You know they're in there somewhere—tiny teeth lurking under your baby's gums or peeking out like grains of rice. Maybe there are enough to tear into a turkey meatball, or maybe that little mouth has even sprouted a full set of shiny white Chiclets. But who can be sure when every time you try to check, those chompers chomp you? No wonder so many parents put off—or even (shh!) skip—the brushing process.
Well, heads up: It's time to stop procrastinating. Tooth decay is one of the most common chronic childhood diseases, according to the Centers for Disease Control, and the problem is getting worse among children ages 2 to 5. Why worry, you ask, when baby teeth start falling out by 6 or 7? For starters, untreated cavities hurt, making eating, sleeping, and concentrating excruciating for all involved. What's more, "the bacteria causing the infection can travel under the baby tooth and lead to problems in the adult tooth behind it," warns Lezli Levene Harvell, a pediatric dentist in Newark, New Jersey. Turn the page for tips on keeping your toddler's mouth clean and healthy—without resorting to a headlock.
My baby has only two teeth—do I really need to clean them?
Afraid so. Dentists recommend using a clean, moist piece of gauze to swab an infant's gums. "This gets babies used to the feeling of something other than a bottle going into their mouths," says Stanley Alexander, chair of the pediatric-dentistry department at Tufts University School of Dental Medicine. By Junior's first birthday, switch to a baby brush, which will gently abrade away lingering food particles, and introduce a baby toothpaste. (The first dental checkup should happen around this time, too, and the first cleaning between 2 and 3.) A little later on, battery-powered brushes are excellent at dislodging food particles before a toddler has the dexterity to do it himself—and the extra bells and whistles may help lure him to the bathroom sink.
What kind of toothpaste is best? With fluoride or without?
It's complicated—and controversial. The American Academy of Pediatric Dentistry (AAPD) calls for just a tiny smear of fluoride paste, starting when the first tooth emerges; close monitoring of the brushing process; and, for infants, a wipe with a wet cloth afterward. That said, New York City pediatric dentist Ruby Gelman generally recommends a fluoride-free paste until children can spit by themselves, since ingesting too much fluoride can leave permanent white and brown stains on teeth—a condition called fluorosis—and can even be toxic in very large amounts. "Then I have kids brush on their own in the morning with a fluoride-free paste, and use a fluoride one at night during more supervised brushing and rinsing," Gelman says. Your dentist's recommendations may vary depending on factors such as whether your water is fluoridated or your child is taking fluoride supplements.
My kids clam up the second I pull out the paste. What can I do?
Persevere. "Kids eventually acclimate when you make it part of your daily routine," insists Jessica Meeske, an adjunct faculty member at the University of Nebraska College of Dentistry. Some tactics: Experiment with toothpaste flavors—a baby who hates bubble gum may go bananas for strawberry-banana. "Demonstrate on a doll or a stuffed animal, or hold the brush with a hand puppet," says Meeske. "Or lie on the couch and have your toddler brush your teeth first. They think that's a riot." The bottom line? Just do the best you can: Reaching all tooth surfaces is more important than the duration. Brush at the beginning of the bedtime routine, then move on to soothing activities. In a pinch, a swig of water or a swipe with a wet washcloth is better than nothing—especially after breast or cow's milk, both of which, Gelman says, contain sugars that "can alter the pH of the mouth, thereby making teeth more susceptible to cavities."
Will the occasional gummy bear rot my kid's teeth?
"The longer something stays in your mouth, the more cavity- causing it is," says Gelman. The worst culprits are sticky sugars and starches, like candy, dried fruit, and even Cheerios, which react with bacteria to produce acids that gradually erode teeth. (Even chocolate is a better bet, because it easily melts away.) There's no need to ban raisins from your kitchen, but rather than letting your toddler munch all day, offer them with a meal and a cup of water, and—hey, we can dream—follow up with a quick brushing to sweep away the sticky bits. Also, since even 100 percent?pure juice contains fruit sugars, beware the bottomless sippy cup. (Harvell says she'd ban sippy cups after age 1 if she could—but she doesn't have to clean our rugs.) The American Academy of Pediatrics recommends no more than six ounces of juice a day, and only at meals or snacktime.
My 2-year-old still uses a pacifier. Is she destined for braces?
So-called "orthodontically correct" pacifiers might make you think otherwise, but "when children suck on anything, the top arch of the mouth narrows and makes teeth protrude in front," Harvell says. That's why the AAPD advises ending all "oral habits" by age 3. To wean their kids, some moms cut holes in pacifier tips to make sucking less satisfying; others go cold turkey and brace themselves for tough nights. Using an upcoming milestone as a goal works particularly well, says Gelman: "I know parents who bring the pacifiers to the baby monkeys at the zoo when their kids turn 3." Just add some banana toothpaste, and the chimps will be all set.
