Talk to me about brushing your kid's teeth!

[sunwise]

Hi all - I am looking for some advice related to tooth brushing. DS is 13 months old, and although we try to brush his teeth before bed everyday, he doesn't always let us do it. Sometimes he just closes him mouth and turns his head away. I've been trying to do some research about tooth brushing under the age of 2 and it seems there are two camps - 1. the group that says you should brush no matter what, even if you have to pry their mouth open and brush while they scream, and 2. the group who says you should try to brush, but don't worry if they don't let you do it everyday and don't try to make toothbrushing traumatic by forcing it on them.

So my pedi is definitely in the first camp. She told us that 2-5 seconds of forced brushing while they scream is better than no brushing. But my instincts are telling me that could make DS less likely to develop good brushing habits when he is older, so I am inclined to not worry when he doesn't let us brush his teeth. (We've never tried to force it on him.)

Another potential complication here is the fact that DS nurses several times overnight, and the pedi also warned us about that causing cavities. (I don't believe evidence supports that, but I haven't looked for any sources, so I'm not sure.) DH tends to take what the pedi says as gospel, so he is concerned about DS's teeth, despite what I tell him. (DH is VERY sensitive to tooth issues, because bad teeth run in his family - he has had lots of cavities and several root canals. I, on the other hand, have a totally different background - my family has great teeth, and I have never yet had a cavity at age 31. So who knows what DS will be like!)

So I guess my questions are - what do all of you do about brushing your LO's teeth? Should I try to force it? Is there an age when it might get easier? Any toothbrushing tips?

Thank you!

[organicviolin]

we go for camp #2.  We sing silly songs and talk about getting the sugar buggies out (not like our kid eats sugar etc but you get the drift) and also what helps a lot is if one of us adults brush our teeth along side.  They like to copy at this age.  Also, let the kiddo do it for a bit by themselves.

PS Breast milk does not cause cavities. 

[hildare]

:(  i am otherwise a very patient and gentle mama.. but i have a friend whose kid had to get put under ga and have teeth removed and repaired due to caries at around the same age as dd was when we noticed staining. 

so we tried all the fun ways but ended up in camp 1.  however, the screaming and awfulness didn't last long, not at all.  now dd can brush surprising well on her own and then will happily let us finish the job, twice a day. 

so my personal experience is that our kid at least wasn't harmed by her brief stay in camp 1, if that helps.  also, you're right, there is no evidence that night nursing increases decay.  there's also some research that shows it doesn't cause problems.  i would take that part with a grain of salt.

[Youngfrankenstein]

DD2 is almost two and I've never brushed her teeth. She has used numerous toothbrushes since baby-hood.  Now I'll put the tiniest dab of toothpaste and she "brushes" her teeth 5 times a day without it. 

[Comtessa]

There is a great, brief article here that summarizes the research about breastfeeding and dental caries: http://kellymom.com/bf/older-baby/tooth-decay.html.  Lots of links to other articles too.  Its basic conclusion: "a valid link has not been made between nursing (nighttime or otherwise) and cavities."  So feel free to print it out and share with your pediatrician, who is giving you bad advice.

I suspect that the rigidity of "camp 1" on the toothbrushing front came about because of the assumption that bad teeth were simply a result of bad dental hygiene.  I was always told that everyone's teeth are about the same to begin with, and that diet/lifestyle/toothbrushing is the most important factor in whether or not a person gets cavities.  It appears, however, that this assumption is untrue.  The hardness and durability of your tooth's enamel, your susceptibility to tooth-attacking bacteria, etc., like other physical characteristics, has a lot to do with your genetic makeup.  My family has rather soft teeth and we get cavities easily; my husband's family is the opposite.  DH has had 1 cavity in his whole life; I've had dozens drilled and filled over the years.  As a result, I am much more hard-line about toothbrushing than he is, because I certainly don't want my poor toddler subjected to any dental drilling.  However, DD loves to brush her teeth and rarely fights about it, so it isn't as much an issue of concern for us.

There are a few ways you might get him to let you brush his teeth without so much resistance: stock up on interesting toothbrushes and let him choose which one to use?  Or use toddler toothpaste in exciting colors/flavors?  Perhaps you could increase the tooth brushing so it's several times a day, so you aren't always fighting the brushing battle with a sleepy, cranky toddler.  There are good picture books available about tooth brushing.  And a few good videos -- DD loves it when we sing the Sesame Street song "Kids Just Love to Brush" while she's brushing.  Here it is, though if you grew up in the 70's-80's you'll probably remember it: http://www.youtube.com/watch?v=xrJaN-OD1ig

[Blessed_Mom]

Apart from other ideas about brushing toddler teeth above I would like to add one more that works excellently with my LO. She is 27 months and I still brush her teeth. She doesn't really like it but gladly gets hers' brushed every day.

what I do is let her sit on the platform beside the sink and have her rest her head (cradle) in my left arm. I then tell her she can sleep (she is rather sleepy anyway) and I will brush her teeth. She likes this pretend-sleeping and closes her eyes and I brush her teeth as long as I should, while singing sleepy-time songs. Mostly 3 songs. rock-a-bye-baby, hush a bye baby and for some reason sing me a song of sixpence(sung in an high opera voice though). I also highly recommend having 2 toothbrushes. One for her hand and one for yourself. This worked when my daughter was about 13-14 months (when we started brushing her teeth). Now we skip this.

Oh I forgot - also - this is the way we brush our teeth, ....so early in the morning. (Mulberry bush)

[Snapdragon]

We are in the camp 1- brushing is necessary and while we are as gentle as possible, even if he is upset about it at the time we brush his teeth as wellas we can at least every night before bed. In the day time I will sometimes give him his toothbrush w- a little paste on it and let him chew on it. I would like to actually move it up to a morning and evening full brushing now- he is 18 mo's.

Re breastmilk/night feeding/ cavity discussion, my understanding is that any form of drink (or food) containing sugar in it, it is best to get that off of the teeth especially for a long stretch such as the night- as it helps keep the mouth less likely to have decay because the sugars are what activate the decay types of things. So it is not breastmilk specifically, but breastmilk as part of other things is could also be - milk, juice, that I think it is best to try to clean off of the teeth for a duration of a long period of time. (sorry I am not phrasing my words well right now- tired).

[Rlin]

Regarding breast milk and tooth decay: When the teeth are clean, breast milk can help fight cavities. When there is food residue on the teeth, breastmilk will cause the teeth to decay even quicker. (There is research to back this up: http://www.aapd.org/upload/articles/Erickson-21-02.pdf)

Because we did extended night nursing (well over 2 years) we always made sure DS teeth were clean before going to bed. We had phases where he would open his mouth willingly, and phases where we would have to hold him down and brush his teeth with two adults. We just dealt with it. To me it is the same as buckling up in a car seat: you just have to do it. DS is 3 y old now and has no trauma from brushing teeth.

[Mom2M]

We do insist on brushing her teeth. I tell her that she can hold the toothbrush after I brush them. Also, I gave her a little cup in the bathroom from the time she was really little (but had lots of teeth!) and she could fill it and drink from it after I finished brushing. She got that pretty fast and had lots of fun dumping it all over herself and playing with the water. But, no fun before brushing.

[coldandsleepy]

We didn't insist on brushing until my son was about 18 months old.  A big part of this was that he didn't really start solids until about 15 months and so as a PP mentioned, it wasn't as big of a concern.  (Just breastmilk = not bad for teeth, breastmilk + food residue = very bad for teeth.) 

This is a very sensitive topic in my  household.  I was taken to the dentist less than half a dozen times between birth and age 18, was not made to brush my teeth (or indeed, supervised in doing so at all) as a kid and between all that and genetic factors and poor childhood nutrition, my adult teeth are pretty horrible.  Like, I'm 27 and I've had 2 root canals, have two teeth left that haven't had as much as a filling in them, and have had one tooth flat out pulled.  It took me years to work up the courage to go to a dentist-- years of being in constant pain while chewing, of only eating with one side of my mouth, being terrified every time my gums were inflamed that this time it would turn into an infection or an abcess that would land me in the ER (never was, thankfully).  I don't want this for my son.

So, now that my kid eats solids, we DO insist on brushing his teeth.  Most of them time, it's not a big deal and he's very cooperative.  Occasionally we have nights where he fights it and screams for the first 30 seconds or so.  But we do it anyway for two reasons-- 1) he's almost two and he's starting put cause and effect together.  I don't want him to have this idea that if he just screams about something, he'll get out of doing whatever it is.  2)  in my mind, it is MUCH better to have him go through this minor discomfort and upset now than it would be for him to have to go through the years and years of agony that I went through with my teeth. 

He likes it best if one parent holds him and brushes while the other one makes silly faces, sings, etc.  He also likes to hold onto my toothbrush and attempt to brush my teeth while my husband brushes his.  And he thinks it's delightful to turn the faucet on and off while he's being brushed.

[neonalee]

We are kind of between camp 1 & 2 actually.  His teeth will get brushed before bed 99.9% of the time, but we try every possible thing before resorting to the forced method.  If it comes down to that we make it super quick.  I guess that makes us closer to camp 1.  I haven't done thorough research but I've seen so many stories about children under 2 having major dental work.... I admit it scares me.  Also, I've read about how nutrition during pregnancy has an affect on tooth development.  Mine was good but not great and lacking enough calcium.  Last, if DS has any real food at dinner, there's no question about if teeth will be brushed or not.  They will.  Because he does nurse several times a night (currently nearly hourly due to teething), and while I know there isn't a link between BFing at night and cavities, I can't imagine that any food stuck to his teeth would be a good thing during that.

I have a soft baby toothbrush and Spry infant gel with Xylitol so it's sweet and he likes it.  I bring the toothbrush to wherever he is and let him keep playing with stuff if possible.  We sing while we brush.  He has 4 top and 4 bottom and I try to go back and forth at least 4 times each.  Sometimes DP distracts.  Sometimes it takes multiple tries.  Right now with the teething I am very gentle and avoid the gums and once he realized that it got easier.  When I'm done I leave the toothbush in his mouth or give it to him and he chews on it for a bit, which I figure is when his gums get brushed ;)

Oh yeah - 1 big help I've found is to do it earlier!  Sometimes right after dinner, always BEFORE changing to the night diaper.  Trying to catch him before he's tired and cranky seems to be a big indicator of success!  For this reason I often bush in the morning as well, since he's nearly always in a good mood in the morning.  I've even brushed after naps.  More often certainly can't hurt if he's in a good mood.

[sunwise]

Wow - thanks for all of the input! This is really great stuff to read....I think I am now leaning more towards camp 1 and trying really hard to brush DS's teeth in the morning and evening. The thought of major dental work at a young age is scary, and given that the genetics of his teeth could go either way (really good or really bad), I probably don't want to risk it.

At 13 months, should I worry about toothpaste? If so, is there a certain kind I should get that is safe to swallow (since he obviously can't spit on command yet)?

[amandabcook]

Mine is the same age (almost 14mo).  Our doc said he would like for tooth brushing to be a real routine starting at 15mo.  Now we give him a toothbrush and he imitates us brushing, and then usually I go over halfway through his brushing and grab the handle and do a little real brushing, which he thinks is funny because of the noise.  I suspect that if I tried to brush them for him from the beginning, he might object, but he likes to do it himself and doesn't seem to mind a little interference in the middle.  This does not generally happen twice a day yet, but we're getting there.  :)

I would also point you to the kellymom article above.  The key thing to my mind is that breastmilk doesn't really pool in the mouth.  If a baby is breastfeeding, they're only getting milk if they're actively sucking (and therefore swallowing), and if they're actively sucking the nipple is very far back in their mouth--so the milk is not pooling around their teeth.  (Obviously this is different from bottle feeding, which I think is why most docs just say no milk before bed and don't distinguish between breastfeeding and bottle feeding.)  Also--this means that research that does something like puts plaque in a bowl of breastmilk and tests what happens isn't really mimicking what happens when a baby is nursing to sleep.  Everything I've read shows that genetics and intake of sugary foods is a better indicator of early dental problems than breastfeeding, even though lots of people like to blame breastfeeding.  If your husband's family has bad teeth, I would be slightly more worried about your son's teeth in general, but I wouldn't blame breastfeeding.

Good luck!!

[Alisse]

Originally Posted by sunwise 

Wow - thanks for all of the input! This is really great stuff to read....I think I am now leaning more towards camp 1 and trying really hard to brush DS's teeth in the morning and evening. The thought of major dental work at a young age is scary, and given that the genetics of his teeth could go either way (really good or really bad), I probably don't want to risk it.

At 13 months, should I worry about toothpaste? If so, is there a certain kind I should get that is safe to swallow (since he obviously can't spit on command yet)?

You have to get toothpaste WITHOUT fluoride.  Fluoride in large doses is toxic and thankfully most toothpaste brands have an emetic in them that will cause vomiting if enough is ingested. There are tons of brands out there that are fluoride-free.

No fluoride until the child can spit and rinse reliably.

Theoretically fluoride isn't necessary; what is is physically removing plaque and food residue from teeth. We brush our 2 year old's teeth twice a day and floss 1-2 times a week (when i have the energy).  Flossing is more important if your child doesn't have good (big) spacing between the teeth.  Our LO's front teeth have little spacing so we pay particular attention to those when we floss. 

And for what it's worth, baby teeth are naturally "softer" and more easily infected by cavity-causing bacteria than are adult teeth which have a thicker enamel, which is one of the many reasons why many ppl experience tons of cavities in their baby teeth, but few in their adult ones.

[somegirl99]

In addition to fluoride, you want to avoid SLS (sodium lauryl sulfate, a detergent) in toothpaste that is going to be swallowed. 

We use Spry xylitol gel.

[behaviourmama]

We are also between camp 1 & 2, and since DD1 is enthusiastic about avoiding as many daily routines as possible, we have discovered a variety of useful techniques to motivate her to brush:

A countdown so she knows when its ending
Allowing her to close her mouth to take frequent "breaks"
Letting a "friend" brush her teeth (e.g. I hold a toy and the toothbrush in the same hand) - she thought it was hilarious to choose new friends
I brush her teeth while she brushes mine (and I try not to gag)
She was really into the time so having her watch for a certain number on the clock before brushing was done
Promising a reward beforehand if she brushed without fighting (and yes we did a candy phase.. Counterintuitive but worked quickly during terrible toddler defiance days and we got rid of it quickly)
Playing with my iPhone during brushing
Promising my iPhone post-brushing if she was very cooperative

[Calliope84]

I only have to get at two bottom teeth right now. I put the toothbrush by her mouth, she opens, and I gently try to brush her two bottom teeth and the gums a little while she tries to chew on it. She doesn't seem to mind one bit. I don't use toothpaste though.