Teeth and Gum Care for Infants and Toddlers

DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines.

Oral care for infants and toddlers is just as important as oral care for adults. Today I’m going to review some of the questions I’m often asked by parents when discussing oral care recommendations for their children. It’s more than most people think and starts earlier than most people realize.

1) Do I need to clean my newborn baby’s mouth?

Yes! Cleaning your baby’s mouth is the first step in introducing early oral care routines that will last a lifetime. Start as soon as possible, and continue at least once a day thereafter. This routine trains a baby to accept oral care as part of a regular routine and it also trains the parent to perform this task regularly.

2) When should I start cleaning my baby's mouth?

From the very beginning! Once a baby starts to drink breastmilk or formula, it is recommended and appropriate to start an early oral care routine. The earlier a routine is started the better. Bacteria and fungus naturally live in everyone’s mouth but the levels and ratio need to stay balanced for optimum health. Starting oral care early helps develop a lifelong routine but also keeps a more balanced oral environment. By gently wiping away residue and bacteria, you are keeping the mouth clean while supporting a healthy foundation for the future eruption of the first teeth.

Some professionals recommend cleaning a baby’s mouth after every feeding. However, this may be a stretch for most sleep-deprived parents. Start by committing to at least once a day, around the same time, and make it a part of your regular routine. You will need a sterile cloth, preferably one that is meant for this activity usually named a mouth wipe or tooth tissue, versus a common household washcloth. Next, wrap the cloth around your adult index finger and proceed to wipe the gums, tongue, and inside cheeks of your baby. That's it!

• Start oral care within the first month.
• Use a sterile cloth or mouth tissue to wipe and clean the baby’s mouth.
• Perform at least once a day, preferably following a feeding schedule.
• Wrap the sterile mouth tissue around your index finger.
• Using your index finger, wipe the baby’s gums, tongue, and inside cheeks.
• One-time usage for all oral care wipes.

3) How do I promote oral health for my infant or toddler?

Starting oral care early is the foundational first step. Once that has been established, protecting the oral environment is next, and that means diet and nutrition. Limit snacks in general, but when they are enjoyed, stick to fruits and vegetables and hold back on foods that are sticky, gummy, or chewy as these types tend to adhere to teeth and gums and cause a higher rate of cavities from their elevated carbohydrate and sugar contents. Regular bristle brushing should be performed on all teeth, twice a day, by an adult. Visit the dentist when the first tooth erupts or by the first birthday, whichever comes first. Implement a rule that after the nightly brushing, food and snacks are off-limits. This includes milk, so no bedtime bottle. One of the most rapid ways parents unknowingly induce tooth decay, is when they allow their children with fully erupted baby teeth, to fall asleep right after having a bedtime milk bottle.

Help prevent decay

• 0-3 months- Wipe baby's mouth with a sterile cloth, at least once a day to remove milk residue and bacteria.
• 3-6 months- Perform an evening brushing routine, using silicone toothbrushes on baby’s gums to remove biofilms and bacteria.
• 6 months and up- Once the first tooth erupts into the mouth, start to use a bristle toothbrush on the tooth and continue to use silicone toothbrushes on teething and budding gums.
• Use a xylitol-based tooth gel for children 3 months and older to help protect teeth and gums.
• Don't allow a child to go to sleep with a bottle that contains a sweetened liquid.
• Don't dip pacifiers in sweet syrups to coax a child to sleep.
• Don’t use your saliva to clean a pacifier, bottle nipple, or around a baby’s mouth. Pathogenic bacteria can be transferred from an adult to a child, including the bacteria that cause oral decay.
• Visit the dentist within 6 months of the first tooth erupting or by the first birthday, whichever comes first.

Establish new routines

• Instead of a bottle right before bedtime, feed your baby first, then give them a warm bath, followed by an oral care routine to clean the mouth, and then rock the baby in a cool and quiet room with a little bit of white noise.
• Avoid sugary liquids. Milk or water is the only thing that should go in a bottle. Children don't need juice, however, if juice is an occasional treat it should be consumed from a regular cup and not from a bottle.
• Don't give children soda. Soda is very harmful to teeth. The acids in soda can cause erosion on tooth enamel and the sugars can cause cavities, not to mention sodas are just empty non-nutritive calories.
• Get set to remove the pacifier!!!! Choose cold turkey and let it just disappear, or apply the gradual approach by slowly reducing its availability. Another option is the transitional method, where you avert the pacifier fixation to something else, something more stimulating like a teether toy, and then prepare yourself for at least a handful of sleepless nights. Keep in mind that this is the best decision for your child's oral health and development, especially when the days and nights start to run together.

Meal Planning Tips

• Make 3 healthy and nutritious meals, with plenty of vegetables and some seasonal fruits.
• Make water the only beverage option, other than supplemental milk, as needed, but keep milk as a treat outside of mealtime for toddlers and kids.
• Don't buy treats and sugar-filled foods for your house. Buy fresh fruits, vegetables, plain yogurts, cheese, nuts, and seeds for snacks. Serve food as age and dietary restrictions allow.
• Enlist a once a week treat. Make it an event and fun. Go out for ice cream, grab a special bakery item, or indulge in something decadent. However, make it once a week.
• Train your toddler to use a regular drinking cup early.

Celebrate special events and accomplishments with something other than “food rewards.” Instead of a sucker or candy as a reward, utilize non-food treats.

4) How do I care for my baby's first teeth?

Once the first teeth erupt it's time to start using a bristle toothbrush. Keep doing previously established oral care routines on the rest of the mouth. This includes sterile mouth wipes and silicone toothbrushes used on the gums. Implement using a bristled toothbrush on newly erupted teeth, continuing this as subsequent baby teeth erupt into the mouth. You may use fluoride-free toothpaste or a paste that has xylitol as the active anticavity ingredient. Fluoride should not be used until a child can spit correctly and this is usually not achieved until age 3. Adults should perform all the oral care for their children.

• Introduce a bristle toothbrush as soon as the first tooth erupts.
• 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.
• Use fluoride-free toothpaste or gels until spitting has been learned. Xylitol is a great fluoride alternative or it can be used in combination with fluoride as directed by your dentist.
• Spitting is an important process to learn and this is usually accomplished by 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, 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.
• Most children will be able to effectively brush independently by age 7 but will still need direct supervision by the parent.

5) What kind of baby toothbrush should I use?

A Bristle baby toothbrush should have soft flexible bristles that are gentle enough to brush newly erupted teeth effectively. The head of the brush should be small enough to fit in a small mouth, and the handle should be comfortable for an adult to hold while using the brush on the baby's teeth. Baby silicone toothbrushes are another great choice for teething gums before teeth fully erupt. You can use both types during an oral care routine as needed. A silicone toothbrush for teething babies assists in cleaning budding gums while a bristle toothbrush is the best for newly erupted teeth.

6) How long should you brush a toddler's teeth?

Brushing routines should last about 2 minutes, especially once all the baby teeth have come in. Children do tend to build up less plaque biofilm than adults. So their needs sway more to the repetition of an oral care routine and training them in the correct way to eventually perform their own oral care. Twice a day, brush their teeth for 2 minutes. To make it fun, get a colorful sand timer or find a song to sing that’s 2-3 minutes long. While you are brushing you can even allow some electronic fun by downloading a kids oral care app that keeps track of brushing frequency and timers, rewarding compliance with stickers and stars.

7) When should I start to teach my child to brush his own teeth?

Adults should perform ALL oral care for children up until the age of 5. This does not mean that you cannot start brush training before then, age 3 is a good training age. When brush training, the actual cleaning is done by you first, and the practice training is done secondly by the child while you directly supervise them as they learn.

Be sure to check out the best baby finger toothbrush and the best toothbrush for kids by visiting https://www.brilliantoralcare.com/collections/oral-care-kits and scooping up one of our amazing NEW oral care kits. These kits come with everything you need to start a lifetime of healthy smiles. Early oral care is important! Talk to your dental professional about any challenges you may encounter or questions you may have about taking care of your child’s teeth and gums. Remember to always #BrushBrilliant

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