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When Should Children Brush Independently?

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When Should Children Brush Independently?

We often find that young children are quite enthusiastic about their independence with brushing, yet they still get cavities! We know it is tempting to take a hands off approach when your youngster is able to brush with an appropriate amount of toothpaste, but if they are not doing a good job then food and plaque left on the teeth overnight can lead to cavities. There are a few considerations regarding the quality of brushing:

Time

When the recommendation for brushing is 2 minutes, this is the average amount of time needed to effectively clean all surfaces of the teeth and tongue. The 2 minutes is not a good indicator of the quality of brushing if some surfaces are left behind!

Dexterity

A certain level of manual dexterity is needed to reach all the surfaces of the teeth, particularly the backsides of the upper and lower molars. Because it is a difficult area to brush and not an area of the tooth that gets swept by the tongue, there is often a large build up of food and plaque that requires more time to clean. Cleaning behind the molars is also quite difficult because of how little space there is towards the back of the mouth. Young children can develop good manual dexterity/hand skills at different ages, and so it is important to recognize that some children will need more help that others.

Consistency

Just like we are motivated to brush and floss before and after seeing the dental hygienist, children can put more effort into brushing only when under supervision. It is possible that when they are not being supervised, young children are not doing as good of a job brushing as they used to!

In general, it is recommended that young children be supervised when brushing to check on the quality of the brushing. Especially when there are new teeth coming in (6 year and 12 year molars), it is important to make sure that the children are brushing further back. Once children are able to demonstrate tasks that require a certain level of manual dexterity (eg. tying their own shoelaces, or being able to write well) they are usually capable of all the toothbrush motions for adequate brushing.

Can Infants Get Cavities?

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Can Infants Get Cavities?

It’s never easy to deliver the news of cavities to parents, let alone when their child is only an infant. It is absolutely possible for children under the age of three to develop cavities.

Let’s take a step back and talk about tooth development. We normally expect a baby’s first teeth around the age of 6 months old, give or take a month or so. Up until the age of 3 years, infants will continue to develop teeth in a symmetrical pattern (left and right sides). A full set of baby teeth comprises of 20 teeth (10 on the top, and 10 on the bottom).

At any point during development, babies can develop dental decay. That means that dentists can see cavities in babies as young as 4-6 months old!

There are usually five reasons why infants develop dental decay:

  1. Goes to bed with a bottle
    • Allowing infants to sleep right after having a bottle or right after nursing is a continuous source of nourishment for your baby AND the bacteria that causes cavities. Even though milk/formula does not usually have added sugar, it does contain some natural sugars which can feed cavity-causing bacteria.
  2. Shares foods and kisses with a caregiver/parent who has cavities
    • Individuals who have untreated cavities have higher concentrations of cavity-causing bacteria in the mouth, and these bacteria can be spread through close contact and sharing food utensils!
  3. Does not clean teeth after meals
    • Regardless if an infant is still nursing or using a bottle, the teeth and gums should be cleaned with a soft toothbrush or soft washcloth to remove milk/formula residue from the mouth because of the sugars in these foods.
  4. Enamel defects
    • It is rare, but new teeth can erupt from the gums with deformities. These deformities can make the teeth more prone to cavities than they ordinarily would be. Enamel defects can be the result of genetic or environmental disturbances that occurred when the teeth were forming.
  5. Sugar-sweetened medications
    • It is a little known fact that many medications formulated for infants and young children contain sugar syrups (‘simple syrup’) which help with medication compliance. It is important to try to take these medications at meal times if possible or brush the teeth after taking the medication.

The difficulty with treating infants at a young age is often the difficulty of cooperation. Additionally, when infants get cavities at such a young age the enamel is still very thin and immature which allows cavities to progress quickly and cause toothaches. Having toothaches at such a young age has the potential to cause lifelong disturbances in development if there are oral aversions and feeding issues due to tooth pain. For these reasons, it is recommended that infants under the age of 3 years get dental check ups 1-2 times per year.