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Ten tips for terrific toddler teeth

BDJ Team volume 3, Article number: 16118 (2016) | Download Citation

What advice should you give patients with young children to ensure that they establish and maintain good oral health? BDJ Team is pleased to publish an article from Claire Stevens' ToothFairyBlog.

Well I am now officially the mother of a toddler. Long gone are the days of the quiet and passive baby (actually, I'm not sure I ever had one of those) and instead I am faced with managing a very independent, strong-willed little girl who has very firm views on what she does and does not want to do! It's such a fine balance between encouraging her development without her believing she rules the roost. It's also a time of change – walking, talking and lots of new teeth! So how do you look after toddler teeth and what advice should you give parents of infants and toddlers? Here are my ten tips for terrific toddler teeth to share with your patients.

Image: ©Igor Emmerich / Image Source / Getty Images Plus

1) Supervise brushing

Don't forget to supervise your child's brushing up until the age of eight; until this time they don't have sufficient manual dexterity to do the job by themselves. If you have an independent toddler, you might wish to let them have a go whilst you brush your own teeth (toddlers love to mirror their parents or sibling) and then swap so you have charge of the toothbrush for a good clean. We actually have two brushes for Ava because she likes to try and clean my teeth as I brush hers. More recently, she has taken to brushing my bump in the hope of cleaning her baby brother's teeth. Either way, we just about keep her distracted long enough to get the job done.

2) Spit, not rinse

Did you know that dentists recommend spitting, not rinsing after brushing? Now with toddler teeth, that's sometimes a little academic but by rinsing out after brushing you are actually washing away the fluoride, the magic ingredient in toothpaste, which helps to reduce dental decay and yes, the same goes for grown-ups too!

3) Use an adult toothpaste

Start brushing your toddler's teeth as soon as they come through. Brush twice a day using a flat smear of 900–1,100 ppm fluoride toothpaste until they are three-years-old. After that you need a small pea sized amount. It is recommended to brush last thing at night and at one other time during the day. Pick a brush which is the right age for your child – I find a normal manual toothbrush easiest for wriggly toddlers.

4) Reward good brushing

Please remember to reward good brushing once you have your little one on board. It might sound obvious but positive reinforcement that is both specific and timely works wonders. Positive reinforcement is very different to bribery. Bribery is a reward that is promised in advance of the event, for example, ‘If you brush your teeth, I will read you an extra story tonight’ whereas with positive reinforcement, the reward is only mentioned after the good behaviour – ‘You were so good with your brushing tonight. Would you like a sticker for your chart?’. The ‘specific’ means that ‘Wow, you are opening your mouth so wide and staying so still’ is more effective than ‘Good girl’ and ‘timely’ in that the reward needs to be given straight after the positive behaviour so that the child links the two. Science aside, a pack of stickers is my go-to parenting trick of the moment. The £2.50 I spent on these cat and star stickers has been money well spent and a major part of our success in getting Ava to wear clothes (yes, really) and allow herself to be strapped into the car seat without a major tantrum…

5) Stop the bottle

From the age of six months you can begin to introduce a free-flow cup, with the aim of eliminating the bottle by the time your child is one. The best drinks for young children aged one to two are full fat milk and water and from two-years-old, semi-skimmed milk and water as long as they are a good eater. Please, please, please don't ever put any sugary drinks such as juice (including no added sugar squash which still contains sugars) or sweetened tea in a bottle – they are a recipe for disaster as far as toddler teeth are concerned as they bathe the teeth in sugar over the course of the day (and night).

6) Get your position right

What you are looking for here is a position which allows you to keep your wriggly toddler more or less in check, but also in direct eye contact. I sit Ava on my left knee and with my left arm support her head in the crook of my arm and hold her left hand whilst her right hand is tucked behind my back. This means that she is resting back just a little, allowing me to see into her mouth and so that she can see me smiling when she is helping (and giving the ‘Mummy look’ when she is not). In terms of technique, try using small circles to brush the top and bottom teeth in turn, making sure to include the gums and the biting surfaces of molars which often trap food during chewing.

7) Look at your own diet

Becoming a Mum has really made me look at my own diet, after all I can't have an unhealthy snack and not expect Ava to want the same. Work on keeping snacks to a minimum. The reason for this is that when whenever we have anything containing sugar to eat, it takes our mouths time to recover and to move from the process of demineralisation (making holes in teeth) to remineralisation (rebuilding them again). I actually give Ava four meals a day – breakfast, lunch before her nap, a snack on wakening such as a sandwich and fruit and then tea which we finish by 6, before bed at 7. I find that this makes her less likely to ask for snacks at other times, thus minimising the number of intakes of food she has in a day. Also take care with giving dried fruits as a snack. This is because the process of drying makes the sugar more concentrated and produces a sticky food which can stay on toddler teeth for hours. Fresh fruit is much less damaging to teeth.

8) Lose that dummy

I'm not against dummies or pacifiers per se, in fact there is some evidence now that suggests they might actually reduce the risk of SIDS. That said, please don't ever dip the dummy in something sweet to get your child to take it... Also take care with prolonged dummy use (by that I mean after the age of one) because this does have the potential to cause something called anterior open bite where the teeth do not grow together and a gap is left at the front of the mouth. You should also find it less traumatic to lose the dummy if you try before a real emotional attachment has formed around 18 months of age.

9) Work on eliminating the bedtime feed

I used to love the fact that Ava nodded off after a bedtime feed. It was such a peaceful way for her to go to sleep and of course entirely appropriate when she was a baby. That said, from the age of one, try bringing the bedtime feed earlier so that ideally any bedtime milk is eventually merged with tea, and finished an hour before bed. I've talked about the golden hour before where the ideal is to try and have nothing aside from water in the hour before bed. When we sleep, our mouths dry out and we lose the protective effect of saliva. This is why eating in the hour before bed is a recipe for disaster. Although milk is a low sugar food, it can still cause damage if left to pool in the mouth overnight, especially if your toddler has got used to suckling on demand through the night.

10) Don't beat yourself up

Finally, parenting can be a tough job, and after a rough night with a nocturnal toddler it is downright exhausting. Implementing change, especially with a strong-willed child involved, can try even the most patient of souls. Be gentle on yourself if things take a little longer than you had hoped, but make sure you are still heading in the right direction slowly, but surely. Call in support in the form of other family if you can but above all try to be consistent. Take it from me, a smart toddler will remember the time you alter the routine in their favour and they won't be in a hurry to let you forget it!

To read more articles on Claire's blog, visit www.toothfairyblog.org.

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  1. Claire Stevens is a Consultant in Paediatric Dentistry and works for the NHS providing dental care for children and young people from birth to 16 years. Claire now has two children, Ava (3) and Archie (1) and is Vice President Designate and Media Spokesperson for the British Society of Paediatric Dentistry.

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https://doi.org/10.1038/bdjteam.2016.118