Brushing

By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist

Brushing
The most effective method for removing harmful plaque is to brush your teeth.  The key is brushing your teeth in a timely manner to prevent the formation of cavity-causing bacteria.  These bacteria are found in the food we eat.  Removing food debris off the teeth and gums helps prevent cavities.

Early prevention is the key.  It is important to begin at your baby’s birth by cleaning the teeth with a toothbrush and water.  Moreover, it is helpful to utilize a small wet washcloth or gauze to wipe off any plaque on your baby’s teeth.  Also, avoid using fluoridated toothpaste until your child reaches age two.

Begin by brushing your baby’s first teeth with a small soft-bristled toothbrush.  Dab a pea-sized amount of fluoride tooth paste on the tooth brush, and encourage your child to brush the teeth.  Make sure to teach your child to spit out the excess tooth paste after brushing, and not swallow the toothpaste.

Children that are ages four or five should be able to begin brushing their teeth on their own.  Only a pea-sized dab of toothpaste is necessary for children under six years of age.  This is due to children’s sensitivity to the higher levels of fluoride.

According to most dentists, the minimum requirement for maintaining proper oral hygiene is brushing three times a day.  However, if your child uses fluoride tooth paste both in the morning and at night, it is okay for your child to skip brushing during the middle of the day.  In addition, simply rinsing the mouth for 30 seconds with water and brushing the teeth after lunch can also compensate for brushing during midday.[1]

Brushing Techniques
I recommend that you come visit me so that I can teach your child the best brushing technique.  Because everyone has different teeth, it is important for me to teach your child the best way to brush his/her teeth.  These are some easy and effective techniques that work:

• In a circular motion, brush two or three teeth at a time.  Do this until you have cover your entire mouth
• Brush your teeth in a 45-degree angle placing your toothbrush next to your teeth, and brush in circular motion (do not brush your teeth up and down because it can lead to problems such as eroding gums, wearing down tooth structure, and even exposure to the root of the tooth).  Make sure that you brush all of the surfaces of the teeth: top, front, back, and in between teeth.  Lastly, make sure to gently brush back and forth on the gums to remove all of the plaque buildup under the gum.
• Brush all surfaces in the mouth that may be covered in bacteria: the floor of the mouth, the gums, the roof, and especially the tongue.  You need to brush your tongue to remove trapped bacteria and other germs that may cause disease as well as to have fresh breath.
• Replace your toothbrush every three months or when the bristles begin to spread to wear and tear, otherwise your toothbrush will not clean properly.

It takes about three minutes to brush your teeth properly.  Some studies show that most people do not brush long enough and that on average only spend one minute brushing.[2]

Toothbrush Selection
Today, the variety of toothbrushes is unimaginable.  There are countless toothbrush colors, shapes, and sizes.  For example, there are oscillating handles and tufts that light up when you use them.  Some have raised bristles and angled heads.  However, there is no proof that one design is better than the others for removing plaque and other food particles.

When shopping for your child’s toothbrush, the most important thing to remember is that your child likes it and will actually use it.  Moreover, it is important to teach your child the correct brushing technique including the proper length of time for brushing (3 min).

The fact is many children do not brush long enough.  To reach all of the areas and brush off all the cavity-causing bacteria effectively, your child must brush for at least two to three minutes

You may be wondering which toothbrush is the best for your child. Most commonly, a child’s toothbrush head should be little (“1/2” by “1”) so that it can fit in all areas of the mouth, gums, and teeth.  It should have a firm and long handle to grasp.  It should have soft bristles made out of nylon (natural bristles have a tendency to harbor bacteria) with round ends to make sure not to hurt your child’s gums.  I do not recommend using medium to hard bristles.

Every three to four months, you should change your toothbrush.  (If your child becomes ill, you should replace the brush when he/she becomes ill and after he/she gets better.)  It is also important to replace the toothbrush before the bristles become frayed and splayed.  Old brushes are ineffective because the bristles are no longer firm and also dangerous because they hold many harmful bacteria that can cause periodontitis (inflammation and irritation of the gums-if untreated can spread to the bone and ligaments that help support the teeth) and gingivitis (bleeding of the gums.)  In adults, periodontitis is the leading cause for loosing teeth.  Although uncommon in childhood, this disease increases during adolescence.[3]