Let’s begin with toddlers and preschoolers. Toothbrushes should have extra soft bristles with small rounded heads. A rubber edge on the head of the toothbrush is a good safety feature. Handles may be larger and covered with rubber for a good grip. A colored area on the bristles, usually blue, designates the spot to ensure minimal application of toothpaste. Parents should do the brushing until age six. Do not permit your child to chew on the bristles or run with a toothbrush in her mouth.
For toddlers, sit on the floor in a straddle position with the child in between your legs. If the child has strong avoidance behavior, place one of your legs gently over the child’s legs and hold his hands with one hand. Brush the teeth as quickly and efficiently as possible. A wet toothbrush may be sufficient if your child rejects the toothpaste. Toothpaste with fluoride usually should not be used until after age three. For children who experience significant decay prior to three years of age, we now recommend that fluoridated toothpaste begin as early as one year of age. Do not use more toothpaste than the size of a match head before five years of age. The fluoride in toothpaste does reduce the incidence of decay, so try to find toothpaste that your child likes.
As soon as the six year molars erupt, it is time to change to a larger toothbrush. This brush should have a larger head to accommodate the larger molars. Your child should be reminded to get the brush far enough back to brush these teeth too. Battery operated spin brushes have been shown to clean far better than a manual brush.
Brushing all tooth surfaces is much more important than the amount of time spent brushing. Begin with the top back teeth first, brushing the chewing surfaces and the side next to the roof of the mouth. The bottom teeth are second, brushing the chewing surfaces and the side next to the tongue. In order to brush the sides of the top and bottom teeth next to the cheeks, the mouth should be almost closed. If the mouth is stretched wide open, the cheeks are tight against the teeth. Be sure to brush near the gum line. The top and bottom front teeth (incisors) are last. Brush the gums of the bottom front teeth in a gentle upward fashion-from the gum line upward to the edge of the incisors.
All brushes, for all ages, should have soft bristles. As soon as the bristles are frayed, the brush should be replaced. Rinse the toothbrush thoroughly with hot water before and after brushing. Do not store toothbrushes in plastic bags or closed containers. Allow the brush to dry between brushing to avoid overgrowth of bacteria and fungus.
A toothbrush should be replaced after an illness, particularly strep throat. The streptococcus bacteria can grow on the toothbrush and reinfect your child. Change to a less expensive brush 24 hours after the antibiotic is begun and begin a good quality toothbrush when the antibiotic is completed.
Soaking a toothbrush in Listerine mouthwash for 20 minutes will disinfect the toothbrush. Strep can grow on orthodontic retainers too. Clean the retainer thoroughly with hot soapy water or soak it in Listerine mouthwash for 20 minutes. Keep all mouthwash out of the reach of young children!
Viruses or bacteria on toothbrushes can be transferred to the toothpaste tube and then on to someone else in the family. During an illness, place the toothpaste on a clean finger instead for transfer to the toothbrush.
Bedtime is the most important time of day for brushing. Morning brushing should be done after breakfast.