in identifying problems and signs of decay. Decay is caused by bacteria in the mouth which create plaques on the teeth. The Australian Dental Association has recently suggested that the state of children’s dental health is declining, and this is leading to an increase in childhood illness and contributing to paediatric hospital admissions. There are several contributing factors, all of which are preventable with the right education and habits:
- A diet that is high in sugar and contains a lot of snack foods. Snacking is related to decay because the teeth do not have time to recover from the plaque acid, and they cannot re-mineralise. Provide healthy, fresh snack foods like cheese, fruit and crunchy vegetables.
- Giving your child a bottle of milk or juice in order to help them sleep. The sugar content stays in the mouth and soaks into the teeth, allowing bacteria to form plaque. A bottle with plain water can offer comfort without compromising dental care. As a child is less reliant on breast milk or formula, regular drinks of water should be encouraged. You can introduce your baby to a cup from as young as six months of age.
- Poor oral hygiene. Wiping your child’s gums after feeding, and getting into a brushing routine at an appropriate age, is essential.
- Lack of professional dental care. Ensure that your child has seen a dentist before their first birthday.
Dental decay in childhood, also referred to as early childhood caries, can cause long-lasting problems. The primary teeth are crucial for chewing properly and learning to speak, as well as ensuring the healthy development and eruption of the permanent teeth. Developing good habits from the outset means that your child is more likely to have healthy teeth throughout adulthood.“When Can I Introduce Flossing?”
It might not seem necessary at such a young age, but flossing your child’s teeth has the same benefits as flossing your own. You can start with very gentle, wide floss at about the age of three, and incorporate it into the evening brushing routine. This additional activity will help to remove decay-causing bacteria from between the gaps in the teeth, keeping the gums healthy and the mouth fresh. Gently move the floss up and down between each tooth, being careful to avoid abrasion at the gums. If there are signs of blood during or after flossing, consider a different technique or a different brand of floss. Rinse the mouth thoroughly after flossing to remove any debris from your child’s mouth. If you’re having trouble flossing your toddler’s teeth, ask your dentist for further advice.
Teaching your Child to Brush
Kids are pretty keen to take the reins from their parents in most areas, and brushing is no exception. From about the age of four or five, children should learn how to develop their brushing technique with your assistance. Because fine motors skills are underdeveloped at this age, the focus should be on paying attention to every single tooth rather than the thoroughness of the clean – the best cleaning will come from you, and that’s why a combined effort is best until your child is seven or eight. Make sure you can see clearly into your child’s mouth during the clean, and again, sitting on your lap or standing behind them in front of a large mirror is perfect. Start by moving the brush in small circles on the front surfaces of the teeth, and then ask your child to demonstrate what you just did. Repeat the teach-back process for all parts of the clean – inner surfaces, the grinding surfaces of the back teeth, the gum line, and finally the tongue.
Your process should be systematic and consistent each time, and take around two minutes for your part, and two minutes for theirs. If your child is irritated by the cleaning, use your imagination and make it fun. A favourite song can be played or sung, or you can offer stickers or small rewards for perseverance. You may even try a child’s size electric toothbrush to add novelty value, but a child should eventually have a good manual technique regardless.
The bristles will begin to fray before too long, so toothbrushes should be replaced around every three months. Once they are frayed, they will be less effective at removing plaque and bacteria, and could scratch the gums. Your child should have a good technique at the age of seven or eight, but supervision should continue until you’re confident they can keep it up independently. Remember that children learn good oral hygiene from their parents. If you are placing a high level of importance on your own dental care, your child is likely to place a similar amount of importance on it.
TIP: You can buy plaque-disclosing tablets from your dentist or pharmacist. They contain a food dye that turns plaque pink, and can help you and your child see exactly what affect that brushing is having on their oral health. It can also help you to make a decision about exactly when you can take a hands-off approach.
A Healthy Diet Means a Healthy Mouth!
Dentists have been urging parents for decades to check the sugar content of foods commonly found in the fridge and pantry. Foods that are high in sugar contribute significantly to dental decay, and should be given to your children sparingly. Soft drinks and juices are by far the most damaging for the teeth, and young mouths risk terrible damage through regular consumption. They are also acidic, causing an erosion of the enamel that protects the tooth. Whenever these drinks are consumed, parents should ensure their children swish water about in the mouth for ten to twenty second to help eliminate the residual sugars from the teeth and gums. Milk and water are always better alternatives, but kids who really prefer a flavoured drink can opt for a dilute low-joule cordial. The fluoride in water helps to protect the enamel on the teeth.
Other foods that can spell bad news include snack bars, lollies (including those labelled as “natural”), biscuits and chips, fruit and muesli bars, and chocolate. Occasional treats form part of all childhoods, but the more of these foods your child eats, the higher the risk to their dental health, as well as their overall health.
The best diet for your child’s mouth is a diet rich in a variety of nutritious, fresh foods, particularly foods high in calcium, D vitamins and B vitamins. Dairy snacks are a favourite with kids, but take care to buy unsweetened products. Fruit is also a perfectly good choice as long as a brushing regime is in place. Crunchy fruits can also aid in removing debris from the mouth. Wholegrain breads and cereals, lean meats, plenty of vegetables and pastas are also good, low-sugar options for a growing family. Although carbohydrates like bread and pasta have a similar effect on the mouth as refined sugars, it takes much longer to damage the teeth, and requires much higher quantities. Brushing and flossing are sufficient to prevent damage caused by carbohydrates.
The Permanent Teeth – Beyond Six Years of Age
Losing baby teeth can be exciting, but some children find the experience a bit frightening. The loss of a tooth should be celebrated as a milestone in the child’s life. The first loss will occur around the age of six, and the last can be expected to shed at about 12 years of age. If your child is not developing within these time frames, or if the teeth appear particularly sparse or crowded, see your dentist as soon as possible. The health of the primary teeth will affect the health of the permanent teeth, which sit partially or fully-formed in the jawbone.
On occasion, the permanent tooth will emerge before the primary tooth has fallen out. Usually the loss will occur quite quickly from this point, within a few days or weeks, but your child may need dental intervention if the delay goes beyond this. If your child’s teeth are developing at a rate that might compromise their future dental health, your dentist may decide to x-ray the mouth to assess whether removing some of the primary teeth may help. Removing teeth to reduce crowding is quite common in childhood, and though it might seem like a dramatic move, it can create a better environment in which the permanent teeth can develop and descend in the right place at the right time.
The Best Care for You and Your Family
We surveyed families with young children to find out a little bit more about their health requirements and concerns, now displayed in our Healthucator. We found that they claim on General Dental and Major Dental extras more than any other type, confirming the emphasis on dental care in this age group.
When comparing insurance providers for your family, remember that Dental is usually in an optional extras category, and packages should be carefully evaluated to ensure your family will reap the benefits. The Healthucator offers sounds advice on evaluating extras and you can keep this in mind as you weigh up the benefits of each option. The best deal for your family is always the one that allows you to seek dental care whenever you need it, and not just when you can afford it.