A caution on toothpaste with young children

A recent article in The New York Times (2/5/19) highlighted something I’ve been telling parents of young children for years: watch the amount of toothpaste your child uses and observe your child brushing until you, the parent, are comfortable they are not swallowing the toothpaste.

The article in The Times reported on a new study by the Centers for Disease Control and Prevention (the C.D.C.) which indicated nearly 40% of children ages 3 -6 were using more toothpaste than recommended, and many were swallowing the toothpaste, which proportionately, is relatively high in fluoride. Just as too little fluoride is not beneficial, too much is also not good.

For children under three years of age, the recommendation is only a small amount of fluoridated toothpaste, about the size of a grain of rice, starting about 18 months of age. Over three years of age, the size of toothpaste used should be no more than the size of a pea. Don’t be swayed by the toothpaste commercials which show a toothbrush fully coated with an “S” curve of toothpaste, such that you almost have two layers of toothpaste on a brush.

That doesn’t mean that you should wait until 18 months of age to start brushing a child’s teeth. I’ve recommended even before the first tooth erupts, that you wrap a gauze pad around your index finger and wipe the ridges of the jaw where the teeth will eventually erupt. Brushing by a parent should commence immediately upon eruption of the first tooth, and my feeling (although I cannot prove it) is that teething will be less uncomfortable if the bacteria on the ridges where the teeth erupt is wiped daily to remove the bacteria by using the gauze pad. It only takes seconds!

I have also suggested that you, the parent, wet-brush and floss the child’s teeth at least once/day until about the age of 7 or when they start to write cursively, the same fine motor skills being necessary to do a good job for both activities; then let he or she go to the bathroom to brush their teeth with toothpaste afterwards, but the parent should observe them brushing to insure they don’t swallow the tooth paste. I don’t advocate parents brushing the child’s teeth with toothpaste—it will foam in the mouth and interfere with observing how good a job you are doing. The purpose of brushing and flossing is to remove the bacteria from the teeth, and brushing using only a wet brush improves the visibility of your endeavors. Have the child lie down either on a bed or on a sofa with their head in your lap, so you can visualize their mouth. Afterwards, let the child brush with toothpaste using a quantity that a parent has monitored.

From my perspective, wet-tooth brushing and flossing by a parent is a non-negotiable process. If you didn’t let your child walk around with a dirty face or a dirty diaper, you also don’t let them walk around with dirty teeth.

Years ago, when our child was born, I bought a Nuk toothbrush training kit. At first I thought it was a gimmicky waste of money, but as I watched our child use it, I realized it was training her how to hold and use a toothbrush. (A word of caution, keep watch on your child/infant using the brush initially so they don’t hurt themselves)

*Individual results are not guaranteed and may vary from person to person. Images other than before and afters photos may contain models.