There’s a lot of discussion about how to prevent cavities in children’s teeth. Basic care includes a parent or caregiver brushing children’s teeth twice a day with fluoride toothpaste and flossing daily once their teeth touch. However, it can be confusing to choose between the many oral care products on the market today. Following are some simple guidelines around appropriate dental care products to use for kids.

Toothbrushes
Gently brushing teeth helps remove plaque and food that is stuck to the teeth.

• Use a toothbrush with a small head to fit a child’s mouth.

• Ultra soft or soft bristles are gentle on the gums but still able to remove plaque and food.

• Power toothbrushes may motivate some children to brush but they aren’t necessary. Recently, some power toothbrushes have been recalled by Health Canada because they came apart in the mouth or shorted out. Before your child uses a power toothbrush, check that the head is securely attached and there are no loose pieces.

Fluoride Toothpaste
Fluoride helps protect teeth from cavities and is a recommended ingredient in toothpaste. Fluoride isn’t added to our water supply so using toothpaste containing fluoride to strengthen and protect teeth is recommended for all ages. If you use well water, it can be tested for fluoride.

• Parents need to be aware that many “baby” toothpastes do not offer the protection of fluoride and often cost more than regular toothpaste. As soon as teeth appear, the Canadian and BC Dental Associations, as well as the World Health Organization, advise that it is safe for children to use fluoride toothpaste as long as it’s the correct amount.

• Fluoride toothpaste for children contains the same concentration of fluoride as adult toothpaste. According to the Canadian Dental Association (CDA), the safe, appropriate amount of fluoride toothpaste is:
For children under 3 years: an amount the size of a grain of rice.
For children over 3 years or those who do not swallow toothpaste: an amount the size of a green pea

• The CDA’s seal of approval should be on the tube of toothpaste used.

• Children often prefer toothpaste that is mild or sweet. Toothpaste does not contain decay-causing sugar but does have other sweeteners to make it more palatable and prevent it from drying out and hardening. The most common sweeteners are xylitol, sorbitol or glycerin. Xylitol is a natural sweetener that helps prevent tooth decay.

• Toothpastes may also have added whitening, desensitizing, tartar-control, breath freshening or anti-bacterial ingredients. When you see the Canadian Dental Association (CDA) seal of approval on a tube of toothpaste check to see what it is approving. It may be approving the fluoride in the toothpaste—not the added ingredients. Some of these additional ingredients have not been tested for safety or effectiveness on children and are not recommended for youngsters.

• For safety, store all toothpaste out of reach of children and monitor how much toothpaste is being used.

Floss
When children’s teeth start touching side-by-side, toothbrush bristles can’t reach in between them anymore. Floss is needed to clear food and plaque from between teeth once per day. Before bed is the best time.

• String-type floss or floss sticks can be used. Try a see-saw motion with the floss to ease it between the teeth and avoid damaging the gums. Parents often find it easiest to floss their child’s teeth when the child’s head is supported and they are lying down.

• Waxed floss usually slides between the teeth more easily than un-waxed floss.

Mouth Rinse
Mouthwash is used by adults for different reasons but children don’t need mouthwash for good oral health. Basic brushing with fluoride toothpaste and flossing will protect their teeth.

• When children can spit, you may choose to purchase mouthwash for your children. Only alcohol-free mouth rinse should be considered.

• Mouth rinses that show where plaque is on the teeth can be used by children who are able to spit the rinse out completely. These may help motivate older children to brush but are not necessary.
Other basic tips for keeping children’s teeth cavity free:

• Children need parent’s help to brush their teeth properly until they are eight years old.

• Make brushing fun to encourage good oral care.

• Offer tooth healthy snacks like fresh fruit and vegetables, cheese, nuts and foods that are not sweet or sticky.

• Give water for thirst between meals. Juice, even diluted juice, can cause cavities.

• Regular visits to the dentist should start around one year of age.
If you have any questions or need help finding a dentist, please call your local Health Unit.

Denise Baillet, RDH, is a dental hygienist with the Vancouver Island Health Authority Child, Youth and Family Dental Program in Victoria.