Getting off to a good start with children's oral health

When it comes to oral care for children, getting off to a good start is essential.  Teeth play an important role in jaw development, eating and speech. They need to be healthy and well-cared for from the beginning. In New Zealand tooth decay is a significant problem, with almost half our children having cavities by the time they reach five years of age.

To give children the best chance of good oral health, pregnant women need to take care of their own oral health and eat a healthy diet with plenty of folic acid and calcium. This provides the essential building blocks their babies need for forming strong, healthy teeth; a process that begins in the womb. Nutrition plays a key role in oral health throughout a person’s life.

Care of baby teeth

If you are bottle-feeding your baby, put only breast or formula milk in the bottle. When given by bottle, fruit juices or other sweetened drinks bathe your baby’s teeth in bacteria-feeding sugars for a long period of time.

Always feed your baby while holding him. Never put him down with a bottle.

If you give your baby a dummy don’t sweeten it first (for example with honey or syrup), as this coats the teeth with sugar and holds it there to decay teeth.

As soon as the first baby tooth comes through you need to start cleaning it. Use a damp cloth or a soft baby toothbrush and either water or a speck of baby toothpaste. A good way to do this is to sit baby on your lap, with you both facing the same way.

Be on the look out for spots or stains on your child’s teeth right from the start. By lifting your child’s lip up you will be able to see if there are signs of early decay on the front teeth. See a family or paediatric dentist or dental therapist at the first sign of any discolouration.

Also watch for signs of gum disease (gingivitis); red, swollen areas that bleed easily when brushed. Gingivitis in children can be quickly treated by a dentist.

Toddlers and oral care

Toddlers are more independent and often will want to brush their own teeth. By all means let them have a go, but it is important to then ensure that all surfaces are thoroughly cleaned by brushing them yourself as well. Most toddlers and young children can’t yet manoeuvre their toothbrush to reach all surfaces of their teeth.

Choose a toothbrush with soft bristles and a small head that can reach to the back of the mouth. Change the toothbrush regularly, whenever it begins to look worn-out, or at least every three months.

Brush your child’s teeth twice a day with a small dot of fluoride toothpaste.

A good way to brush is in front of the mirror, both facing it. Crouch behind your toddler, or sit him on your knee. Positioning the brush at a 45-degree angle to the gums, brush all surfaces of every tooth back and forth in small, tooth-wide strokes. 

Brushing should take two minutes and is best done after breakfast and last thing at night.

Encourage your child to spit out but not to rinse.

Children’s dental hygiene

Children should start to floss from age four. At first parents will probably need to do this for their child.

Around six years of age your child will get his first adult molars behind his baby teeth. These, and his other teeth, will benefit from a pea-sized amount of fluoride toothpaste each time you brush his teeth.

Until your child is at least eight or nine years old, you should continue to help him brush his teeth. By this age, he should have developed the dexterity and understanding required to do a thorough job.

Tooth-friendly foods

A diet of sugary snacks allows the bacteria and acids that create tooth decay to thrive in your child’s mouth. The New Zealand Ministry of Health recommends the following foods, with no added sugar, salt or fat, as appropriate snacks: 

• whole wheat breads, crackers, muffins
• raw vegetables and fruits, unsweetened canned or frozen fruits, vegetable juices
• milk, plain yoghurt, cheese, cottage cheese
• egg, seafood, lean meat and chicken
• nuts, seeds and legumes.

Local school and community dental services

Dental care is free for New Zealand children and young people up to the end of their year eight (form two) at school.

It is a good idea to enrol your child in your local community-based dental service before their first birthday. This allows for problems to be prevented, detected and addressed early. It also helps your child develop a positive association with dental visits, rather than an aversion to them.

To find your local community dental service, contact your local school dental clinic or District Health Board, your GP, Plunket nurse or WellChild provider.

See also: Mother's oral health predicts child's dental health,  "Lift the Lip" campaign to spot early cavities in children, Oral health for adults.

Original material provided by everybody. Reviewed by Pam Brennan, Professional Adviser, Auckland Regional Dental Service. September 2009