Dr Evelyn Crowley, Senior Administrative Dental Surgeon, HSE, answers the most commonly asked questions on Caring for Your Child's Teeth to help your child have a healthy mouth.
Yes, they do. Habits established early in life are more likely to continue. As soon as teeth erupt into the mouth, bacteria begin to build up on the teeth. Tooth decay (holes in teeth) is caused by bacteria in the mouth found on teeth and gums. Bacteria can eat sugars present in milk, formula and breastmilk. Brushing your baby’s teeth removes the bacteria and reduces their risk of getting tooth decay. Everyone enjoys the feeling of a nice clean mouth. Your baby will feel better if their teeth are brushed regularly, twice a day. We give the same advice to adults. Imagine if you didn’t brush your teeth for days! The advice is not to use fluoride toothpaste until your child is 2 years of age. However, if you think your child may be at higher risk of tooth decay, please ask your dentist for further advice.
Yes, even breastmilk and milk contain some weak sugar. After feeding and before bed, wipe your baby’s gums with a clean damp cloth to remove bacteria and sugars.
When you brush your baby’s teeth you are trying to remove bacteria from the teeth and gums. The bacteria are called Plaque. Plaque is like a ‘town’ of bacteria and left to build up on the teeth can be very sticky and hard to remove. When you can see a furry white coating on the teeth, especially by the gums these are bacteria that have been left on the teeth for at least a few days.
When your baby is 2 years of age, dentists advise that you use a small pea-sized amount of fluoridated toothpaste (at least 1000ppm fluoride – see label on tube) twice a day. You are then brushing your child’s teeth to remove bacteria and to place fluoride on the teeth to strengthen them.
Baby teeth are important because they hold the position for the adult teeth until they come through. Losing baby teeth early can cause crooked teeth for your child. Tooth decay in baby’s teeth can cause your child to have pain and can be difficult to treat. It is better to keep the baby teeth healthy to avoid pain, sleepless nights, and frequent visits to the dentist.
Yes. Plaque bacteria grow along the gums on the tooth surface, so it is important to gently brush the area where the gums meet the teeth. Make sure to brush every surface, of every tooth. Include the outside and inside of the teeth by the gums and the flat biting surface of each tooth. Lift your baby's lips out to brush the front teeth near the gums. As more baby teeth come in, it will take longer to brush, about 2 minutes.
No. It is not advised for a child to use mouthwash until at least 7 years of age. This is because young children find it difficult to spit drinks out and are likely to end up drinking a lot of mouthwash. Mouthwashes are made for rinsing and spitting out and are not meant to be swallowed. If you think your older child (7 years or older) should use mouthwash, please ask your dentist or hygienist for advice.
Most tap water in Ireland contains fluoride which helps protect teeth from tooth decay. If your home has well water, which will not have fluoride in it, your dentist will want to know so that they can give you further advice about how to keep your child and the rest of the family’s teeth safer. This advice may emphasise the importance of brushing the teeth twice a day with fluoridated toothpaste (at least 1000ppm F) and spitting out but not rinsing after brushing. The dentist may advise if your child is 7 years or older to use fluoride but no alcohol mouthwash at another time other than brushing. The dentist will encourage a healthy diet with not too many sweet snacks or drinks.
Eating a lot of sweet snacks and drinks will put your child at more risk of getting tooth decay. Many processed foods (packaged) are high in sugar. Giving sweet snacks to your child can lead them to develop a ‘sweet tooth’ and may cause them to refuse healthier foods. Sweet drinks, for example, juices, drinks with added sugar, flavoured milk, flavoured water, sweetened yoghurts and fizzy drinks can damage your child’s teeth. Dried fruits and honey are high in sugar and can stick to baby teeth. This is a risk for tooth decay if eaten often. Reducing both the amount and the number of times your child has sugar throughout the day will help reduce the risk of tooth decay.
Healthier snack options for your child include wholemeal crackers, natural yoghurt, cheese, and fresh fruit and vegetables cut into safe size pieces. It is best not to eat and drink all the time to give their teeth a break from food.
Giving sweet drinks to your child can give them a ‘sweet tooth’ and may cause them to refuse to drink plain tap water. Drinking a lot of sweet drinks will put your child at more risk of getting tooth decay. If your child refuses to drink water, try to cut down on sweet drinks especially between meals. Many crèches and schools now only allow plain water and milk. Encourage the same at home. Use of novelty ice cubes, colourful cups and bottles, reward charts and stickers and keeping water cold in the fridge may help.
Flavoured water is a sweet drink. It is very like other sweet fizzy drinks, juices, cordials and diluted drinks. If your child drinks a lot of sweet drinks this will put them at more risk of getting tooth decay. Tap water and milk are the healthiest options for children over 12 months to relieve thirst during the day.
The use of sugar free drinks can still give your child a ‘sweet tooth’ (where they like the taste of sweet drinks over plain water and milk). Sugar free drinks also contain acid which can weaken the tooth enamel and make the tooth more prone to tooth decay.
The best drinks for children aged 1 to 4 are water, breastmilk and milk.
Full-fat milk should be given to children under the age of 2 years. This is sometimes called ‘whole milk’ on the label.
Low-fat milk can be given to children from 2 years of age. This is sometimes called ‘semi-skimmed’ milk.
Skimmed milk is not suitable for children under 5 years of age. This is sometimes called ‘slimline’ milk.
Younger children will need an adult to brush their teeth properly until they are older. Generally, once a child can tie their shoelaces, around 7 - 8 years of age, they can take over more of the brushing along with some parental supervision. You will still have to remind them to brush their teeth twice a day.
A lot of parents say that when their child gets older, 2 to 3 years of age, they want to take over the brushing completely. This should be avoided as they do not have the ability to brush their teeth properly. Involve them in the brushing by giving them an important job, like choosing a toothbrush from the supermarket or marking off the toothbrush chart once the adult has finished the brushing. Toothbrush charts are available HERE
They also need to get ready for a big spit-out! But remember not to rinse after brushing to keep the fluoride in the mouth and on the teeth.
Some brushing tips
Spread toothpaste (small pea if between 2 and 7 years of age) with the toothbrush around all the teeth before starting to brush. Toothpaste works when in contact with the teeth so make sure every tooth gets a tiny wipe of paste.
Brush every surface of every tooth, especially where the teeth meet the gums and the biting surface of each tooth. Brushing should take 2-3 minutes.
It may be easier to brush small children’s teeth with them lying back on a bed or beanbag with their chin lifted slightly up. This position is often more comfortable for the child and allows the parent to see the teeth better.
No toothpaste is to be used if under 2 years of age unless the dentist has advised you to do so.
As your child gets older you may still have to remind them to brush their teeth twice a day as otherwise, they may forget. Brushing teeth twice a day with fluoridated toothpaste is important to help stop tooth decay so it is worth checking with them that they are brushing their teeth twice a day.
There are 20 baby teeth. At 10 years of age, your child may have up to 12 baby teeth still in their mouth. This is normal. The dentist will check that the baby teeth are getting loose and that the permanent teeth are coming into the correct position. As some baby teeth are meant to last 10 years it is important to keep them healthy and avoid tooth decay.
It is best to feed your baby and then put them to bed rather than sleeping with the bottle in bed. This is safer for the baby and also for their teeth. Formula and milk contain weak sugars and if sucked over a long time add to the contact time with the teeth. This can cause tooth decay especially if the teeth are not brushed twice a day.
It is best to feed your baby and then remove the bottle. This is safer for the baby and also for their teeth. Formula and milk contain weak sugars and if sucked over a long time adds to the contact time with the teeth. This can cause tooth decay especially if the teeth are not brushed twice a day.
Prolonged bottle use can change the position of your baby's teeth. Encourage your baby to drink from a free flow sippy cup, one with no valve, from 6 months and then move to an open cup. Teaching your baby to drink from an open cup can take many months. Your baby has to move from a sucking action (bottle and sippy cup) to a free flow cup and to be able to drink from an open cup.
No, it doesn’t. Most dental problems are caused by eating or drinking sugary foods and drinks too often rather than genetics and this is something you can change for your child. The best drinks for children aged 1 to 4 are water, breastmilk and milk. Brushing the teeth well twice a day and from the age of 2 years using fluoridated toothpaste is very important as well.
It’s best not to lick your baby’s spoon or soother as you can pass on bacteria that can cause tooth decay from your mouth to your baby.
We now know more about what causes tooth decay and how to prevent it. Your dentist and hygienist can give you some small tips that will help your child have better teeth.
If you are very concerned about your child’s teeth and that they are ‘weak’, visit your dentist early to get specific advice for your child.
Even if your child has weak teeth the general advice on preventing tooth decay becomes even more important. That is, to prevent tooth decay, reduce the amount and how often your child eats sugary foods and drinks. When the first tooth appears (around 6 months) clean with a soft brush and water twice daily to remove the bacteria on their teeth and gums. Use fluoride toothpaste once your child is 2 years old as fluoride helps to make teeth stronger and bring your child for regular visits to the dentist. Clean every tooth, brushing gently for 2-3 minutes (about the length of a song).
We now know more about what causes tooth decay and how to prevent it. Your dentist, hygienist and other members of the dental team can give you some tips that will help your child have healthier teeth.
To prevent tooth decay, reduce the amount and how often your child eats sugary foods and drinks. Clean your baby's teeth twice a day to remove the bacteria on their teeth and gums. Use a fluoride toothpaste (small pea-sized amount) once your child is 2 years old as fluoride helps to make teeth stronger and bring your child for regular visits to the dentist. Your dentist can give you some tips that will help your child have healthier teeth and avoid expensive treatments. Preventive treatmentS at the dentist, that help prevent tooth decay are much cheaper than having to have teeth filled. Problems caught early will need cheaper treatments than if problems are left longer.
Tooth decay can cause the loss of teeth and if many teeth are lost this could affect speech.
Using a soother during active daytime (playtime) can disturb speech development, such as babbling and making sounds. Sucking a soother or a finger can change the position of your baby's teeth. Help your child to give up the soother or thumb as soon as possible. This can be done from one year of age. Advice is available at www.mychild.ie
Tooth decay (holes in teeth) is caused by bacteria in the mouth found on teeth and gums. Bacteria eat sugars present in food and drinks to form acid which makes a hole in the tooth over time. As the hole gets deeper and near the nerve of the tooth, the tooth will become painful. If the hole grows further into the tooth the child can develop an abscess, which is an infection under the tooth. This can cause swelling of the gum around the tooth. Sometimes the outside of the child’s face can swell up and need immediate dental care.
To prevent tooth decay, reduce the amount and how often your child eats sugary foods and drinks. Clean your baby's teeth very well twice a day to remove the bacteria on their teeth and gums. Use fluoride toothpaste once your child is 2 years old as fluoride helps to make teeth stronger. Visit your dentist regularly for advice and treatments that can help prevent tooth decay.
No. The recommended advice is to NOT rinse after brushing to keep the fluoride in the mouth and on the teeth. The dentist may advise if your child is 7 years or older to use fluoride but no alcohol mouthwash at another time other than brushing. As well, they will encourage a healthy diet with not too many sweet snacks or drinks.
The most important ingredient in toothpaste is fluoride. Fluoride in toothpaste helps to protect the teeth from tooth decay. Toothpastes come with different amounts of fluoride in them. The most common amounts are 1000ppm and 1450ppm of fluoride in the toothpaste. The advice is from 2 years of age to use a small pea-sized amount (at least 1000 parts per million (ppm) fluoride) twice a day. Large tubes of toothpaste often called family toothpaste generally have 1450ppm fluoride in them. These toothpastes are suitable for everyone in the family except for babies under 24 months but with the advice to use a small pea-sized amount of paste if your child is 2 to 7 years of age. Help your child to spit out the toothpaste and avoid swallowing. Do not rinse after brushing to keep the fluoride in the mouth and on the teeth.
If you decide to use non-fluoride (0 ppm F) or very low fluoride toothpaste (less than 1000ppm F), your child will be at much higher risk of tooth decay. As a result they should attend a dentist very regularly (at least every 3 months) to have their teeth checked.
Does it matter how much toothpaste my child uses?
Yes. Studies conducted in the early 2000s found that most young children were putting too much toothpaste on their brush. This is one of the reasons why it is recommended to supervise your child when they are brushing their teeth and to use a small pea-sized amount of fluoride toothpaste.
The advice on using fluoride toothpaste in Ireland is:
Under age 2 years
Brush the teeth with water but do not use toothpaste unless a dentist has advised you that your child is at high risk of experiencing dental decay.
Children aged between 2 and 7 years of age – brush your child’s teeth twice a day with fluoride toothpaste than contains at least 1000 ppm Fluoride. As young children cannot spit out properly and tend to swallow most things that enter their mouth, they should only use a pea-sized amount of fluoride toothpaste twice a day.
Other tips – Toothpaste that contains 1450ppm of fluoride offer greater protection.
Spit no rinse after brushing. Spit out the excess toothpaste after brushing. It is better not to rinse with water after brushing to keep the fluoride in the mouth and on the teeth. This helps to repair the teeth and make them stronger.
Keep all fluoride containing toothpaste out of reach of children and do not allow your child to eat toothpaste.
Fluoride mouthwashes/rinses – Because of the risk of swallowing, young children under 7 years of age should not use mouthwashes.
A lot of parents say they find brushing their child’s teeth difficult. The advice is not to stop trying. Even the small bit you do can help a lot and lower your child’s risk of getting tooth decay. The advice is to start early once the first tooth erupts. Habits established early in life are more likely to continue.
Once your child is 2 years of age find a toothpaste that your child likes, checking that it has at least 1000ppm fluoride in it. If your child has a sensory issue they may not like any flavoured toothpaste. There are some unflavoured toothpastes on the market e.g., oraNurse unflavoured toothpaste and using these can help.
As your child gets older, 2 to 3 years of age, they may want to take over the brushing completely. This should be avoided as they do not have the manual dexterity (ability) to brush their teeth properly. Involve them in the brushing by giving them an important job, like picking out their own toothbrush or marking off the toothbrush chart once the adult has finished the brushing. Toothbrush charts are available HERE.
They also need to get ready for a big spit out! But remember not to rinse after brushing to keep the fluoride in the mouth and on the teeth. It is best if a parent brushes the child’s teeth. Generally, once a child can tie their shoelaces, around 7 - 8 years of age, they can take over more of the brushing along with some parental supervision.
Some brushing tips
Spread toothpaste (small pea if between 2 and 7 years of age) with the toothbrush around all the teeth before starting to brush. Toothpaste works when in contact with the teeth so make sure every tooth gets a tiny wipe of paste.
Brush every surface of every tooth, especially where the teeth meet the gums and the biting surface of each tooth. Brushing should take 2-3 minutes.
It may be easier to brush small children’s teeth with them lying back on a bed or beanbag with their chin lifted slightly up. This position is often more comfortable for the child and allows the parent to see the teeth better.
No toothpaste is to be used if under 2 years of age unless the dentist has advised you to do so.
Tooth decay (holes in teeth) is caused by bacteria in the mouth found on teeth and gums. Bacteria eat sugars present in food and drinks to form acid which makes a hole in the tooth over time. Teeth can decay quickly if sugar is eaten often, and the teeth are not brushed.
To prevent tooth decay, reduce the amount and how often your child eats sugary foods and drinks. Gently clean your baby's teeth for 2-3 minutes twice a day to remove some of the bacteria on their teeth and gums. Use a small pea-sized amount of fluoride toothpaste, at least 1000ppm fluoride, once your child is 2 years old as fluoride helps to make teeth stronger.
The advice is to brush your child’s teeth twice a day, morning and especially at night. Once your child is 2 years of age start using a small pea sized amount of toothpaste with at least 1000pppm fluoride. Fluoride works best if applied to the teeth twice a day. Brushing only once a day is like them doing only half their schoolwork and will put your child at higher risk of getting tooth decay.
Younger children will need an adult to brush their teeth until they are older. Generally, once a child can tie their shoelaces, around 7 - 8 years of age, they can take over more of the brushing along with some parental supervision. You will still have to remind them to brush their teeth twice a day.
Sometimes the teeth can look dirty after brushing especially if the area where the tooth meets the gum is not brushed. When we brush our baby’s teeth we are trying to remove bacteria from the teeth and gums. The bacteria are called Plaque. Plaque is like a ‘town’ of bacteria and left to build up on the teeth can be very sticky and hard to remove. When you can see a furry white coating on the teeth, especially by the gums these are bacteria that have been left on the teeth for at least a few days.
Some brushing tips
Spread toothpaste (small pea if between 2 and 7 years of age) around all the teeth with the toothbrush before starting to brush. Toothpaste works when in contact with the teeth so make sure every tooth gets a tiny wipe of paste.
Brush every surface of every tooth especially where the teeth meet the gums and the biting surface of each tooth. You may have to gently lift out your child’s lips to see and brush where the tooth meets the gum line. Brushing should take 2-3 minutes.
It may be easier to brush small children’s teeth with them lying back on a bed or beanbag with their chin lifted slightly up. This position is often more comfortable for the child and allows the parent to see the teeth better.
No toothpaste is to be used if under 2 years of age unless the dentist has advised you to do so.
Plaque disclosing tablets are available in many pharmacies and can be used to improve your child’s brushing technique as they get older because they show where the plaque is on the teeth. Please read the instructions carefully before use.
If your child has marks or discolouration on their teeth it is advised to get a dentist to check their teeth.
This is a question that is often asked of members of the dental team. The World Health Organization says that we are all eating too much sugar and that this could affect both our general and oral health. They recommend that we should reduce the amount of free sugar we consume to less than 6 teaspoons of sugar a day. Some foods like raisins have a lot of sugar.
It is recommended to limit sweet treats to once or twice a week. Sweet drinks are the worst treats for teeth as the sugar goes on every surface of every tooth. It is best to stick to plain water and milk. If your child is eating a sweet treat try to pick the treats that are NOT sticky. Sticky treats will stick and stay on the tooth for a long time. This includes caramel bars, sticky fruit bars especially if they have honey in them or sugared chewing gum. If sweet treats are given it is best to give them as part of the main meal, like a dessert. When you eat other foods with a sweet treat more saliva (the water in your mouth) is produced and the treat is less likely to cause damage rather than eaten as a snack between meals.
Giving sweet treats or drinks to your child just before bedtime or during the night is very damaging time for the teeth and should be avoided. At night and especially during sleep the saliva in your mouth dries up a little, so the teeth are not being cleaned and protected as they would be during the day. Sweets that you suck like boiled sweets or chewy sweets and sugared gums are more damaging to the teeth than less sticky sweets as the teeth are exposed to the sugar for a longer period of time.
If you do give your child sweet treats remember that brushing their teeth well twice a day is very important. Once your child is 2 years of age use a pea sized amount of fluoride toothpaste (at least 1000ppm) spitting it out and not rinsing after brushing to reduce the damage of any sugar eaten during the day. It is also best for your child not to eat and drink all the time to give their teeth a break from food and a chance to recover from a sugary attack.
When you brush your child’s teeth you are helping to remove bacteria from the teeth and gums. At 2 years of age, you should start using a small pea-sized amount of fluoride toothpaste twice a day. If your child is under 7 years of age it is not recommended to use fluoride toothpaste MORE than twice a day as they may end up swallowing too much fluoride toothpaste. Fluoride used appropriately is a very important and powerful tool against tooth decay. However, it is not powerful enough to reduce the damage that multiple sweet treats and drinks would have on your child’s teeth.
Yes. If your child has special care needs then they should see a dentist when they are very young, ideally before their first birthday to get advice specific to your child’s needs. The dental team will be able to give you tips on how to keep your child’s teeth healthy. Contact your local HSE public dental service, traditionally called ‘the school dental service’ for further advice on how to access services for your child with special care needs.
White or brown marks on the teeth can be a sign of early tooth decay or weak teeth so it is important to bring your child for a dental check-up.
With your child lying flat and with clean hands, lift your child’s upper lip to show the upper teeth and especially the gums. If you see any white lines along the gum line or brown or yellow spots that don’t brush off, you should make an appointment for your child to see a dentist. Sometimes you may be able to see the back teeth as well. Again look for white lines along the gum line, brown or yellow marks or holes in the teeth.
Sometimes when doing this ‘lift the lip’ check you may notice that your child’s gums are red or bleed on touching. This again may be a sign that a visit to the dentist or hygienist is necessary. Bleeding gums can be a sign that the teeth and gums are not being brushed thoroughly to remove the bacteria. Using a soft toothbrush gently wipe the gums and the teeth twice a day and you should notice that their gums within a few days will bleed less when touched by the toothbrush. If this is not the case you should bring your child to the dentist for a check.