Children's Teeth: Brushing, Decay, And What To Do In An Emergency

Everyone knows that brushing your teeth is an essential factor to having healthy teeth. But are you sure that you, as a parent, have stressed the importance of oral care to your children?

Two numbers from our readers set up the problem neatly.

86% brush their toddler’s teeth regularly (4,657 votes).

61% have never taken their child to a dentist (1,863 votes).

Diligent at home, absent at the clinic. And the first visit should be by the first birthday, or within six months of the first tooth appearing. Years earlier than most families go.

How to brush

Start with the first tooth, twice a day, one of them last thing at night after which nothing but water.
Fluoride toothpaste from the start. A smear the size of a grain of rice under three; a pea-sized amount from three to six.
Spit, don’t rinse. Rinsing with water washes away the fluoride you’ve just applied. This single change makes brushing meaningfully more effective, and almost everybody rinses.
An adult brushes or supervises until about seven or eight. Children lack the dexterity before then, however capable they seem.
Brush from behind, with the child’s head resting against you: better view, better control, less wrestling.
Two minutes, which is far longer than it feels. A song or a timer solves this.
Start flossing once teeth are touching.

If they refuse: keep it consistent instead of negotiating, let them brush first and then you “check”, use a mirror, brush your own teeth alongside them, and let them choose the brush. Skipping isn’t an option. It becomes an argument you’ll lose repeatedly if it’s ever presented as optional.

What causes decay

Frequency counts for more than quantity.

Every time sugar hits the teeth, acid is produced for a period afterwards. A biscuit eaten in one go does far less damage than the same biscuit nibbled across an afternoon, and a bottle of milk sipped over an hour is worse than a bottle drunk in ten minutes.

So: sweet things with meals, not between them. That’s the whole principle.

Never put a baby to bed with a bottle of milk or juice. Milk pools around the front teeth overnight while saliva flow drops, and the resulting decay pattern is severe and well recognised.
Move from bottle to cup from around 12 months.
Water and plain milk between meals. Juice, even diluted, and even “no added sugar”, is acidic and sugary.
Watch the hidden ones: yoghurt drinks, dried fruit which sticks to teeth, cough syrups, and gummy vitamins.
Cheese after a meal helps; it raises pH in the mouth.

“They’re only baby teeth”

They’re important. Decayed baby teeth cause pain and infection, affect eating and speech, and hold space for the adult teeth. Losing them early leads to crowding that becomes an orthodontic problem later. Treating decay in a small child often needs sedation or general anaesthetic, which isn’t a minor undertaking.

What to do in the first ten minutes after a knocked-out tooth

A knocked-out permanent (adult) tooth is a genuine emergency, and what you do in the first minutes determines whether it survives.

Pick it up by the crown, the chewing part, never the root.
Don’t scrub it. If dirty, rinse briefly in milk or saline. Not water, and no soap or disinfectant.
Put it back in the socket if you can, and have the child bite gently on a cloth to hold it.
If you can’t, store it in milk, or the child’s own saliva. Never in plain water, which damages the root cells.
Get to a dentist immediately. Within 30 minutes gives the best chance.

A knocked-out baby tooth shouldn’t be put back. Reimplanting it can damage the developing adult tooth underneath. Still see a dentist, but don’t push it back in.

A few more

Thumb sucking and dummies affect the bite if they continue much past four. Before that, they usually cause no lasting problem.
Singapore’s water is fluoridated, which does a substantial amount of work for free. Tap water is the best between-meal drink on every count.
Primary school children are seen through the School Dental Service, which helps but isn’t a substitute for a check-up in the toddler years.
Don’t transfer your own dental anxiety. Avoid words like “hurt”, “needle” or “pull” when preparing them, and don’t promise it won’t hurt.
Don’t clean a dummy or spoon in your own mouth. Decay-causing bacteria are transmitted from adult to child this way.

Frequently asked questions

When should a child first see a dentist?

By the first birthday, or within six months of the first tooth. This is years earlier than most families go. 61% of our readers have never taken their child at all, and an early visit is mainly about prevention and getting the child comfortable with the setting.

When should I start brushing my baby’s teeth?

With the first tooth, twice a day, using fluoride toothpaste: a smear the size of a grain of rice under three, and a pea-sized amount from three to six. An adult should brush or supervise until about seven or eight.

Should my child rinse after brushing?

No. Spit, but don’t rinse. Rinsing washes away the fluoride just applied. It’s a small change that makes brushing noticeably more effective, and almost everybody does it wrong.

What causes tooth decay in children?

Frequency of sugar more than quantity. Each exposure produces acid for a period afterwards, so a biscuit nibbled across an afternoon does far more damage than the same biscuit eaten at once. Keep sweet things to mealtimes, give water and plain milk in between, and never put a baby to bed with a bottle.

Do baby teeth really matter?

Yes. Decayed baby teeth cause pain and infection, affect eating and speech, and hold space for the adult teeth. Losing them early causes crowding that becomes an orthodontic problem. Treating decay in a small child often requires sedation or general anaesthetic.

What should I do if my child knocks out a tooth?

For a permanent tooth: pick it up by the crown not the root, don’t scrub it, rinse briefly in milk if dirty, put it back in the socket if you can, and otherwise store it in milk or the child’s saliva, never water. Get to a dentist immediately; within 30 minutes gives the best chance. A knocked-out baby tooth shouldn’t be put back, as it can damage the adult tooth developing underneath.

What to remember

First dental visit by the first birthday. Most families are years late.

Brush twice daily from the first tooth with fluoride toothpaste, and spit, don’t rinse.

Sugar at mealtimes only: frequency does the damage, not amount. And never a bottle in bed.

If an adult tooth is knocked out: milk, not water, and a dentist within thirty minutes.