By: Hesham Al-Sharani

Parenting is a journey filled with many 'firsts,' and one of the most crucial is establishing your baby's oral hygiene. The early stages of a child's life are critical for setting a lifelong course of dental health, and as parents, this responsibility is in your hands. Good oral care goes beyond preventing dental decay; it affects your child's overall health, ability to eat and speak, and even their self-esteem.1

This article aims to be your guide in this important aspect of parenting. We will articulate the essentials of infant oral hygiene, from the emergence of the first tooth to the development of healthy brushing habits. It's about more than just keeping cavities at bay; it's about instilling a routine, being a positive role model, and ensuring that your child's smile remains healthy and vibrant. Join us as we explore practical tips and strategies to make oral care an enjoyable and practical part of your child's daily routine.

The Importance of Early Dental Care
Dental decay is a chronic disease that can begin as soon as the first tooth appears. It starts as small white spots or lines and can progress to more extensive, yellow, or brown cavities. Untreated decay can lead to infection, pain, swelling, and early tooth loss. Children with dental decay may experience difficulty eating, sleeping, talking, and concentrating, impacting their overall well-being.2

Preventing Dental Decay
Dental decay in children is largely caused by bacteria, often transferred from parents to children through shared utensils like bottles and spoons. It's crucial for parents to avoid sharing these items with their children and to maintain excellent oral hygiene themselves.3

Another significant contributor to dental decay is the frequent consumption of sugary and acidic foods and drinks. These substances feed the bacteria in the mouth, which produce acids that erode tooth enamel and lead to cavities. The duration these sugars and acids remain in contact with the teeth is also important; prolonged exposure increases the risk of decay.4

To mitigate these risks, parents should limit the frequency and duration of their child's exposure to sugary and acidic substances, promote healthy eating habits, and ensure regular and thorough tooth brushing. By understanding and addressing these factors, parents can significantly enhance their children's dental health.4

Beginning Oral Hygiene
Around 4 to 6 months, babies begin teething, but oral care should start even before the first tooth appears. Parents can gently clean their baby's gums with a moistened gauze pad or a soft silicone finger brush. This practice helps in removing any food particles and sugars that can harm emerging teeth and also acclimates the baby to the sensation of oral cleaning.

A clean, damp cloth or a soft, silicone finger brush is ideal for this stage. These tools are gentle on the baby's gums and can effectively remove residue without causing discomfort.5

Toothbrushing
The journey of proper dental care begins as soon as the first tooth makes its appearance, typically around six months of age. At this stage, it's advisable to introduce a soft-bristled children's toothbrush specifically designed for tender gums and tiny teeth. These brushes are gentle yet effective in removing plaque and food particles from the baby's teeth and gums.6

Selecting the right toothbrush involves looking for one with a small head to comfortably fit in the baby's mouth and a large handle to ensure a good grip. Additionally, brushes with colourful designs or characters can make the brushing experience more enjoyable for the child.

Toothpaste
When it comes to toothpaste, the primary focus should be on its fluoride content. Fluoride is a key ingredient in preventing tooth decay by strengthening the enamel. For infants and toddlers, start with a fluoride toothpaste but in a very minimal amount — no larger than a grain of rice. This small quantity is sufficient to provide the necessary fluoride protection while minimizing the risk of the child swallowing too much toothpaste.7

As the child grows and learns to spit out toothpaste, around the age of three, you can increase the amount of toothpaste to the size of a pea. This is also the time to ensure the toothpaste has a fluoride concentration of 1000-1450 parts per million (ppm). This concentration is ideal for effectively fighting cavities while being safe for young children.7

Building Good Habits
From 18 months, you can give your child their first toothbrush. Although they might initially chew on it, encourage play and gradually introduce brushing. Use small circular motions, focusing on areas where teeth emerge. Parents should assist in brushing until the child is about eight years old, making the process fun and engaging to establish a lifelong habit.4

Brushing Technique
Effective brushing should be done at least twice a day, especially after meals and before bedtime. Lay the baby down with their head on your lap for support. Use the recommended amount of toothpaste and avoid rinsing after brushing to allow the fluoride to work effectively. Brush the front and back of each tooth with small circular movements and use back-and-forth strokes for the molars. Remember to brush the tongue and cheeks gently.6

Conclusion
Good oral health in early childhood sets the foundation for a lifetime of healthy habits. Baby teeth are crucial for eating, speech, facial structure, and holding space for adult teeth. By instilling good oral hygiene practices from the start, parents can significantly contribute to their child's overall health and well-being.

References

1. Berzinski M, Morawska A, Mitchell AE, Baker S. Parenting and child behaviour as predictors of toothbrushing difficulties in young children. Int J Paediatr Dent. 2020;30(1):75-84.
2. Wong HM, McGrath CP, King NM, Lo EC. Oral health-related quality of life in Hong Kong preschool children. Caries Res. 2011;45(4):370-376.
3. Featherstone JD. Dental caries: a dynamic disease process. Aust Dent J. 2008;53(3):286-291.
4. Stormon N. Predictors of oral health in Australian children. 2021.
5. Wigen TI, Baumgartner CS, Wang NJ. Identification of caries risk in 2-year-olds. Community Dent Oral Epidemiol. 2018;46(3):297-302.
6. Kumar S, Tadakamadla J, Johnson NW. Effect of Toothbrushing Frequency on Incidence and Increment of Dental Caries: A Systematic Review and Meta-Analysis. J Dent Res. 2016;95(11):1230-1236.
7. Leite Filho AM, Valdivia-Tapia AC, Costa R, Espinoza EV, Ricomini Filho AP, Cury JA. [Not Available]. Braz Dent J. 2022;33(2):52-60