How to clean tiny teeth : Expert Tips from Actual Dentist

Happy healthy smiles!

Happy healthy smiles!

Last month, I was very fortunate to be invited to a talk on dental hygiene for children at Expat Kitchen given by an ex-classmate of mine who is a specialist in Paediatric Dentistry, Dr Ng JingJing from The Oral Care Centre. This talk was hosted by Colgate Singapore in conjunction with the launch of their new toothpaste, the Colgate Maximum Cavity Protection plus Sugar Acid Neutraliser.

Now that J is 7 years old, his baby teeth are dropping out and are being replaced with permanent teeth which he has to learn to look after for the rest of his life…and Little E is becoming more independent with her morning routine (which includes brushing her own teeth). So it’s up to me to teach them how to look after their teeth. I have always wondered if I am doing it right so this dental hygiene workshop was very useful for me.

I actually learned a great deal from Jing – she has two kids of her own so she had plenty of practical advice to share and it was enlightening to learn about kid’s oral hygiene from an expert mom!

Dr Ng JingJing’s Expert Advice on Paediatric Oral Care

1. Instil good brushing habits from young a stepwise approach

Step 1: Once babies are beginning to wean onto solid food, use a clean, damp washcloth to clean the mouth and massage their gums – this helps them get used to having their mouths cleaned after mealtimes.

Step 2: When the first few little teeth start erupting, transition to a baby toothbrush with a very small head and very soft bristles. Use only cooled, boiled water to clean the teeth. Avoid ‘kiddie flavoured toothpaste’.

Step 3: Teach your child to spit. Once your child is around 18 months old, get your child to observe you brushing your own teeth and spitting toothpaste out into the sink. Then, clean their teeth with water and a soft bristled toothbrush and get them to try spitting into the sink. They will not yet be able to master spitting at 18 months, but hopefully with practice they should be able to spit effectively around 2-3 years old.

Dr JingJing’s Expert Mom Tip #1: Being able to spit is one of the key steps to brushing teeth. This is because swallowing toothpaste containing fluoride is undesirable as this leads to fluorosis which causes discolouration of the teeth. For this reason, Dr Jing advises parents to teach children that toothpaste is medicine, and cautions parents against using ‘kiddie flavoured toothpaste’ which is designed to be more palatable for children, as this encourages children to eat the toothpaste instead of spitting it out.

This is what a ‘very tiny smear’ of toothpaste looks like. Picture Credit: The Dental Studio

Step 4: Introduce toothpaste as soon as possible (i.e. once your child is attempting to spit into the sink). It is now recommended for children under 2-3 years old to use fluoridated toothpaste as this has been shown to greatly reduce dental caries (i.e. tooth decay). Start by putting a very tiny smear (not a ‘pea sized amount’) of fluoridated toothpaste onto the toothbrush. Once your child is effectively able to spit (usually over 3 years old), increase the amount of toothpaste to a pea-sized amount.

Dr JingJing’s Expert Mom Tip #2: Parents should use a very tiny smear or a ‘rice sized amount’ of adult toothpaste for kids under the age of 2 who are not yet proficient at spitting. The mint flavour of the toothpaste tends to be unpalatable for kids and will reinforce the idea that toothpaste is medicine and the child will be more likely to spit the toothpaste out (or dribble it out) into the sink instead of swallowing it!

Picture credit: Colgate Singapore

(Any fluoridated toothpaste should be good enough, however, if you are particularly paranoid about dental caries especially in kids who may not be very thorough when cleaning their own teeth, you can consider using Colgate’s new toothpaste, Colgate Maximum Cavity Protection plus Sugar Acid Neutraliser, which contains a triple combination of arginine, an insoluble calcium compound as well as fluoride that has been shown to aid in remineralising tooth enamel and reversing early dental caries by neutralising sugar acids and restoring the pH of the tooth surface to a healthy level. I received a sample of this fancy new toothpaste from Colgate and I’ve been using it at home for the last month.)

Step 5: Continue to brush your children’s teeth for them until they are around 6-7 years old. This is because a child’s motor skills are generally not good enough to effectively manipulate a toothbrush to properly clean the inner surfaces on the teeth, especially the back teeth in the upper jaw.

Dr JingJing’s Expert Mom Tip #3: If your preschooler is becoming more independent, it is okay for them to start learning to brush their own teeth, however, parents should continue to monitor their preschooler’s teeth daily to make sure that they are adequately cleaned, and consider brushing their teeth for them a second time, especially in the evenings before bedtime.

2. Treat dental caries or tooth decay like an infectious disease – because it is!

Dental caries is actually the most common transmissible and infectious disease in humans. It is possible to minimise dental caries by adopting habits that minimise the transmission of cariogenic, tooth decay-causing bacteria.

Dr JingJing’s Expert Mom Tip #4: Be more paranoid! Teach your kids never to share anything that goes in the mouth. This means no sharing toothbrushes, drinking cups, straws or eating utensils with people outside the immediate family or even with a parent or sibling who has known dental caries or tooth decay. Additionally, parents should not allow people to kiss babies on the mouth as this introduces cariogenic bacteria into an infant’s otherwise ‘sterile’ mouth.

3. Look after the permanent teeth by looking after the baby teeth

Some parents do not worry about caring for baby teeth as these are deciduous and will ‘drop out anyway’. However, it is important to remember that baby teeth act as guides to help permanent teeth to erupt in the correct position. Additionally, teeth are necessary not only to ensure proper nutrition (by being able to chew food properly), but also to help with good speech development. So it does no good for young kids to have their baby teeth removed early as a result of tooth decay.

It is also worth noting that the permanent teeth are often present within the gums of children, waiting directly underneath the roots of the baby teeth – which often means that tooth decay in baby teeth can also spread to the unerupted permanent teeth leading to malformation. So it is worth keeping the baby teeth in good condition!

Dr JingJing’s Expert Mom Tip #5: When the permanent teeth are erupting, sometimes they start erupting behind the baby teeth instead of directly underneath – when this happens, encourage your child to wiggle the baby tooth loose and remove it as soon as possible. If the permanent tooth completely erupts before the baby tooth drops out, it will stabilise the loose baby tooth and lead to more problems such overcrowding, crooked dentition, even tooth decay as permanent tooth surface cannot be adequately cleaned by brushing – in such cases, visit your dentist to have the baby tooth removed.

4. Practice good eating habits for healthy teeth

We all know that sugar is the main culprit behind tooth decay as it is the food on which cariogenic bacteria thrive, making acids that ruin tooth enamel. Parents should be aware that sugar occurs naturally in many foods, but the amount of sugar hidden in processed foods (especially marinades and bottled sauces) beggars belief! I’ll be sharing a low-sugar recipe from Expat Kitchen later on this week which was SUPER easy to make, the kids actually did it all by themselves.

However, just adopting a low-sugar diet is not enough to prevent tooth decay in children. Dr JingJing told us that she has seen many cases of tooth decay in children (and infants) who do not consume any soft drinks, processed foods, sweets or any form of added sugar in their diet. It turns out that these children have a few of the following in common:

  • They take a long time to eat during mealtimes.
  • They hold food in their mouth for a long time without chewing or swallowing it (‘food pouching’).
  • They drink milk/juice or nurse to sleep.
  • Despite adequate solid food intake during the day, they breastfeed “on demand” throughout the night (sometimes even nursing constantly for several hours at night).
  • They have many tiny meals/snacks frequently throughout the day, or they drink only juice/cordial or milk, spending several hours sipping them slowly.

In these children, their teeth are nearly always in contact with food during the day (and sometimes throughout the night). Even though their diet has been carefully selected by parents to be low in sugar or sugar free, the food is eventually converted into natural sugars by the enzymes present in saliva. Thus, their teeth are constantly sitting in a sugary, acidic environment which leads to decay.

Dr JingJing’s Expert Tip #6: Limit the number of mealtimes to five a day (three main meals and a mid-morning/mid-afternoon snack, or for breastfeeding infants who have teeth it means 3-4 hourly feeds), and limit the length of mealtimes (or nursing time) to 20-30 minutes. During these mealtimes, children can literally have as much sugar-containing food and drinks as parents will allow, but in-between meals, they should only have water.

5. Love your dentist

Once your child’s first tooth comes in, you can start bringing your child to visit the dentist for biannual checkups. Teach your child to love the dentist – do not use trips to the dentist as a threat or a punishment for errant behaviour!

J and Little E started seeing the dentist for ‘checkups’ waaaaay before they could even walk because we have a Convenient Dentist Uncle in the family. He blows them balloon elephants and chickens out of latex gloves.

Dr JingJing’s Expert Mom Tip #7: Primary school going children attending local schools in Singapore actually receive free dental care from their school dental clinic and are entitled to a free checkup every year! Make an appointment on behalf of your child with the school dentist for a checkup midway through the school year, and for the second visit, make an appointment with a friendly dentist of your choice – there are many dental clinics that cater specially to children.

P.S. Check out more great tips on dental care over at Life’s Tiny Miracles!

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20 thoughts on “How to clean tiny teeth : Expert Tips from Actual Dentist

  1. Thanks for the post! I literally went “O no!” at some of the points… I gotta start thinking about my girl’s eating habits to prevent dental caries… 🙂

      • IT’S THE SAME!!! My girl does that food pouching thing too! I’m worried cos I don’t have good teeth and struggle with dental problems that require me to spend thousands of dollars on them. I hope my girl doesn’t need to go thru all these…

  2. Great article, Debs! We recently had a baby, so I’m trying to figure out when we should start caring for her teeth. I’ll be sure to follow your suggestion of cleaning her teeth with a washrag after each meal. Do you know of any nongranulated toothpastes?

    Lily de Grey |

  3. There are some really great tips for brushing your child’s teeth in here! I’ve been having the hardest time with my little one, she hates teeth brushing time. And she ALWAYS tries to swallow the toothpaste! I love the tip about telling your kids that toothpaste is medicine. That will get them to spit it out, for sure!

  4. My son just went to the dentist for the first time, and he ended up having 2 cavities. I think it is because since he has such small teeth, it is hard for him to clean them properly. So I really appreciate you talking about these tips on how to clean small teeth. I’ll make sure I start helping my son with this right away.

  5. Thanks for the tips! I thought that you said something really interesting about the importance of taking care of baby teeth. It seems like it’s easy to neglect baby teeth since they come loose and are replaced by permanent teeth. You’re right, taking care of baby teeth is important since permanent teeth wait directly under baby teeth roots. If there’s something wrong with the baby teeth roots, then that will affect the permanent teeth when they come in. I wouldn’t want my kids to have permanent teeth that are already decaying, so it seems like I should be doing more to make sure that they’re taking better care of their teeth.

    • Yes, I think many people are not aware that the permanent teeth are hiding in the child’s gums and can be there for years before they actually erupt.

  6. Thanks for the tips! My little sister just had a baby, so I’ll show her this article. I think dental hygiene is so important, so I want her children to have great teeth. Is there anything you should do to clean a baby’s mouth when they are just drinking milk?

  7. It surprised me when you talked about seeing tooth decay in children who didn’t eat a lot of sugar. It equally surprised me to find out that taking a long time to eat, eating small snacks throughout the day, or nursing to sleep with milk or juice also increases the chance of getting cavities and experiencing tooth decay. Thus, I definitely agree that it’s important to teach your children correct eating habits, so that they are not only in-taking the correct foods, but they are eating those foods in a way that your body can handle them healthily. Additionally, I think that this is important for adults to read about for their own dental hygiene. I often find myself eating my meals very slowly or snacking throughout the day. Reading that this could potentially cause tooth decay makes me more conscious about how I am eating to ensure proper dental hygiene. Thanks for the great insight!

  8. Even little children’s teeth need to be cleaned. Maybe I should take better care of my child’s teeth while she is young. I never thought that I should teach my child how to spit. That seems like something I should get started on while there’s still time.

  9. I like that you included care starting at an early age. Starting kids with good hygiene habits early helps ensure that they will maintain good oral care. I wish my parents did this with me, so I will definitely do this. Thanks for posting!

  10. Thank you so much for talking about this! I have been having the hardest time helping me son clean his teeth. His teeth are just so small, and it is super hard making sure he brushes them the right way. So I really appreciate you giving me these great tips on how I would go about cleaning small teeth. This is going to help me out a ton.

  11. Our children are getting to that age where we want to take them to the dentist’s office! We agree with you that taking them as early as possible is a great idea to make sure that they adopt health habits. I know that my wife has a pretty soft bristled brush, and we will more than likely get similar ones, if not softer, for our youngest child to use.

  12. I would have to agree that it’s important to instill good brushing habits from a young age. That way as they continue to grow they will continually keep up their good oral health. I also like that you bring up good eating habits, because that’s also an important part of oral health.

  13. It has been a really interesting experience teaching our kids how to brush their teeth. Playing different games while brushing can keep them engaged as well as teach them great habits! Talking to your dentist about different methods can also be really beneficial! I really like your tip about teaching healthy eating habits because no matter how much you brush, there are definitely some foods that will cause damage either way.

  14. I definitely agree that it’s important to instill good brushing habits at a young age for your kids. Specifically, you talk about when the first few teeth start showing up, it’s smart to begin transitioning to a toothbrush with a small head and soft bristles. I think that starting this when they’re young will show them the example and create a routine that it’s always important to brush your teeth. Thus, they will be more willing and more prone to brush their teeth when they get a little bit older. Thank you for sharing!

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