A young child’s temperament may help predict future oral health. A recent study in Pediatric Dentistry found that toddlers with negative temperaments are more likely to develop tooth decay than their more easygoing counterparts. In the study, toddlers’ temperaments were scored using the “Early Childhood Behavior Questionnaire.” Researchers scored behavioral characteristics, such as activity level, frustration when interrupted, discomfort in new social situations and trouble focusing on one activity. They looked at whether or not a child liked to be cuddled and could be easily soothed. The study adjusted for several variables, including frequency of sugary drinks and caregiver dental health.


Researchers periodically evaluated these children’s teeth over a three-year period. Children who were identified with negative temperaments had significantly more decayed, missing or filled dental surfaces at the end of the study.

Children who are at increased risk for poor dental health benefit from early interventions. Here are some actions that parents can take:

Establish a Dental Home

As soon as your child’s first tooth appears or no later than the first birthday, schedule a visit to the dentist. The American Academy of Pediatric Dentistry (AAPD) recommends establishing a “dental home.” A dental home fosters an ongoing relationship between the child, family and dentist. A dental home guides preventive, acute and comprehensive oral health care.

Children with uncooperative behavior benefit from a pediatric dentist, who is trained in coping with dental fear as well as temperament challenges.

Support Good Oral Hygiene Habits

As soon as the first tooth appears, begin brushing your child’s teeth with a soft, small-bristled toothbrush. Discuss the use of fluoride toothpaste for children under 2 years old with your doctor or dentist. The American Dental Association (ADA) recommends using a tiny amount of fluoride toothpaste (about the size of a grain of rice) for children younger than 3 years old. For children over 3 years old, use a pea-sized amount.

 Brush your child’s teeth thoroughly twice a day (morning and night) or as directed. Keep doing the brushing until the child is old enough to brush effectively. Supervise children younger than 6 years old. Remind them not to swallow the toothpaste. Coach brushing for two minutes, making sure all teeth surfaces are cleaned. Use oral hygiene apps or playlists to make brushing fun (see sidebar).

Build brushing into the child’s morning and bedtime routines. It is helpful to always brush teeth at the same time within a repeated sequence of activities. This helps eliminate arguments about when to brush teeth.

Take Steps To Prevent Tooth Decay

To prevent tooth decay, limit sugary drinks and snacks. Provide water or unsweetened beverages instead of sodas. If you give your child juice, serve it at mealtimes only. If your child carries around a sippy cup during the day, put only water in it. Provide nutritious snacks, such as vegetables, fruits or yogurt. It is best to eat mostly at meals instead of snacking off and on during the day. 

Talk to your child’s dentist about fluoride varnish and dental sealants. Fluoride varnish can prevent about 33% of cavities in baby teeth. Dental sealants are applied to the chewing surfaces of the back teeth. They can prevent up to 80% of cavities for years.

Be a Role Model

Parents and caregivers with poor oral health are more likely to have children with tooth decay. Practicing good dental hygiene yourself encourages your child to do the same. Make comments about the importance of brushing and flossing, such as “I’m going to go brush and floss my teeth now. It keeps me from getting cavities, and I love how clean my teeth feel afterwards.”

Teach Your Children About Oral Health

Download and print oral health activity sheets for kids to do at home. The AAPD website offers the following fun, free resources at bit.ly/3inpy7W:

  • Coloring sheets featuring members of the “Little Teeth League,” including Brushing Boy, Cavity Clasher and Flying Flosser
  • “Escape the Dark Tooth” maze puzzles
  • Mouth Monster crossword puzzles and wordsearches that teach basic dental health concept. 

Other activity sheets are available from the ADA at mouthhealthy.org.


Use an App To Make Brushing Fun

Use an oral hygiene app designed for kids to encourage good brushing and flossing habits. The free Toothsavers Brushing Game, developed by the Partnership for Healthy Mouths, Healthy Lives, is a fun option. The game features a fairy tale kingdom whose inhabitants are under a wicked spell that makes their teeth rot. The child has two minutes to brush away the spell for each character. The app prompts brushing for each tooth area, such as bottom, left molars. Brushing twice a day unlocks rewards. After 30 days, your child can battle the evil sorceress who cast the spell.

Search for “brushing teeth game” or “brushing teeth timer” in your iTunes or Google app store for other dental hygiene apps that teach and motivate.

Brenda Schoolfield is a freelance medical writer based in Austin.

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