Parent's Guide to Brushing and Flossing Children's Teeth

DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines through Compac Industries. See terms below.

How important are baby teeth?

Baby teeth are very important, but not a lot of people realize just how important they are. There is an assumption by some that, because baby teeth eventually fall out, they are disposable and more like “training wheel teeth” that are meant to take a beating, rather than teeth with a defined purpose.

So why are baby teeth so important?

• They support the progressive eating stages throughout childhood. Liquids to semisolid, semi-solids to first foods and, finally, and hopefully, a well rounded and healthy diet.
• Baby teeth are intricately connected to the process of learning to speak first-words and adapting to proper diction. Thereafter, adult teeth continue in this process.
• They hold the space for the developing adult tooth underneath the gums. If the baby tooth is lost prematurely, it can cause drifting and spacing issues in the surrounding teeth. This, in turn, can also affect speaking and chewing.
• Baby teeth will be in your child's mouth a pretty long time so they need to be healthy and not infected with cavities. Front baby teeth start shedding between 6-8 years of age but back molar baby teeth need to stay in place and healthy until ages 10-13 years old when the adult molars come in.
• If an infection does occur in a baby tooth, called a cavity or caries, it needs to be addressed. The same blood supply that goes to each tooth also moves throughout the rest of the mouth and body. Infections in teeth move outward and downward, spreading deeper and to other teeth and their supporting tissues in the mouth. This will eventually cause pain and swelling and warrant immediate attention.

Just how do I take Care of my Baby’s Teeth?

Now that you know some of the top reasons why baby teeth are important, let's address HOW to take care of those pearly whites. The first tooth can appear as early as 4 months and as late as 12 plus months. Nonetheless, oral care should start before the first tooth makes its big debut.
When oral care starts very early, research shows that those children experience fewer dental issues and challenges. This is mostly due to habit and routine adaptation. Nothing is more challenging than trying to brush the teeth of a squiggly 2 year old who has had little to no oral care done.

How to Establish a Routine for Oral Care

When oral care starts during the infant/baby stage before any teeth arrive, this establishes a routine that is just another normal process for the baby to adapt to, and they do adapt quite easily and without much fussing at this early age. When oral care is put off until later, not only do you have teeth involved that are vulnerable but you most likely have a very opinionated toddler who might not trust a new activity like brushing.

The Importance of Wiping a Baby’s Mouth

Wiping an infant/baby’s mouth cleans the tissues by removing bacteria and milk residue that can build up over time and contribute to an imbalance in the oral environment. This simple starting point is highly effective in laying the foundation for a healthy mouth that those cute little “first teeth” can erupt into.

When Should I Buy a Toothbrush for Baby?

Even if oral care was not started early, it's never too late to start now. Once teeth erupt into the mouth they need to be bristle brushed. No matter how many teeth your little one has, if that’s all 20 of the baby teeth or just the first few, head out now to buy a toothbrush. Pick a brush that is made for your child, whether that be a 6-month-old baby or a 5-year-old child. Most toothbrushes will come with some sort of age range recommendation listed on the package. Make sure that the head is the right size for your child's mouth, that it has soft bristles and the handle is something you are comfortable holding since the adult is the one who should be providing all the oral care. 

When Can my Child Clean his/her own Teeth?

Adults should perform ALL the oral care for their children until the age of 5, thereafter, directly supervising their children doing independent brushing and checking for effective results.

Here's why:

• Children don't acquire the grip strength or dexterity to effectively brush their own teeth, by themselves, until the age of at least 5 and sometimes much later than that. As a rule, to help you gage ability, when a child can tie their own shoes, they most likely have the skills necessary to explore more independence in brushing their own teeth.
• Spitting is an important process to learn and this is usually accomplished around age 3, but only through the training sessions of an adult. Kids will not inherently know to spit out pastes, gels, or even their own saliva. In fact, they will always swallow first, which is all the more of a reason to not allow solo brushing at this age.
• Children must be brush trained first before being allowed to independently brush. They will instinctively place a brush in their mouth but instead of brushing, they will suck and chew, which can look like brushing from afar but it is not. Bristle toothbrushes should never be chewed or teethed.
• Sometime around age 4, it is a good time to start brush training. This is when the adult still performs all of the cleanings by brushing their child's teeth first but then allows the child to mimic or copy what was done by the adult, as the adult coaches them through the process of brushing each tooth surface.

Once brush training has begun, you are well on your way to having an independent brusher. Most children accomplish effectively brushing their own teeth by age 7, however, you will still want to monitor their results by taking a peek inside, to look for any plaque that may still remain or food that can hide in the top crevices of the molar teeth.

When do children shed their Baby Teeth?

This age range between 6 and 13 is also the time when kids start to shed baby teeth, as bigger adult teeth begin to erupt. This season in oral care is called “mixed dentition” and can create spaces, crowding, gaps, and additional nooks and crannies that may need more brushing attention. Additionally, kids can experience some normal pain or tenderness as the adult teeth move into their permanent place while pushing out the baby teeth. When this occurs, kids may brush tender areas less effectively or not at all to avoid aggravating teeth or tissues any further.

How Often Should my Child brush their Teeth?

Tooth brushing should be done twice a day, in the morning and at night before bed. Brushing for a full two minutes is what is recommended by the ADA to effectively remove plaque and bacteria. Brushing every surface of every tooth is important, so the ADA recommends brushing each quadrant of the mouth for 30 seconds, that is the upper right, lower right, then upper left and lower left. Brushing the tongue also removes food and bacteria. Rinse and then spit. Finish up by flossing in between every tooth and then be sure to not have food or drinks other than water before bedtime.

Should a child Floss Their Teeth?

We’ve talked about brushing a lot, so let's not forget brushing’s equally important sibling, “Flossing”. Most children have space between the baby teeth initially, making flossing not quite as necessary early on. However, anytime two teeth are touching they need to be regularly flossed for children. Most baby molar teeth will touch, so if flossing was absent for the front baby teeth, it will be time to implement it once the baby molars come in. Over time, if spaces remain between teeth, whether they are baby teeth or adult teeth, flossing will need to become a regular part of the oral care routine, regardless. This is because of a developing and maturing diet, and how our saliva changes as we get older and in response to our nervous system. Little children do not build up plaque and tartar the same way older children and adults do. In essence, little kids can, shall we say “get away” with not flossing, but just for a little while.

Just like brushing, an adult will need to show a child how to floss, which can be tricky and honestly takes some time to learn. Visuals and videos are the best choice as you begin. The most important aspect of flossing is that it is done correctly. The floss will need to be wrapped around the index finger to secure it so it does not slip. Then two hands will be needed to floss down and underneath the gums of every tooth, while lightly applying pressure to the sides of every tooth, making a C shape. This is the most effective way for anyone to floss. If you google C shape flossing for kids, and then select videos, you will find a wide library to choose from with great visual steps. If after doing that you are still struggling, using flossers is a great option.

The age at Which a Child Should be Brushing and Flossing

By age 8 kids should be regularly brushing twice a day, mostly independently, while still being supervised by an adult. They should be flossing every day, and they should be seeing the dentist regularly for check-ups and getting professional cleanings by a hygienist. Fluoride-free toothpaste and gels may be introduced as early as the first tooth erupts, and once children can spit correctly, fluoride toothpaste may be used, if recommended by your dentist.

So let's recap everything we’ve discussed, and make sure you are ready for each stage and season.

• Baby teeth are important and need to stay healthy
• Start Oral Care Early, before the first tooth, wipe baby's gums, tongue and inside cheeks to remove milk residue and bacteria.
• Use silicone toothbrushes to continue oral care on gums, from 3 months of age and up.
• Introduce a bristle toothbrush as soon as the first tooth erupts. Continue to use silicone brushes on teething gums.
• Use fluoride-free toothpaste or gels until spitting has been learned. Spitting out toothpaste is usually learned by age 3, but requires adult direction. Then implement pastes and gels as needed or directed.
• Choose appropriately sized toothbrushes. The head should fit your child's mouth, have soft bristles and the handle should be something you are comfortable using.
• Adults will perform all oral care for children until age 5. Adults will monitor and supervise all oral care thereafter.
• Introduce brush training around age 4. You brush them first, then let them copy what you did. Their abilities and technique will mature as their grip and dexterity strengthen.
• Most children can effectively brush independently by age 7, but still, need direct supervision.
• If teeth touch, they need to be flossed.
• Flossing should become a normal part of the nightly brushing routine no later than age 5. This will be done by the adult to begin with and take over once the child has adapted.
• Using flossers is a great alternative if regular flossing is too challenging this early. Be sure to keep doing regular flossing practice so this skill is eventually acquired.
• The first professional dental visit should happen sometime between the first tooth erupting and the first birthday, whichever comes first.

Now that you know how to handle oral care for your growing child, any challenges or struggles can be addressed individually with the help of your local dental professionals. There are medical conditions, trauma and injuries, genetic mutations, structural abnormalities, dental anomalies, and growth factors that can affect any of the above reasons. Having a trusted team of professionals to help a parent navigate through is always beneficial.

Sometimes you just don’t know…. what you don’t know! The right words at the right time can be monumental. A lifetime of healthy smiles is a process…..a process that starts one step at a time. No matter when or where you begin, it’s never too late to start. 

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