Toothbrushing and Toothpaste
Regular tooth brushing is important to remove plaque and food debris, and most importantly for distributing the fluoridated toothpaste.
Brushing Guidelines
- Brush twice daily beginning as soon as teeth emerge.
- Bedtime is most critical due to decreased salivary flow.
- Caregiver should brush child's teeth until age 8 or 9, at least until they have developed the manual dexterity to write in cursive and tie their own shoes.
- Young children can not reliably spit and will swallow toothpaste. Children learn to expectorate well between age 3 and 5 years.
- Young children have difficulty adequately brushing all areas.
- Parents should continue to intermittently supervise brushing after children assume independence.
- Caregivers should place only a smear (under two years) or pea size dab (children over age 3) of fluoridated toothpaste on the child's toothbrush.
- Caregiver should stand or sit behind child.
- Lift lip and brush along the gumline.
- Child should spit out, not rinse, after brushing to increase topical fluoride exposure.
Small Smear (grain of rice size):
Less than 3 years of age
Pea Sized:
3 years & over, regardless of caries risk
References
Chestnutt IG, Schafer F, Jacobson AP, Stephen KW. The influence of tooth brushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dentistry & Oral Epidemiology. 1998;26(6):406-11.
Wright JT, Hanson N, Ristic H et al. Fluoride toothpaste efficacy and safety in children younger than 6 years: A systematic review. JADA. 2014. 145(2): 182-189.
Sotthipoka K, Thanomsuk P, Prasopsuk R, et al. The effects of toothpaste amounts and post-brushing rinsing methods on salivary fluoride retention. Journal of Health Research, 2018; 32(6): 421-431.
Duckworth R, M, Maguire A, Omid N, Steen I, N, McCracken G, I, Zohoori F, V: Effect of Rinsing with Mouthwashes after Brushing with a Fluoridated Toothpaste on Salivary Fluoride Concentration. Caries Res. 2009; 43:391-396.
Krol D, Whelan K. THE SECTION ON ORAL HEALTH; Maintaining and Improving the Oral Health of Young Children. Pediatrics. January 2023; 151 (1): e2022060417.Â