Children ages 2 and over should have their teeth brushed with fluoridated toothpaste twice a day with fluoridated toothpaste. This removes plaque, strengthens the teeth, and encourages good oral hygiene practices.

Head Start staff (or volunteers, if available) should help children brush their teeth once a day, after a meal, with a pea-sized amount of fluoridated toothpaste. Staff should make sure that children spit out the toothpaste after brushing. Children should not rinse with water because the fluoridated toothpaste that remains in the mouth helps prevent tooth decay.

Staff should also advise parents that it is especially important to brush their child's teeth with a pea-size amount of fluoridated toothpaste before bed to prevent food debris from remaining in contact with the teeth throughout the night.

Performance Standards

1304.23(b)(3)

References

American Academy of Pediatric Dentistry, Liaison with Other Groups Committee. In press. Clinical guideline on fluoride therapy. Pediatric Dentistry. http://www.aapd.org/media/policies_guidelines/g_fluoridetherapy.pdf.

American Dental Association. 2006. Interim Guidance on Fluoride Intake for Infants and Young Children. Chicago, IL: American Dental Association. http://www.ada.org/prof/resources/positions/statements/fluoride_infants.asp.

American Dental Association, Council on Access, Prevention and Interprofessional Relations. 1995. Caries diagnosis and risk assessment: A review of preventive strategies and management. Journal of the American Dental Association 126(Special supplement):1S-24S.

Bickel HW Jr. 2001. Toothbrushing and Head Start: What's it all about? Head Start Bulletin 71, p. 27-28. http://www.headstartinfo.org/publications/hsbulletin71/cont_71.htm.

Casamassimo P, Holt K (eds.). 2002. Bright Futures in Practice: Oral Health--Pocket Guide p. 37. Washington, DC: National Maternal and Child Oral Health Resource Center. http://www.mchoralhealth.org/PDFs/BFOHPocketGuide.pdf.

Centers for Disease Control and Prevention. 2001. Recommendations for using fluoride to prevent and control dental caries in the United States. Morbidity and Mortality Weekly Report: Recommendations and Reports 50(RR-14):1-42. http://www.cdc.gov/mmwr/PDF/rr/rr5014.pdf.

Clarkson JE, Ellwood RP, Chandler RE. 1993. A comprehensive summary of fluoride dentifrice caries clinical trials. American Journal of Dentistry 6:S59-106.

Hausen H. 2004. Benefits of topical fluorides firmly established. Evidence Based Dentistry 5(2):36-37.

Kanellis MJ. 2000. Caries risk assessment and prevention: Strategies for Head Start, Early Head Start, and WIC. Journal of Dental Public Health Dentistry 60(3):210-217; discussion 218-220.