Oral Care For Babies and Toddlers

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.

 

When you think of the term “oral care”, I’m sure the first thing that pops into most people’s mind is “toothbrush, toothpaste, and teeth”. Simple, right? Not quite that simple. Oral care is much more than a few items to pick up at the store, and it should begin much earlier than when actual teeth are involved. Not only should successful oral care start early, like “Newborn Baby Early”, but there’s more to it than just brush, spit, repeat. It begins when life begins.

The thought process a family goes through when planning the home care routine for a newborn baby usually doesn’t involve oral care, but it definitely should. We make schedules for feedings, diaper changing, bedtimes, naps, bathing, and we should also include early oral care intervention, and here’s why!

Babies have delicate and actively developing immune systems, in fact, their immune system doesn’t start fully working on its own until 3 months of age and then continues to get more effective with time. Infants are more susceptible to the effects of new bacteria and viruses in the earliest stages of being introduced to this amazing new world, whether that be from respiratory inhalation, direct contact or oral absorption. This factual reality should show us the importance and need for protecting and implementing a newborn’s contact points during this vital period. This can be done by keeping the baby at home as much as possible during those first 3 months, which helps with exposure to bacteria and viruses by inhalation and direct contact. You can help prevent oral infections by wiping and cleaning your baby’s mouth at least once a day, to begin with, and more often, as needed, as they grow and develop.

Maternal Breastmilk and formula supplementation 

Maternal breastmilk and formula supplementation both have the potential to contribute to oral infections like bacterial overgrowth, and even gastrointestinal events plagued by excessive reflux or regurgitation episodes. This can allow acids to coat the oral cavity, which changes the protective pH balance of the mouth and irritates the tissues, possibly leading to oral conditions that may need intervention later on, like yeast infections or what’s commonly referred to as thrush.

Thrush happens when the small amount of normal candida fungus that lives in the mouth, grows and proliferates, abnormally, leading to the development of white patches on the tongue, gums, and cheeks, signaling, a candida fungal infection is present. Usually, candida in the mouth is kept in check by the body’s immune system and the delicate balance of oral bacterial flora, but because babies have immature immune systems, they are more vulnerable to the oral environments they are exposed to and any variability in their own immune system or the immune systems of their mothers.

Up until about 3 months of age, there’s not much saliva to help wash away any of the milk residues that can build up in your baby’s mouth, so starting an oral care routine early is the key to prevention. After 3 months, the salivary glands start producing fountains of liquid where drool elicits the need for bibs that are not just needed but become quite a necessity! During the first 3 months, babies are either nursing or being bottle-fed, and this is a great time to introduce cleaning your baby’s mouth after feedings, to help reduce the build-up of pathogenic bacteria and fungus that can lead to “thrush”, and even oral diseases and cavities later on in life.

 

Early Oral Care Routines

You can initiate an early oral care activity by using a sterile cloth to gently wipe baby’s gums, tongue, and inside cheeks with after feedings. The best way to start is by scheduling this within the other activities in your routine.

What this activity accomplishes is twofold: It removes any milk residue that has been leftover from feedings throughout the day, helping to prevent a build-up from occurring in the mouth, which in turn, if leftover time, can potentially cause negative issues.

Remember, you’re not just cleaning the mouth, you are training yourself and your baby to adapt to, and accept this new routine. Studies in early oral care prevention have shown that children who were introduced to early brushing and gum wiping routines had a significant reduction in the incidence of oral care diseases and cavities later on in life. Babies are programmed to be oral explorers in the first few years of life. From suckling to teething, their most dominant sense during this time frame is oral stimulation, so if you introduce this routine early, not only are you laying the foundation for a lifetime of healthy habits but you are preparing the oral environment for the arrival of new budding teeth to grow into, during a time frame when your child is the MOST accepting to this type of routine.

Babies love to have their mouths wiped and cleaned, it is a sensory activity to them that forms a trusting bond with you. You are the catalyst for instilling this vitally important routine into their mental programming as a necessity, and they will continue to build upon this as they grow and mature. An excellent tool and product that can help you in this process are Brilliant’s Tooth Tissues Mouth Wipes.

 

Parents perform all oral care

For the first 5 years of a child’s life, YOU are the one who will be doing ALL of the oral care for your child. Children usually do not acquire the proper dexterity to effectively brush their own teeth until around age 5, and in some cases, later than age 5. So, with that being said, you’ve trained yourself as the parent/caretaker to feed them regularly, bath them regularly, put them to sleep with regularity, and you will also need to do their oral care regularly for them. Now, this does not mean they won’t eventually be brushing their own teeth, there’s just a “best” time for that and we will explore that later.

Babies can begin to teethe as early as 3 months of age. This is the time frame that begins with increased saliva as the mouth prepares for the arrival of the infamous “First Tooth”. Many children get their first tooth between 4-8 months of age, yet some pass their first birthday still sporting a toothless smile. No matter what time frame your child falls into, “teething” is a foundational milestone that you and your child will go through together that creates a great opportunity for you to continue an early oral care routine.

 

Silicone Toothbrushes

The next step is to add in a silicone toothbrush to oral care time. There are several different styles of silicone toothbrushes for babies. A great choice to start with is a finger brush, where the brush fits snugly over an adult’s finger, it has small bristles on one side that you will use to brush with in the mouth.

Execute this by wiping and brushing over the baby’s gums and tongue. Brilliant’s Finger Toothbrush is a great example of the type of brush you want to use at this stage. You don’t want to use fluoride pastes or gels yet because fluoride is not safe for a baby to accidentally swallow. However, Xylitol enhanced mouth gels are fantastic alternatives to using fluoride at this age. Xylitol actually helps to control the pathogenic bacteria in the mouth by inhibiting their ability to proliferate and grow, essentially starving the bacteria of a food source, making them less adherent to oral tissues.

Spry Tooth Gel contains Xylitol and has a great strawberry-banana flavor that kids love! You only need a small smudge of gel, about the size of a grain of rice, for brushing. Xylitol is safe if swallowed within the recommended safe dose for babies and children. 

Xylitol works so well at inhibiting bacterial growth, that you will find it in many ear drops, nose sprays, or throat lozenges as the active ingredient that helps to prevent and even treat infections.

 

Teething

At some point, your baby will be in full “active teething”, with all the chewing, biting, gnawing and probable fussing, your heart (and ears) can handle. This is a stage where they will put just about anything in their mouths, so caution and supervision is monumentally important. You may suddenly notice how strong their little bite has become when you try to put your finger in their mouth for brushing or wiping. This is a good time to transition to a silicone toothbrush design that has handles or grippers on it that will allow you to brush without putting your fingers in their mouth and it can allow your baby to self soothe by teething on the toothbrush independently.

There are some really fun styles of brushes to choose from. One is Baby’s 1st Teether-Brush (toothbrush) by Brilliant. You will notice that the silicone brush is a bit firmer type of brush and this is a good thing. Now your baby is not only getting a good gum brushing, they are also helping to soothe and ease sore and tender gums as the teeth begin to bud and erupt through the gums.

You may notice little swollen bumps in the mouth. Not to worry, those are little teeth trying very hard to peek through the tissue. Allow your baby to teethe on safe items as much as possible to help ease discomfort. When you use silicone teethers, you can also chill and freeze many of them, which helps to provide pain relief. Be sure to wash teethers, brushes, and any toys that your baby chews on regularly.

 

The First Tooth

Finally, at some point, you will notice that the first tooth has emerged through the gums. Hallelujah, the first tooth is here! Get the camera, and snap a pic because nothing is sweeter than that cute little pearly white tooth busting through your sweet angel’s gummy smile. Mission accomplished!

Once a tooth fully erupts into the mouth, it’s time to add a bristled toothbrush to the routine. This is a time frame where the baby will still be teething and need teething relief but will have new teeth that will need a good bristle brushing as well. Keep using the silicone toothbrush and add in the bristle toothbrush for the new teeth. You will find the Brilliant Baby Toothbrush will clean their brand new teeth successfully!

Bristle toothbrushes are not to be used for teething purposes by babies or chewed on by children. The bristles are not meant to be chewed or bitten, nor is the plastic handle designed for that type of bite pressure. Biting down on bristles can cause painful mouth ulcers by piercing the gum tissue. Choose a baby toothbrush with soft, and short bristles. Remember, you are performing all the oral care from now until around age 5.

 

Early Childhood Caries

Eruption patterns differ from child to child. However, most children will get the two “bottom” front teeth first, then the two “top” front teeth. This is also the season where first foods get introduced. This adds additional starches and sugars to the diet, making oral care vitally important, especially before bedtime. If oral care has been absent up to this point, don’t worry, but NOW is the time to get a regular routine.

Early childhood caries (cavities) are considered the most chronic infectious disease that plagues our children today. It can begin early, progress rapidly, and often goes untreated until there are painfully obvious visual or sensory symptoms. Children should visit the dentist for their first “Smile Visit” somewhere between the first tooth appearing and the first birthday.

This is when they will be examined for normal anatomy and function, oral care routines will be reviewed, and future visits will be determined. Most children will receive their first professional dental cleaning around age 3. If you are concerned that your child is having feeding or latching issues early on, a lip or tongue tie may be the culprit and if not corrected, can negatively affect growth milestones and anatomical development. Never hesitate to reach out to your pediatrician or dental professional for an evaluation. Treatment is usually very simple and mostly painless for your baby.

 

Toddler Time

Hold on, and brace yourselves because now in the timeline you most likely have, “ A Toddler “. A glorious little bundle of everything you ever thought was beautiful about this world! They love to explore, babble, and talk, they crawl, walk, and scoot their way across your heart, while assessing that YOU are the best thing that ever existed.

They are enamored by the purest things in life, like color, animals, water, happy sounds, sensory stimulation, and blissful snuggle sessions. Toddlers roam about between the ages of 12 months to 36 months (age 1-3 years). This is such an amazing cognitive, emotional, and social season for them and for YOU.

They will become fiercely more independent during this time, as you watch a little piece of your soul toggle off into the world of “I do, I do ” and “No… Mama/Dada”.

Their molar teeth are piercing through the gums, and the teething pain and fussiness have almost ended. They are eating more sticky, gummy, and chewy foods now, a time frame when they have more pits, grooves, and fissures that need additional oral care attention. Now is the time to consider upgrading to a toddler toothbrush that has soft, yet more firm bristles. Silicone toothbrushes can be removed from the oral care routine once all the front teeth have come in. Most toddlers will get their first molar tooth between the 13-19 month stage.

By now your toddler should have had their first dental visit under their belt, and be steadily working their way to eating mostly solid foods. Oral care is now a daily thing that must be done…by you.

Use a toddler toothbrush with a smudge of  paste or gel every day, especially at night before bedtime. Be sure to reach the tops of the back molar teeth when brushing. As your child matures and grasps the routine you have implemented, you can begin to “Brush train’ them.

This means you are starting an oral care routine by doing the brushing and cleaning for them, but as your child is able, you teach them to spit, and then allow them to hold the toothbrush and mimic the motions you perform while providing their own oral care. As they mirror you and you guide them through these sessions, they will eventually build up enough dexterity to effectively brush their own teeth.

As a rule to follow: If your child can tie their own shoes, then they have the grip strength and control that’s needed to brush their own teeth. I find that this is not usually accomplished until age 5 or later, while spitting capability is achieved earlier, usually age 3 or 4. The Brilliant Child Toothbrush will help you as you teach them the basics of learning how to independently brush their teeth.

 

The Way…

Let there be no question, raising a child and training them in “The Way”, is a noble and constant endeavor. It encompasses so many different avenues in this life, and oral care is just one of those foundational branches. Never fear that you are too late or too far past a milestone to start a prevention routine.

Never underestimate the value of a team approach and remember, it really does take a village! Sometimes that village is all family and homecare bodies, and sometimes that village comes in the collective form of supportive educational care that’s found in doctors, nurses, dental professionals, and childcare supporters, to establish routines and therapies that work for you and your family.

Baby teeth matter, (I honestly cannot stress that enough) and it’s important to keep them healthy, in their correct spacing place, disease and trauma-free, until the permanent adult teeth are ready to come in. Just because baby teeth eventually fall out, it does NOT make their oral care any less important.

Baby teeth are spaced just right to allow for the growth and development of the jaw, skull, and incoming adult teeth. Any disruption in that pattern can affect many factors that will ultimately have an impact on future eruption patterns and bone development.

Start oral care early, with interventions that help to build routines while supporting the process of eating, and oral exploration. Continue established routines while introducing professionals into your repertoire, while expanding food choices to curious toddlers and young adolescents. Begin training them to spit and eventually to brush independently of your direction, always directly supervising their routines. Before you know it they will be existing without much of your direct control and you will wonder where your curious dependent toddler went and how this precocious teenager became so independently compliant. It’s a journey, so don’t forget to enjoy the ride!

 

Brilliant Oral Care exists to make sure you and your family have the best at-home oral care available. We want your children’s baby teeth and permanent teeth to be the healthiest teeth possible and we want to help you as you begin caring for baby’s first teeth. Cavities and tooth decay are the enemies, we have the only weapons you will want to use in this fight! Choose only the best for you and your family, choose Brilliant!

 

 

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