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Clean mouth for good health: Pediatric oral hygiene recommendations

Erin Martin, APRN, CNP
Erin Martin, APRN, CNP

Erin Martin, APRN, CNP

Most babies cut their first tooth by 6 months, but do you know when the experts recommend beginning oral hygiene practices? How old should your baby be when he or she first visits the dentist? At what age are children susceptible to decay and cavities? How can you best protect your child’s teeth between birth and adulthood? The answers may surprise you. Read on for the latest recommendations from the American Dental Association (ADA) and American Academy of Pediatrics (AAP).

Beginning oral hygiene 

Begin oral hygiene within a few days of birth by cleaning your baby’s gums with a soft cloth or gauze every day. This removes plaque from the gums and will help them become accustomed to you cleaning their teeth once they do appear.

And remember: Nothing that goes in your child’s mouth belongs in your mouth. Bacteria from adult mouths cause tooth decay and cavities in infants.

Tooth time

Toothbrush
At 6 months, use a soft-bristled toothbrush and a rice-sized bit of fluoride toothpaste to clean the teeth twice a day. At age 3 years, pea-sized amount of fluoride toothpaste may be used to brush the teeth twice a day.

First tooth (3 years old)

At 6 months, most infants have four front teeth pushing through. These teeth are susceptible to decay as soon as they break through the gums. Begin brushing your child’s teeth (or tooth!) as soon as they are visible. Use a soft-bristled toothbrush and a rice-sized bit of fluoride toothpaste to clean the teeth twice a day (in the morning and at night). Do not rinse the mouth after brushing.

This also is the time to schedule an appointment with the dentist. The ADA recommends visiting a dentist within six months of the first tooth’s eruption or by age 1 — whichever comes first. The first visit is to examine the child’s mouth, check growth and development, and help make your child comfortable at the dentist’s office. Don’t wait until there’s an emergency for your child to meet the dentist — visit twice a year.

During this time, your child’s dentist can offer expert advice on common concerns during this age, including baby bottle tooth decay, thumb sucking, pacifier use and teething.

When the child is old enough to brush without assistance, supervise the brushing to ensure that he or she isn’t using too much toothpaste. When your child has two teeth that touch, it’s time to start flossing between them every day.

Another important tip to keep in mind: Only water should be offered in bottles after 12 months of age.

Primary teeth eruption chart

Primary teeth eruption chartSource: American Dental Association’s Mouth Healthy

Ages 3-6 years

By age 3, most children have a full set of 20 baby teeth. You should visit your child’s dentist at least twice a year to make sure these are developing normally.

At this point, most children still need supervision to ensure they’re not using too much fluoride toothpaste. A pea-sized amount of fluoride toothpaste may be used to brush the teeth twice a day (in the morning and at night). Remind kids not to swallow the toothpaste. Don’t have them rinse their mouth after brushing.

Be sure to limit candy and soft drinks, as they promote tooth decay.

Ages 7-13 years

Continue to visit your child’s dentist at least twice a year.

Ensure that he or she brushes twice a day (after breakfast and before bed) using a soft bristle toothbrush and a pea-sized portion of fluoride toothpaste, and floss once a day.

Continue to limit candy and soft drinks, and if your children are active in sports, have them wear a mouthguard to prevent jaw injuries and having teeth broken or knocked out.

Ages 13-18 years 

Continue to visit your child’s dentist at least twice a year.

During these visits your child’s dentist will discuss important topics including:

  • Braces
  • Wisdom teeth
  • Sealants
  • Smoking
  • Mouth jewelry
  • Meth mouth
  • Eating disorders

Teeth should be cleaned twice a day (after breakfast and before bed) using a soft bristle toothbrush and toothpaste with fluoride, and floss every day.

Permanent teeth eruption chart

Permanent teeth eruption chartSource: American Dental Association’s Mouth Healthy

Dental emergencies at any age 

A knocked-out tooth should be kept moist at all times. If you can, place it back in the socket or between your child’s cheek and gums where saliva will keep it from becoming too dry. If that’s not possible, put it in milk. Then, call your dentist immediately.

For a cracked tooth, rinse the mouth with warm water and clean the area. Use an ice pack or cold compress to minimize swelling and call your dentist.

For toothaches, rinse the mouth with warm water and floss between the teeth to remove any debris. Over-the-counter pain medications can be used age appropriately. Do not put aspirin on the aching tooth or gums. Then, call your dentist.

Visit the American Dental Association’s Mouth Healthy website and select “Babies and Kids” or “Teens” from the menu bar for more information.

Erin Martin, APRN, CNP, is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.