Anticipatory Guidance

Discuss with Parents:

Oral Hygiene

• If the child has not yet been to a dentist, making an appointment for the child’s first dental visit, thereby establishing a dental home.
• After the initial dental visit, making the next appointment for the child according to the schedule recommended by the dentist, based on the child’s individual needs or susceptibility to disease.
• For children with special health care needs, making appointments for more frequent dental visits based on the child’s individual needs or susceptibility to disease. Obtaining special oral health equipment (e.g., a mouth prop) to brush the child’s teeth.
• For children under age 2, brushing the teeth with plain water twice a day (after breakfast and before bed). For children at increased risk for tooth decay, consulting with a dentist or physician about brushing the teeth with a pea-sized amount (small smear) of fluoridated toothpaste.
• For children ages 2 and above, brushing the teeth with no more than a pea-sized amount (small smear) of fluoridated toothpaste twice a day (after breakfast and before bed). Making sure the child spits out the toothpaste after brushing, but does not rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps prevent tooth decay.
• For effective plaque removal, making sure that a parent brushes the child’s teeth. Because brushing requires good fine motor control, young children cannot clean their teeth without parental help. After children acquire fine motor skills (e.g., the ability to tie their shoelaces), typically by age 7 or 8, they can clean their teeth effectively but should be supervised by a parent.
• Becoming familiar with the normalappearance of your child’s gums and teeth so that problems can be identified if they occur (see Tooth Eruption Chart). Checking the child’s gums and teeth about once a month.
• Giving the child fluoride supplements only as prescribed by a dentist or physician, based on the risk of developing tooth decay and the known level of fluoride in the child’s drinking water (see Systemic Fluoride Supplements: Recommended Dosage).
• Discussing with a dentist or other qualified health professional the need to apply fluoride topically (via varnishes, gels, foams), which renews the high levels of fluoride in the outer layer of the tooth enamel. Topical fluoride may be especially effective for children at high risk for tooth decay because they have a history of decay, are not exposed to fluoridated water, snack frequently on foods containing sugar, or have a medical problem that decreases their resistance to decay.
• Discussing with a dentist or other qualified health professional the need to apply dental sealants (thin plastic coatings applied to pits and fissures on the chewing surfaces of the teeth) to prevent tooth decay by creating a physical barrier against dental plaque. Dental sealants should be applied shortly after the teeth erupt.
• If the child has sore gums caused by tooth eruption, giving the child a clean teething ring, cool spoon, or cold wet washcloth. Other options include giving the child a chilled teething ring or simply rubbing the child’s gums with a clean finger.