Dental Care and Cavities

Brushing Teeth – When, How and with What

Figure A

Figure A

Figure B

Figure B

Cavities are related to specific types of bacteria that are often passed from mother to child. Bacteria reduces acids that demineralize the tooth’s enamel. Other risk factors for cavities include consumption of simple sugars (ex. candy and juice), inadequate brushing, and suboptimal fluoride exposure. Fluoride works primarily by a topical application to the teeth allowing calcium and phosphate to be incorporated into the enamel. This helps prevent demineralization and subsequently cavities. Parents need to help their children strike the right balance between not enough fluoride that will cause increase cavities, and too much fluoride, which will cause Fluorosis. Fluorosis causes permanent stains on the teeth. Fluoride is found mainly in water fluoridation (most city water supplies) and Fluoride toothpaste. Until recently, many of us were worried that giving Fluoride toothpaste to children younger than 3 could cause Fluorosis. However, there is evidence that using Fluoride toothpaste as noted below is extremely helpful in preventing cavities and without causing Fluorosis.

The recommendations are as follows:

  1. Parents should start brushing teeth with the eruption of the first tooth using a toothbrush.
  2. Parents should brush teeth twice a day until children are able to brush teeth by themselves.
  3. For Children less than 3 years old, a “rice grain size” amount of Fluoride toothpaste should be used (Figure A).
  4. For Children 3 years and older who can spit out the toothpaste, a “pea size” amount of Fluoride Toothpaste is used (Figure B).
  5. DO NOT rinse after brushing. This causes younger children to swallow the toothpaste and older children to remove the Fluoride and the topical beneficial effect.

****Children may be seen by the dentist as early as their first tooth eruption. But, if parents are following the above guidelines and there are no brown or white plaques on the child’s teeth, bottle and breastfeeding have stopped after 12-13 months of age and there is no family predisposition to cavities; children may be seen at 3 years of age.

Source: Photo and information above from Pediatrics in Review Jan 2014, an American Academy of Pediatrics Publication.