1. At what age is it appropriate to use toothpaste to clean my child' s teeth?

Teeth begin to accumulate plaque as soon as they are introduced into the oral cavity, therefore it is important to keep the teeth clean by physically removing the accumulation. Fluoride toothpaste is a great adjunctive in removing the bacteria, mainly because the main active ingredient, fluoride prevents bacterial growth. However, one must be careful not to swallow the toothpaste because the fluoride can interfere with the developing teeth and cause fluorsis in the permanent dentition. Toothpaste with little or no fluoride is also available, which is optimal for children' s use. This acts well, as practice, before the use of fluoride toothpaste. It is only recommended to use fluoride toothpaste once the child can successfully expectorate all excess toothpaste. Most children can understand this and perform well between ages 4-6, and subsequently this is the age range for incorporation of toothpaste into an oral hygiene routine. More importantly the parents should pay attention to the child' s ability to expectorate. Once the child can do this well, he/she can use fluoride toothpaste.


2. Toothpaste: when should we begin using it and how much should we use?

One should begin to use toothpaste consistently around ages 4-6. The toothpaste brand is important. It should be a fluoride toothpaste with the American Dental Association seal on it. You have to use a very small amount of toothpaste, pea-sized , until the kids can rinse and spit. A lot of kids 2, 3, and 4 will swallow a small amount of toothpaste. Try to have younger children learn to expectorate early, this will help to prevent swallowing of the toothpaste. We recommend a toothbrush at age 1, but if they want to use it earlier that' s fine. We always tell the parent that you should brush your child' s teeth until he can tie his shoes. Children who have the manual dexterity to tie shoes have the dexterity to hold a toothbrush. Children under the age of 2, use a smear of toothpaste to brush teeth. Starting at birth, clean your child' s gums with a soft infant toothbrush or cloth and water.


3. How do I make my child' s diet safe for his teeth?

Make sure your child has a balanced diet, including recommended servings of: fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child' s teeth from decay. It is important to make sure the child has nothing in the diet that will linger for extended periods, as this may cause decay. Limit sugars, especially those that are slow released (jolly ranchers, ect.) and do not allow children to sleep with bottles in their mouth because the constant source of sugar is known to cause rampant decay.


4. Should my child take a fluoride supplement?

You or your dentist may evaluate the fluoride level of your child' s primary source of drinking water. This information is available through city resources (city website, city hall). If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient as your main water source is well water, or if your child drinks bottled water, which in most cases is void of fluoride), then your dentist may prescribe fluoride supplements. However, it is extremely important that your child do not take fluoride supplements unless absolutely in need, as this may lead to visual fluorisis.


5. How do I know if my child is getting enough fluoride?

There are many things to look for when fluoride levels are questionable. The main signs are in direct relation to bacterial build up. Without proper fluoride, bacteria will grow uninhibited resulting in significant gingiva linflammation and plaque buildup. Tell tale signs of increased buildup are

1. Red bleeding gums,

2. Significant noticeable plaque on teeth,

3. Fractures in the absence of excessive trauma,

4. High caries rate on dental visits.

5. Consistent bad breath.If your fluoride levels are questionable advise your dentist of your concerns and ask for a professional opinion.