Use boiled tap water when making up infant formula. This will ensure the baby teeth are exposed to tiny amounts of fluoride as soon as they erupt. Bottled waters should not be used unless they have a label indicating suitability for use with infant formula.
Babies are born without decay producing bacteria strep mutans in their mouths. They are infected with these bacteria by kissing and sharing utensils with infected parents and siblings. If parents and siblings have little or no dental decay in their mouths, transmission of the bacteria is greatly reduced.
When the first baby teeth appear in the mouth at about 6 months you can start cleaning them straight away. There is no need to use a brush, instead use a piece of gauze wrapped around your small finger to rub away any plaque or debris that collects on the teeth.
All the baby teeth appear in the mouth from about 6 months to 2 years. A small, soft toothbrush should be introduced gradually during this period, according to the willingness of a child to accept it. Use tap water for cleaning, toothpaste should only be introduced after 2 years.
A small pea-sized amount of fluoride toothpaste should be introduced after the child’s 2nd birthday. If you can find a suitable flavour, adult toothpaste can be used. The problem with some children’s toothpastes is that the level of fluoride is too low and may have little or no protective effect.
Young children need to be supervised with tooth brushing until about six years of age. It is important that they use the correct pea sized amount of fluoride toothpaste and ideally should spit out rather than rinse out after brushing. This keeps small amounts of fluoride in their saliva giving extra protection to their teeth. It also takes a number of years for children to have sufficient manual dexterity to be able to apply the correct level of pressure to their gums (gingiva) and teeth when removing dental plaque.
For children under six years, the emphasis should be on getting the habit established as a daily practice of at least once or preferably twice a day, first thing in the morning and last thing at night. Demonstrate the correct pea-sized amount of tooth paste. Provide a toothbrush with soft bristles, which is the appropriate size for the age and stage of development of the child. As a general rule, use a brush with a small head and short handle for baby teeth and a brush with a bigger head and longer handle for the permanent teeth. The parent or carer should assume responsibility for monitoring the cleaning of the gums until the child can demonstrate the necessary competence for this task.
The vast majority of people clean their teeth using a simple scrub technique. A slight modification of this is an easy and effective method for cleaning the gums. The soft bristles of the brush are angled so that they fit right into the sulcus or gum margin where the gum meets the teeth. A very short back and forth motion using gentle pressure, almost like a vibration of the bristles, over two or three teeth at a time will dislodge most plaque from this vital area for gum health. Particular care is needed in the area where the teeth meet each other; plaque removal from this area is usually deficient because of the changing curvature of the teeth and gum margin. It will take about two minutes using this method to go around the mouth doing the inside, outside, uppers and lowers and finishing by scrubbing the biting surfaces. Good gum health can be achieved and maintained using this method once every 24 hours.
Sources: 1. Clinical Periodontology and Implant Dentistry, Jan Lindhe, Thorkild Karring, Niklaus P. Lang. Editors 4th edition, Blackwell Munksgaard 2006 2.Department of Health and Children (2002) Forum on Fluoridation. Stationery Office Dublin. http://www.fluoridationforum.ie 3. Dental Caries, The Disease and its Clinical Management, Ole Fejerskov, Edwina A.M. Kidd Editors, Blackwell Munksgaard 2006