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Module 3: Prevention of Tooth Decay

3.2 Oral Hygiene Practices

  • Begin cleaning an infant’s gums with a damp cloth or a soft infant toothbrush and water after feedings even before the teeth erupt.
  • Begin cleaning an infant’s teeth as soon as the first tooth erupts, usually around age 6 to 10 months. Use a soft infant toothbrush that is easy for the parent to hold and small enough to fit in the infant’s mouth. Lift the lips to brush the front and back of the teeth and at the gum line.
  • Brush an infant’s or child’s teeth two to three times a day, preferably after eating. Brushing before bed is most important. Remember not to give the infant or child anything to eat or drink (except water) after brushing at night.
  • To brush an infant’s teeth, the infant should be seated in the parent’s lap, with both facing in the same direction. To brush a child’s teeth, the parent should stand or sit behind the child, with both facing a mirror.
  • For infants and children under age 3, parents should start brushing the teeth as soon as they begin coming into the mouth by using fluoridated toothpaste in amounts no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children's brushing to minimize swallowing of toothpaste.
  • For children ages 3 to 6, parents should dispense no more than a pea-size amount of fluoridated toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children's brushing to ensure that they use the appropriate amount of toothpaste.
  • Make sure the infant or child spits out the toothpaste after brushing, but do not have the infant or child rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps build strong healthy teeth.
  • Young children will want to hold the toothbrush and participate in toothbrushing, but they cannot clean their teeth well without parental help. After children have fine motor skills (for example, the ability to tie their shoelaces), typically by age 7 or 8, they can clean their teeth well on their own but should be supervised.

Case Study #003

A mother of a 22-month-old tells you that she's concerned because her son throws a tantrum when she tries to brush his teeth. What should you do?

Stanton H. Wolfe, D.D.S., M.P.H. Replies:

Stanton H. Wolfe

You should let the mother know that we’re really pleased that she’s concerned about her toddler’s teeth. There is a problem, though. A toddler cannot really brush his teeth in a way that will prevent tooth decay. He is probably walking around the room with the toothbrush in his mouth, sucking on it or just scrubbing one spot in his mouth, and that’s not going to promote good oral health. So let mom know that until the child has the proper coordination, and that doesn’t happen until about the time a child can tie his own shoes, which is about the age 7 or 8, the mother needs to help brush the teeth. She needs to supervise. She needs to actually do some of the brushing, and gradually transition the child into his own good oral hygiene practices

mother brushing infant's teeth
mother brushing toddler's teeth
pea-sized amount of toothpaste on a brush

Pea-sized amount of toothpaste