Your child’s mouth is a dark, mysterious place (for both of you). So how do you help him develop solid dental habits? Here are answers to your most gnawing questions.

By Marisa Cohen
Updated August 12, 2013
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I love you tooth fairy in toothpaste
Credit: Russ and Reyn

Taking care of your kids’ teeth—brushing, nagging about brushing, flossing, nagging about flossing—is probably one of your least favorite parental jobs. But it’s a necessary evil: Cavities are the single most common chronic childhood disease in America, affecting one in four kids ages 2 to 5. So open wide; here’s a painless pediatric dental checkup.

When Should I Book My Baby’s First Dental Exam?

The official recommendation of the American Academy of Pediatric Dentistry (AAPD) is to schedule a checkup by his first birthday. That said, many dentists admit that this is hard for parents to swallow—especially if only a handful of tiny teeth have come in by then. “Many parents who clean little teeth from the start with tooth wipes, a washcloth, or a soft toothbrush and water often choose to wait until age 2,” says Ruby Gelman, D.M.D., a pediatric dentist in New York City, who points out that your pediatrician will be able to spot any obvious red flags that would require earlier intervention.

Whenever you go, don’t worry that your squirmy toddler won’t be able to sit still in a dentist’s chair or tolerate a stranger poking around in his mouth with metal instruments. These early visits are a lot more about talking than touching, says Ed Moody, D.D.S., the president-elect of the AAPD. The dentist will discuss your family’s dental history, demonstrate how to clean your child’s teeth, and give general tips. For instance, don’t put her to bed with a bottle of milk or juice, which can linger in the mouth all night, causing decay. Think of it like a well-child visit: An ounce of prevention is worth a pound of fillings.

If My Kids Drink Only Bottled Water, Are They Getting Enough Fluoride?

Ever since American cities began adding fluoride (a mineral that helps prevent the breakdown of enamel) to their water supplies in the mid-1940s, the rate of childhood cavities has decreased by as much as 40 percent, according to the American Dental Association. Still, plenty of kids subsist on bottled water—or, worse, sugary sports drinks and juices—so they’re missing out on that benefit. (As are the 26 percent of Americans who live in communities that don’t add fluoride to their water.) “Your dentist can help you figure out how much fluoride your children are actually getting and come up with a plan to increase it if necessary,” says Moody. Here are a few options.

  • Drink filtered water. If you live in a fluoridated area, skip the bottled H2O and run your tap water through a carbon filter, like the ones made by Brita. It will remove chlorine, copper, and mercury but keep the fluoride in. There are also portable versions by Bobble, essentially reusable sports bottles with a built-in filter, which can replace disposable bottles.

  • Buy enhanced, tooth-friendly bottled water. Bottled water with added fluoride (sold in supermarkets) provides the mineral and has no funny aftertaste.

  • Ask about supplements. For kids living in non-fluoridated areas, who are at high risk for decay, dentists may prescribe chewable fluoride supplements, to be taken once a day after brushing. Just don’t go over the recommended dose. Too much fluoride can lead to dental fluorosis (a condition causing white spots or stains on teeth).

  • Try fluoride toothpaste and rinses. Once your child is able to spit out toothpaste (around age 2), she can start using a smear of fluoride toothpaste on her toothbrush. Following with a fluoride rinse is particularly useful for kids with braces, who might have a hard time getting to each tooth with a brush.

My Dentist Says My 7-Year-Old May Need Braces. Isn’t That Much Too Young?

Braces used to be a rite of passage for middle schoolers and teens, appearing around the same time as pimples and crushes. But in the last few years an increasing number of kids as young as second grade are being fitted with orthodontic devices (such as palate expanders, retainers, and partial braces) well before all their baby teeth have fallen out. This early treatment isn’t as over-the-top as it sounds. Meant to address the growth of the jaw, not the teeth themselves, it’s recommended for a few specific types of bites, says John Buzzatto, D.M.D., the immediate past president of the American Association of Orthodontists, who estimates that about 15 percent of children ages 7 to 9 who are referred to him require treatment. One example: “If the child’s lower front teeth are in front of the upper front teeth, moving the upper front teeth forward may allow for normal jaw growth and development,” says Buzzatto. Early braces may be advised for children whose top front teeth have grown out too far (what used to be called “buck teeth”), because evidence shows that those teeth are more likely to be fractured in accidents. An orthodontist may also recommend early braces for kids who have open bites (which means the top and bottom front teeth don’t touch) due to thumb-sucking, tongue thrusting, or good old genetics.

But keep in mind that even after you go through the expense and inconvenience of these proactive measures, your child may need more orthodontic aids later on. “Nine out of 10 children who have early treatment will still need full braces in the future,” says Buzzatto. “However, going through the first phase does reduce the severity of the problem and could prevent more serious procedures, like surgery or extractions.”

My 5-Year-Old Insists on Brushing His Own Teeth, but Is He Getting Them Clean? It Looks Like He’s Just Moving the Brush Around.

For a 5-year-old, brushing is a lot like handwriting or getting dressed—his enthusiasm to prove what a big boy he is probably far outpaces his physical dexterity. So encourage him to keep practicing, but make sure you step in once a day to give his teeth a proper cleaning, says Gelman. “Use a soft-bristled electric or manual brush, add a dab of toothpaste, and move it around each tooth in small, circular motions,” she says. And explain your technique as you go: Have him picture the wheels going around on a teeny-tiny choo-choo train. By the second or third grade, most kids will be able to brush well on their own, says Moody.

How Can I Get My Kids to Floss When I Can Barely Remember to Do It Myself?

Flossing is one of those things we know we should do but manage to “forget” until a problem pops up. Big mistake. “Flossing at least once a week is one of the best things you can do to remove debris that’s stuck between the teeth, where toothbrush bristles can’t reach,” says Gelman. Since most kids under the age of 8 lack the needed fine motor skills, you’ll have to take matters into your own capable hands.

To that end, Gelman recommends using dental flossers, which are easier to fit inside a kid-size mouth. (See more dentist recommendations.) “With a younger child, let him lie back and put his head in your lap, so you can see everything,” says Gelman. Another option? Make flossing part of your kid’s bath routine: “They know everything is getting cleaned in the tub, so they’re usually OK with you cleaning their teeth, too,” says Gelman. Whatever your approach, consider this your free daily (or, OK, weekly) reminder to take care of your own dental health.

My Preschooler Had Two Cavities at His Last Checkup Even Though I’m Careful With Brushing! Is It All My Fault?

Even the best brushers can get bad news at the dentist’s office. There are so many factors that play into childhood cavities, says Moody, including the depth of grooves in the molars, diet, and genetics. (Even the composition of saliva is hereditary and affects decay.) And know that it’s not just sodas and gummy bears that pose dietary threats. “Research shows that snacking all day can increase the rate of decay,” says Moody, adding that it’s wiser to eat one snack (whether it’s an apple or a cupcake) followed by a cup of water than to have a steady stream of crackers or raisins making constant contact with the teeth.

Other surprising ways you may be inadvertently increasing your toddler’s risk for cavities: kissing him on the mouth, sharing his ice cream spoon, or letting him put his little fingers inside your mouth. “Adult mouths contain bacteria that convert sugars into acids that attack the tooth structure,” says Moody. Babies are born without these bacteria and pick them up later in life. However, anytime saliva from your mouth gets into the baby’s, the bacteria can sneak in and set up a permanent home. So make sure to use separate toothbrushes (and utensils, when you can), and aim most of your cavalcade of kisses at his sweet-smelling head or soft belly. He’ll thank you for it one day.