The arrival of baby's chompers comes with excitement (big milestone!) and maybe some trepidation (please don't bite, baby!). It also comes with a new responsibility: brushing those teeth. Helping baby learn positive dental hygiene habits early helps prevent cavities while establishing a healthy lifelong practice. But what exactly should you be doing to clean those new baby teeth? Short answer: brushing twice daily with fluoride toothpaste is recommended as soon as teeth emerge. Read on for additional evidence-based recommendations for dental hygiene.
We've all heard of cavities (known more formally as tooth decay or dental caries), but what exactly causes them? Simply put, bacteria in your mouth eat stuff (they really like sugar) and produce acid, which can erode tooth enamel (Selwitz et al., 2018). In young children cavities can to lead to pain, infections, difficulties eating, sleeping, and speaking (Wagner and Heinrich-Weltzien, 2017). Tooth decay is one of the most common chronic diseases worldwide, affecting a shocking 42% of children aged 2 to 11 in the United States (NIDCR, 2018). Unfortunately, treatment is very expensive and often requires time-consuming dental work. But don't be discouraged, in the case of cavities the best offense is a good defense. Cavities are largely preventable with proper care.
Here are some suggestions for promoting oral health, mainly from Brecher and Lewis, 2018:
Use fluoride toothpaste. "Fluoride is the single most important caries preventive agent available" (Brecher and Lewis, 2018). That's because it interacts with tooth enamel where it's incorporated to make teeth stronger and resistant to decay. Although parents may worry about fluoride toothpaste being swallowed, when used in the correct amount "the quantity of fluoride ingested is safe" (Brecher and Lewis, 2018). For babies under 3, the correct amount it a rice-grain size, and for babies older than 3 years old a pea size amount is appropriate. Avoid toothpastes marketed as "infant" or "training" because these typically don't contain fluoride.
Brush teeth twice daily for 2 minutes. This is the recommendation from the American Dental Association, and when applied to a full set of baby teeth breaks down to about 6 seconds per tooth. So if baby only has 4 teeth you can probably get by with a shorter brushing time.
Visit the dentist by the time baby is one years old. "Establishing a dental home by age 1 year helps children and caregivers implement proper preventative practices and reduces the risk of preventable oral disease" (Brecher and Lewis, 2018). Also, application of fluoride varnish twice per year is recommended to reduce tooth decay.
Limit sugary food and beverages, including juice. "Children who consume foods and drinks with added sugar more frequently are more likely to develop dental caries" (Hong et al., 2018). Also, drinking only water between snacks and meals helps reduce acid production by bacteria.
Consider using xylitol products. Some studies suggest that xylitol (a common sugar substitute) can reduce cavities. For example, one study looking a xylitol wipe use in infants found that "significantly fewer children in the xylitol-wipe group had new caries lesions at 1 year compared with those in the placebo-wipe group" (Zhan et al., 2012). However, the data is far from conclusive. A systematic review of the xylitol literature in 2017 concluded that the small effect size and low quality of evidence makes the "preventive action of xylitol uncertain" (Marghalani et al., 2017).
There you have it. Start these dental hygiene habits early to keep baby's pearly whites clean and healthy!
Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007 Jan 6;369(9555):51-9.
Wagner Y, Heinrich-Weltzien R. Risk factors for dental problems: Recommendations for oral health in infancy. Early Hum Dev. 2017 Nov;114:16-21.
NIDCR. "Dental Caries (Tooth Decay) in Children Age 2 to 11.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, July 2018, www.nidcr.nih.gov/research/data-statistics/dental-caries/children.
Brecher EA, Lewis CW. Infant Oral Health. Pediatr Clin North Am. 2018 Oct;65(5):909-921. doi: 10.1016/j.pcl.2018.05.016. PMID: 30213353.
Hong J, Whelton H, Douglas G, Kang J. Consumption frequency of added sugars and UK children's dental caries. Community Dent Oral Epidemiol. 2018 Oct;46(5):457-464.
Zhan L, Cheng J, Chang P, Ngo M, Denbesten PK, Hoover CI, Featherstone JD. Effects of xylitol wipes on cariogenic bacteria and caries in young children. J Dent Res. 2012 Jul;91(7 Suppl):85S-90S. doi: 10.1177/0022034511434354. PMID: 22699675; PMCID: PMC3383105.
Marghalani AA, Guinto E, Phan M, Dhar V, Tinanoff N. Effectiveness of Xylitol in Reducing Dental Caries in Children. Pediatr Dent. 2017 Mar 15;39(2):103-110.