This time I’m going to talk about toddler oral care!

As babies grow into toddlers, they often form opinions. Opinions about everything including having their teeth brushed! Having been through this twice now, I have found a few tricks that make the task simpler.

​So here is a glimpse into my evening routine with my two little ladies:
Before bed, we brush and floss every night (because brushing before bed is the most important time!). Many people ask me if flossing is even necessary on children. I say ABSOLUTELY! For a couple of reasons, I am a huge advocate of starting the flossing routine with kids as early as you can:
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1. Flossing will help keep their gingiva (AKA gums) healthy by disturbing the plaque or bacterial biofilm between the teeth. There has been many times when the kids pull the flosser out of their mouth and say “mom, look, chicken” or “mom, carrot” and I know it was worth my time to get them to floss!
2. Even though some youngsters have large gaps between their baby teeth which makes cleansing from saliva easy, the point of flossing for these kids is routine. If kids start flossing at an early age, it is part of their routine and they won’t know any different! In fact, there are nights when I’m exhausted and just want them to sleep now, but they remind mommy that they need to floss!

​I find that flossing while they are sitting on the counter top or with their head laying in my lap is the easiest. You get the best view and can floss quickly. Another tip I often suggest is letting the little ones use a floss handle on their own. Once they are done or a few minutes has elapsed, I take my turn. Floss handles work great for toddlers, especially if you don’t want to have your fingers bitten! As they grow older, they can practise with string floss. Parents should also help with brushing because at 2 years old toddlers don’t have the dexterity or ability to effectively remove all of the plaque by themselves. 

Toothpaste- what should I buy? For the longest time, we just used water. Yes, water! My toddler then became very annoyed and bored with this twice daily routine of brushing. That’s when I added toothpaste! Until your child can spit the toothpaste out and you are confident that he/she is not ingesting any of it, stick to fluoride free toothpaste. The amount of fluoride in toothpaste is in very low concentration, but for little people it can be toxic in larger amounts if they are not spitting it out. Around age 4 is when you can test them to see how well they can spit. Currently, our 2 year old spits out her fluoride free paste as she copies and learns from her older sister who uses fluoridated paste. They each have their own toothpaste though until I am 100% sure Quinn isn’t eating the other half of the paste! 

​Fluoride Application. Most dental offices offer a fluoride application with a child’s dental visit. Depending on the office and the type of fluoride they offer, a fluoride varnish, foam, gel, or rinse may be given. I am a huge advocate of topical fluoride for kids where suitable.

​Electric Toothbrushes.
 If parents are having a challenging time getting their child to brush, there is an abundance of plaque on the teeth, and/or many cavities have been diagnosed, an electric toothbrush may be a good option. They are kind of like a “toy” for kids, have a 2 minutes timer built-in, and effectively remove more plaque than a manual brush if they are being used properly. I would recommend rechargeable electric brushes for kids like Oral-B or Sonicare. 

​Fillings on baby teeth? Hopefully, early on, you have established a healthy diet and stellar brushing and flossing routines so that your child is at lower risk for cavities. If a cavity does occur at a young age, many parents ask if it’s necessary to even have it filled since they’ll be losing it anyways. YES. Adult teeth will start coming in at the age of 6 and end around 13 years of age. This means if a child has a cavity at a young age and doesn’t get it taken care of, he/she may have that decayed tooth until age 13! By this time, infection of the entire tooth and other teeth in the mouth may occur. The child may experience pain and infection could spread. It is very important to have baby teeth filled.  Please refer to the permanent chart to find out when your child’s adult teeth will start coming in.  

Here are a few tips for keeping your toddler low risk for cavities:

-Diet also plays an important role in cavity formation. If the diet has a lot of sugar in it, then the toddler will be at higher risk to get cavities. Actually, any carbohydrates and sugars can combine with germs in our mouth to create acid which can cause cavities. Sticky carbohydrates like gummy bears, fruit roll ups, caramels etc. are especially bad since they cannot be easily washed away. Hard cheese is an example of a good food for our teeth!

-Does your child drink juice, pop, and milk? If yes, eliminate the pop and juice. It can be given as a treat or on special occasions. Milk can be consumed at mealtime and water in between meals.  No food or drinks should be consumed after brushing the teeth at night time.

-Does your child snack frequently? It is better for our teeth to eat a few meals a day opposed to several snacks or small meals throughout the day. This is because our mouths are more acidic for about 30 minutes after eating, meaning cavities can form more easily if we snack frequently.  
 
I hope you have found this post helpful! Please feel free to contact me if you need further information. If I do not have an answer for you, I may know someone who does!
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References:

1. Tooth Eruption, The Permanent Teeth. JADA, Vol. 137, Pg 127. January 2006
2. Clinical Practice of the Dental Hygienist, 10th Edition by Ester M. Wilkins (2009).
3. Kidshealth.org, Yamini Durani, (2015).
4. Canadian Dental Association, www.cda-adc.ca/en/, (2016). 

Kelsey Voelker is a labor doula and lactation educator with Full Circle Birth Collective. Learn more about Kelsey here.