Our children’s dental health
We all want the best in life for our children, and taking good care of their dental health in their early years makes a lifetime of healthy teeth and gums a reality for them. It’s a wonderful gift to give them, and you can do it for your child by following the simple steps laid out below.
The two main dental diseases that people encounter in life are tooth decay and gum disease. Both of these are preventable. As a parent, the earlier you start to lay the foundation for lifelong dental health for your child, the easier it will be to achieve. We have three young children ourselves, so we are aware of some of the many challenges that parents may face. We can help to support you in safeguarding your child’s precious dental health by providing the information and services that you need to do this, now and in the future.
‘It takes a village to raise a child.’ (African Proverb) Every person who is involved in your child’s day to day care has their part to play in maintaining and protecting their dental health. That includes crèches, childminders, family members, playschools and schools. Please tell them about this resource so that they can be involved and support your efforts. Tell your friends, as it will be easier for you to make healthy choices for your children, if your friends and their children do too.
Here are the three core guidelines to follow for safeguarding your child’s dental health:
1. Clean your child’s teeth at least twice a day Read on…
Cleaning removes the sticky layer of plaque that contains the bacteria that cause tooth decay and gum disease. If we remove the bacteria thoroughly they don’t get a chance to cause problems. Unfortunately we can never remove all the bacteria, and when we finish cleaning they grow back again, so that’s why we need to clean at least twice a day to keep them under control.
We can’t emphasise this enough: Parents should brush their children’s teeth for them until they can do ‘joined-up’ handwriting with ease. Before this time they do not have the manual dexterity to brush their teeth well enough themselves.
- Do let them have a go at brushing themselves too, so they can learn how to do it right by copying what you do!
- Once your child is able to brush their teeth well themselves, (this could be as old as 9 or 10 years of age) we recommend that you still supervise their brushing for them. It is very easy for them to miss certain areas repeatedly and this can lead to decay developing in certain teeth despite their best efforts. We recommend that you continue to supervise them directly until they are at least twelve, and then check regularly that they are actually doing it thereafter.
- For advice and ideas on brushing and motivating your child, please take a look in theF.A.Q.section below.
- Teeth should be cleaned after eating breakfast in the morning, and just before bedtime.
- No more food or drinks, other than water should be taken after the night-time brushing.
- Thorough tooth brushing takes a minimum of 2-3 minutes each time.
- Brushing every surface of every tooth correctly is more important than how long you brush for. Quality not quantity.
- Use a piece of damp gauze to clean a very young baby’s gums (and teeth).
This is very gentle and it helps them get used to having their mouth cleaned.
- For children 0-2 years please use a soft brush with tap water only. The HSE strongly recommends that you DO NOT USE TOOTH PASTE at this stage, (not even children’s tooth pastes);
Because such young children will easily swallow the paste and this can lead to fluorosis of the adult teeth that are developing in their gums. Fluorosis, caused by ingesting excessive amounts of fluoride, can cause rough white/brown spots and lines on the enamel surface of the tooth and it can also cause the enamel to be brittle.
- For children 2 years and older, use a soft tooth brush with a very thin smear of paste on the tip of the brush. See image below.
The official HSE guidelines say to use a pea-sized amount of paste, but even this may be too much, depending on what kind of peas you go by! Ask the dentist to show you how much is enough.
- Use ordinary FLUORIDATED toothpaste. The fluoride, found in most family toothpastes available in the supermarket, is able harden up damaged areas of enamel, and is a very important tool in the fight against tooth decay.
- Spit out the tooth paste but don’t rinse it off, it needs to stay in contact with the teeth to work, the longer it is in contact with the teeth, the more effective it will be at preventing tooth decay, especially when left over-night. Also don’t preload your brush with water before applying the tooth paste, it just dilutes it and makes it less effective.
- The concentration of fluoride needs to be at least 1000p.p.m. or more for the fluoride to be effective. Using a thin smear of an ordinary fluoridated tooth paste will be more effective than using paediatric/children’s toothpaste, because the concentration of fluoride in most paediatric toothpastes is less than 100p.p.m. Also, children are much more likely to swallow the fruity paediatric pastes, and this can become a habit. Read the small print of the toothpaste before you buy it. Sometimes it will be shown as Active Ingredients: Sodium Fluoride 0.32% w/w (1450 p.p.m. F-), it’s the last measurement in p.p.m. that you need to know. 1450ppm will be very effective. See images below for details.
- Please store all toothpastes and mouth washes out of reach and sight of children. Treat them as medicines; they are dangerous if consumed by children.
Did you know that ingestion of toothpaste can even be fatal-a 2 year old child can get acute toxicity from ingesting less than 4g of a ‘kids’ toothpaste! While less serious, We have come across a teenager whose front teeth were quite disfigured by fluorosis, and she admitted to us that when she was very young she used to secretly eat the toothpaste, which was kept on the sink in their family bathroom. Her mother had no idea that she had been doing this. Luckily we were able to help improve the appearance of these teeth, but it could have been prevented.
- Choose a small tooth brush, they are often sold by age e.g. 0-2 yrs etc, and that is usually a good guide.
We find the Colgate Smiles good because they are small and soft, but still firm enough to remove plaque well. At your next dental health check, ask your dentist to show you how to pick the correct size brush for your child’s teeth.
- Change the brush when the bristles become ragged and bent out. See image below. You could say every three months
but that is only a rough guide. Toddlers particularly love chewing and clamping down on brushes, so keep a ragged (clean!) one for them to use themselves, and reserve the new one for you to use on them. You’ll get a lot longer out of each brush and save money too.
The best way to learn this is to ask the dentist or hygienist to show you. It would take pages of text to tell you in words, and even then it might not be completely clear! We advise you to use the Modified Bass Technique. So, since a picture is worth a thousand words have a look at these diagrams until you can visit us in person. We hope to
have our own video demo with the advice we think is best on it soon.
- It’s very important to brush right up to the gum level because this is how you can prevent bleeding gums (gingivitis), and using the Modified Bass Technique helps your child to get used to this from the beginning.
- Plaque disclosing tablets stain dental plaque so that you can see it better, and remove it more easily. They are available from your dental practice and from many pharmacies. You can use the tablets and time how long it takes to clean it all off and this is a good guide for how long you should spend brushing. It can be used after brushing to check how well they are brushing by themselves. See the section below, on motivating your child about cleaning their teeth, for more suggestions.
- For very small children and babies it is often easier to brush their teeth when they are lying flat on a bed or changing table, under a good source of light. This means you will have the use of both hands, a help in keeping their heads in one position.
- For older children, and especially once you start using tooth paste, you can try sitting on the edge of the bed or bath, your child standing between your legs, with their back to you. Hold your child snugly against your body, and ask them to tip their head back into the crook of one arm so you can support it, while you brush their teeth using the other hand.
- Yes, because it cleans between the teeth where nothing else can. This becomes more important as your child gets older to protect their permanent teeth and prevent gingivitis, but please ask your dentist or hygienist to show you exactly how to do this.
It is important to remove food that has packed between teeth, because it can cause decay quickly. It can be very difficult to floss a young child’s teeth, but if it is necessary, it’s best to ask your dentist to show you how to do it correctly. Oral B Satin Floss is one of the best.
- Use floss before brushing, this clears out the spaces between the teeth so that the tooth paste foam can more easily get in there, and harden up the enamel where the teeth touch.
No. Mouthwashes are not necessary except in certain circumstances.
- They are never a substitute for brushing and flossing, because they do not remove the sticky layer of plaque.
- Do not use immediately after tooth brushing as they will dilute the effect of the fluoride in the tooth paste. If you must use them, then use them at some other time during the day.
- We do not recommend them unless we believe it is necessary. Many contain significant concentrations of alcohol, and are certainly not advisable for children. The dentist or the hygienist may recommend special mouthwashes for those who have a high decay rate, who have braces, gum disease, dry mouth (xerostomia), and certain medical conditions.
2. Avoid giving your child sugary foods or drinks, especially between meals. Read on…
- Offer healthy snacks between meals, e.g. cheese and crackers, cheese strings etc, hummus and veg sticks breadsticks, peanut butter sandwiches, steamed carrot sticks, apple. For older children peanuts, nuts (except allergy sufferers) and seeds, plain or salted popcorn, olives, are great, but beware of the toffee-like raisins and other dried fruit!
- Check the ingredients labels of the foods and drinks you buy for the sugar content.
Sometimes supposedly healthy foods are not very good for your teeth, or say ‘no added sugar’ but contain natural sugars, e.g. children’s yogurt, fruit squashes. Did you know that there are approximately 3 teaspoons of sugar in a 180ml pouch of smoothie, and one teaspoon of sugar in a little pot of fromage-frais? Look out for sugars by different names: sucrose, glucose, dextrose, maltose, fructose, syrup, invert syrup, invert malt syrup. The nearer the start of the ingredient list the sugar is, the more sugar the product is made of. You can also look at the ‘Carbohydrates: of which sugars’ list to see how much sugar is in 100g of the product.
- The only tooth safe drinks are water and milk.
Don’t give sugary drinks like minerals and fruit squashes between meals, and keep fruit juices for meal times too. The liquid sugar solution in them is very good at causing tooth decay when consumed regularly between meals. Give your child a straw when they are drinking sugary drinks as it will bring the liquid further back into their mouths where it is in less contact with the teeth. Try to finish meals with water, cheese or milk.
- It’s best not to eat or drink anything except water within half an hour of going to sleep.
Only water is suitable for drinking after brushing your child’s teeth at night. When we go to sleep our body reduces the amount of saliva that we produce (because it’s not needed then), and saliva is good at neutralising the acid that plaque bacteria produce. So if we eat just before going to bed, the mouth doesn’t have a chance to naturally cleanse itself with saliva, and the plaque bacteria have a night long party on our teeth. If eating before bed, e.g. a bowl of cereal, is a habit, it can have serious consequences for your child’s teeth. Give it to them earlier, make sure it is a tooth friendly food or cut it out.
- Prevent ‘baby bottle/nursing’ decay: NEVER allow your child to have fizzy drinks, juices, milk or breastmilk in constant contact with their teeth.
Don’t let them sleep with a bottle or feeder in their mouths. Never dip a soother in anything sweet before giving it to your child. Encourage your child to start drinking from a beaker or cup (you can gradually do this from about 6 months old). Don’t forget to brush their teeth after the last feed of the day.
- Ask for/choose sugar free medicines. Your pharmacist and doctor will be happy to help you with this. This is especially important if your child takes regular medication.
- Don’t give ‘sweet treats’ between meals, keep them for just after main meals, and give ones that can be eaten quickly in one go, and not slowly over time. There are sugar free treats available in some stores like M&S and Boots. They contain artificial sweeteners instead of sugar, but they are still a treat and the same rules should still apply to give your child good habits.
- Sugar free chewing gum is great for making saliva: Saliva is great for teeth.
Please read the label, as not all gums are sugar free. It is only suitable for older children, and you will need to tell them how to use it and dispose of it carefully, but it is great to use after a sweet treat to help neutralise plaque acid and remove debris from the biting surfaces of back teeth.
- The older your child is before they are introduced to sweet treats and drinks the better.
This is easier to do with your first child, but hold firm, you are not being a ‘mean’ parent by not giving them sweet treats at a young age. You are protecting their teeth, and they don’t miss what they don’t know. Their ability to appreciate savoury flavours may lead them to healthier food choices later.
- A ‘Diet Diary’ is a good way to assess the tooth friendliness of your child’s diet. A diet diary can also be a very helpful thing to bring along to your child’s dental visit, your dentist can read through it to look for any “hidden-sugar” foods. If your child is diagnosed with tooth decay then your dentist may ask you to complete the diet diary and bring it in so they can give you further advice on a tooth friendly diet. Download Diet Diary and instructions here.
3. Bring your child to visit the dentist regularly, as often as your dentist recommends. Read on…
- ‘First visit by first birthday’ is a good guide but you can bring your child to the dentist as soon as their first tooth erupts. This is what the Irish Dental Association, and all the international dental associations recommend.
Prevention is ALWAYS better than treatment.By bringing your child to the dentist at this young age, and before problems have a chance to arise, we can:
- show you how to clean your child’s teeth properly;
- give you the best advice on your child’s diet for their age (many foods that seem healthy can be very damaging to teeth);
- check for any potential problems that may be there, e.g. early diagnosis can be made of oral disease, developmental tooth defects or perhaps missing or unusual shaped teeth. The earlier problems are found, the better we can plan to manage them. Early advice on soother use & thumb sucking can save on bills for braces later.
- It gives your child a chance to get know and trust your dentist, and helps ‘visiting the dentist’ to become a normal, enjoyable, routine event in their lives.
This starts your child off on a lifetime of good oral habits. Please read our section on the importance of healthy baby-teeth.
- Your dentist will advise what is best depending on your child’s needs, but generally we recommend twice a year. People who attend the dentist regularly go on to need much less treatment than those who don’t.
This depends entirely on the age, personality, and confidence of your child, and any preconceptions they may or may not have about visiting the dentist. It also depends on the status of their dental health.
- For very young children and babies, all we seek to do is check their teeth and mouth in so far as they will let us, help them to get used the dental environment (bright lights, shiny instruments and strange smells) and give you advice and demonstration on how to clean their teeth and manage their diet.
- For older children we aim to do the same, and the more cooperative they are able to be, the easier it will be to check their teeth.
- With the exception of a child attending after a dental trauma (e.g. knocking a tooth out) we will try not to do any treatment at the first appointment even if it is the main reason for coming in. The reason for this is that it is very important that we can gain your child’s trust, before we attempt to treat them. Pushing a child into treatment in a situation where they do not feel comfortable can often result in them not wanting to attend ever again. It is very important that your child’s first visit is pleasant. In the event that your child is in pain from a toothache or open cavity, we may opt to give an antibiotic to treat the infection, or place a simple temporary filling first . We request that you bring them back to have the treatment they need at a subsequent appointment, when they are no longer in pain. We find that they are able to accept treatment much more easily in this way.
As we said above, we really want your child’s first visit to be enjoyable and memorable, so a little bit of positive preparation at home in advance is also a good idea.
Frequently asked questions:
How can I help my child to develop good dental habits and be motivated about cleaning their teeth?
Contributors: Dr Catherine Vaughan, Dr John Burke, Dr Martina Kelleher, Dr Amita Bhagwat, Ms Hilda Reid. Many thanks to all those who gave time and expertise so willingly.
We really appreciate your feedback, it helps us better meet your needs, improve our services, and be the best we can be! If there is something here that you would like further information on, or like covered in the future, please email us at email@example.com, or telephone 093-60333.