Who should read this chapter? If children have teeth, they should be brushed. If you need help getting their teeth brushed, then you should read this chapter.

Summary: Children don't like getting their teeth brushed. They usually cry and scream when parents brush their teeth. Giving up and failing to brush their teeth rewards children for crying and screaming and it promotes dental erosion and decay. Children must learn that no matter how much they cry and scream, they will still get their teeth brushed. They will eventually learn that crying and screaming are pointless and a waste of their energy, so they might as well relax and get their teeth brushed. Electric toothbrushes are easier to more effectively brush children's teeth. The noisy and more vigorous action of the electric toothbrush better prepares children for their first dental visit.

Your infant's first teeth will emerge on average at 8 months of age, but this can be as early as three months and as late as 14 months. When your child's first teeth emerge, you should brush them. In addition to keeping their teeth clean, brushing trains your child to get accustomed to others sticking things into their mouths. The doctor needs to look in your child's mouth and the dentist will eventually need to look in there also. You can purchase an infant toothbrush and a toothpaste with a mild taste to start brushing for the first time. Do not use adult toothpastes since the taste of these are too strong for infants. Other ways of cleaning their teeth at this age include using a wash cloth to clean their teeth during baths and a specially made rubber finger sleeve with tiny rubber bristles molded onto its surface for brushing. I found these rubber finger sleeve brushes to be the easiest to use for the first few months of brushing.

As infants get older, they will not like getting their teeth brushed. They will cry, shake their heads, and throw tantrums. This is enough for some parents to give up. Many children never have their teeth brushed until 2 or 3 years of age. Well, it's only baby teeth. But there's a more important reason why brushing at a young age is important.

Eventually, usually at age 3, a dentist will need to check your child's teeth. It is much easier for a dentist to examine a cooperative child. Uncooperative children often receive incomplete exams. General anesthesia for dental exams is feasible, but it is expensive and it involves some ADDITIONAL MEDICAL RISK. Rather than put all children to sleep for a dental examination, it would be preferable to have awake and cooperative children during a dental exam. If children won't let their parents brush their teeth, it is likely that the dentist won't be able to examine their mouths.

The benefit from brushing is more than just cleaning their teeth. Children must get used to dental manipulation so that the dentist can properly take care of their teeth. Be firm with your children. They need to permit parents to brush their teeth. By being firm, you will teach your children that there is no point in throwing a tantrum. Their teeth will be brushed whether they throw a tantrum on not. They will learn to just open their mouth when they see the toothbrush.

Unfortunately, it may be very difficult for some children. When children throw a tantrum during tooth brushing, they must get the message that no matter how much they scream, they will still have to get their teeth brushed. For difficult cases, the following approach works well. It has worked well for my children. If it sounds too harsh for you, try some other firm approach first or discuss this with your pediatrician, family physician or dentist. The goal is to get them to cooperate with tooth brushing and dental exams. There are many strategies to get this accomplished.

For difficult cases, the firmest approach to brush their teeth is to hold them with your legs while you use your hands to brush their teeth. Your child should be lying down on his/her back. You should be sitting on the floor with your child's head between your thighs. Your thighs should be over your child's shoulders. By bringing your thighs together, you can hold your child's head position steady. If necessary, you can curl your feet in to control your child's legs. Open your child's lips with your left hand and brush his/her teeth with your right hand (or vice versa). Even if your child screams and cries, continue on. If your child gags or vomits, you will have to let go to turn his/her head to the side to prevent saliva, toothbrush foam, and/or vomit from being inhaled into the lungs. However, once the gagging and vomiting has stopped, go back to continue brushing. DO NOT teach your child that gagging or vomiting will relieve him/her of the need to brush.

It's not possible to do a perfect job when they are not cooperative, but do the best you can. If you continue with this firm approach, your child will learn to cooperate. Your child should learn that no matter how much I scream and cry, my teeth will still get brushed. I might as well save energy and just be cooperative since there appears to be no way that I can avoid this.

Use an electric toothbrush. I have found that an electric toothbrush is beneficial for two reasons: 1) It is easier to brush a child's teeth. 2) It is noisy, intrusive and vigorous. This better prepares your child for the dentist. The instrumentation by the dentist with their mirrors and mini ice picks (those dental instruments) is a new and unpleasant experience for the typical 3 year old first time dental patient. Coupled with anxiety and this new and uncomfortable experience in his/her mouth, many young children become uncooperative making it even more difficult for the dentist. Since electric toothbrushes are noisy and less gentle, these better prepare children for their first dental visit. My first two children who were brushed with a hand toothbrush, were very difficult patients during their first dental visits. We later changed all the children over to electric toothbrushes. My youngest child who was brushed with an electric toothbrush for a year before his first dental visit was very cooperative with the dentist on his first visit. I think the electric toothbrush had some benefit in this regard.