Dental decay is a serious problem in children. About 1 in 5 young children has high levels of untreated cavities, according to the Centers for Disease Control and Prevention (CDC).

Parents are often unsure of how to promote good oral health, so we asked Dr. Anil Gudapati, DMD, to answer questions from local moms and dads. Dr. Gudapati is a board certified pediatric dentist practicing in the Austin area.

When should I start brushing my child’s teeth, and when can she brush her own?

As soon as your child’s teeth erupt, brush them with a soft-bristled toothbrush. Even wiping your child’s teeth with wet gauze goes a long way for toddlers. For ages 2 to 5, use a “pea-size” amount of toothpaste. Supervise brushing until age 7 to 8. Allow your child to brush her own teeth, making sure that you get a turn, as well.

How often should my child brush her teeth and for how long? She says she is “finished” after about 30 seconds.

Children should brush 2 times a day, for 2 minutes each time. Ideally, brush once in the morning and once before bedtime. To encourage your child to brush long enough, try the free “Toothsavers Brushing Game” app.

What kind of toothpaste should I use for my toddler?

Use toothpaste approved by the American Dental Association (ADA). ADA-approved toothpaste meets strict standards for safety and effectiveness. The best choice will contain fluoride. But don’t allow your child to swallow fluoride toothpaste—teach him to spit it out. If your child can’t spit it out, use one without fluoride until he learns.

My 7 year old says adult toothpaste “burns.” What should we use?

Children are unique in which flavors they can tolerate. Some don’t like mint flavor and say that it “burns.” But there’s a wide range of other flavors available. Just make sure that the toothpaste contains fluoride and is ADA approved.

Should my child floss? She refuses, and I have trouble because her mouth is small.

Children should floss at least once a day with adult supervision. If your child’s mouth is too small for regular floss, you can use floss designed for children. It’s smaller, comes with a handle and is easier to manipulate. Flossing is the best way to clean in between your child’s teeth, an area the toothbrush can’t reach.

How do I know if my child needs flouride treatments? Is flouride safe?

Fluoride has been shown to be beneficial to teeth. In the right amount, fluoride is a leading factor in stopping cavities. But too little or too much can harm teeth. Little to no fluoride fails to strengthen teeth enough to resist cavities. Excessive fluoride ingestion by preschoolers can lead to dental fluorosis—a chalky white to brown discoloration of the permanent teeth. Consult with your pediatric dentist to see if your child needs fluoride supplements.

When should my child have his first checkup?

Once a tooth erupts, it can develop a cavity. The American Academy of Pediatrics, the ADA and the American Academy of Pediatric Dentistry all recommend that your child visit the dentist no later than age 1.

Does my child need to go to a pediatric dentist?

Children need different approaches to guide their dental growth and development. Just as a pediatrician is trained to handle the unique medical needs of children, a pediatric dentist is trained to handle their dental needs. A pediatric dentist has an extra two to three years of specialized training and is best qualified to provide care to infants and children through adolescence.

My toddler sucks his thumb. Will this cause problems when he’s older?

Thumb and pacifier habits generally only become a problem if they go on for a very long time. Most children stop on their own. But if your child is still sucking her thumb when her permanent front teeth are about to erupt, a mouth appliance may be recommended.

Do all children need braces? When do you know itís time?

Not all children need braces. The American Association of Orthodontists recommends a screening at age 7. By this age in most children, several permanent teeth have erupted, and your pediatric dentist can make an effective evaluation. Developing malocclusions or bad bites can be recognized as early as age 2 to 3. Often, early steps can be taken by your pediatric dentist to reduce the need for major orthodontic treatment later.

Brenda Schoolfield is a freelance medical writer in Austin.


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