Expert Talk: Q&A With A Pediatric Dentist

You should start brushing as soon as they have teeth present. Baby teeth usually start to erupt around the age of 6 months. Brushing should happen twice daily, once in the morning and then again after their final feeding before bedtime. For infants, it is usually easiest to brush their teeth with them laying on your bed or their changing table.

Rule of thumb for brushing: If your child can tie their own shoelaces, they can brush by themselves (you still may want to double check and make sure they aren’t leaving dental plaque behind). Until then, an adult should be brushing their teeth daily or make it a team effort. Let them brush first, and you brush second.

I like using a standard toothbrush designed for ages 4-24 months (something like this or this). A toothbrush with a long neck works better to reach the teeth in the back of the mouth. I also like this toothbrush which has a gum massager for teething as part of the handle. With any toothbrush, you can use the brush head to massage gums where teeth are erupting. I don’t recommend the finger toothbrushes, as they don’t protect your fingers well and kids will bite down hard sometimes when brushing.

If your child feeds during the night, be sure to re-brush their teeth before they fall back asleep (no need for toothpaste). You can do this with a toothbrush or use a damp washcloth. Keep them by the bedside so it’s easy for you to grab and use.

This varies for every child. As long as there is visible space between teeth, then brushing alone should suffice. Some kids have lots of spacing between their baby teeth (aka “open contacts” in dental lingo). In this scenario, flossing occasionally to help build the habit is beneficial. Other kids will have no spacing at all and most kids fall somewhere in between with open spacing between some teeth and no space between others. Flossing is advised when the teeth are touching (or have “closed contacts”). Floss once daily to clean the side surfaces of those teeth. The best time to floss is before bedtime, so the teeth are as clean as can be while your child is sleeping.

Floss sticks work great for infants and toddlers! They are less messy and easy to use with one hand. Regular floss works great too; it just takes a little bit more practice to get the hang of it with a wiggly infant or toddler. Make flossing part of the bedtime routine. Bring the floss into the nursery or bedroom and have them lay down on a flat surface, such as the floor, your bed or a reading chair. When they open their mouth, it will be easier for you to see their teeth and reach the ones in the back. Flossing should not be painful. It is a gentle swipe on the side of one tooth, from the top edge to beneath the gum tissue and back up, then shift the floss and do the same on the adjacent tooth. The floss should wrap or curve slightly around the tooth you are flossing.

Rule of thumb for flossing: Most children need help flossing up until the age of 9-10 years.

Moira Groh, DDS, is a Pediatric Dental Associate based in Colorado.