Brushing teeth with children

Brushing teeth with small children is an everyday conflict almost every family knows. Two things help more than any art of persuasion: a fixed place in the daily routine and the clarity that it is not up for negotiation — like fastening the seatbelt in the car.

From when and how often

From the first tooth, twice a day. Up to the first birthday once a day is enough, after that morning and evening. The evening occasion is the more important one.

The amount of toothpaste

• First tooth to 12 months: a rice-grain-sized amount of a children's toothpaste with 1,000 ppm fluoride, once a day.
• 12 months to 2 years: the same amount, twice a day.
• 2 to 6 years: a pea-sized amount with 1,000 ppm, twice a day.
• From 6 years: adult toothpaste with 1,000 to 1,500 ppm.

The stated amount is not a detail. Small children swallow part of the toothpaste; what matters for tolerance is the total amount of fluoride taken in across the day. Hence: keep the tube out of reach and apply the toothpaste yourself.

Whether a child additionally receives fluoride tablets is a question to be settled with the paediatrician or the dentist — toothpaste and tablets are not simply combined.

The technique: KAI

Children need an order they can remember. KAI has proved useful:

1. Kauflächen (chewing surfaces) — scrub back and forth, the simplest movement, therefore first.
2. Außenflächen (outer surfaces) — in large circles with the teeth closed.
3. Innenflächen (inner surfaces) — wipe out with the mouth open, from gum to tooth.

The finer technique for adults comes later. What a child of primary school age needs is completeness, not elegance.

Brushing again afterwards — and for longer than one thinks

Children cannot brush their teeth clean on their own before they can write fluently. The fine motor skills needed for it develop at around primary school age; until then parents brush again afterwards. And even after that the occasional check is worthwhile, especially in the evening.

In practice this works best as follows: the child brushes first — that is the part that practises independence. Then the parents brush again, with the child's head supported, from behind or from the side, with a clear view. The hardest parts are the inner surfaces of the lower molars and the rearmost teeth; that is exactly where most caries.

Interdental spaces become important once the teeth touch — with milk teeth often only in the molar area. Then dental floss belongs to it, guided by the parents at first.

When it does not work

• Fixed order, fixed time, fixed place. Rituals spare you the daily discussion.
• An hourglass or a song gives the child a sense of the duration.
• Brush together — children imitate.
• Brushing teeth lying down is often easier for brushing again afterwards than standing in front of the mirror.
• An electric children's toothbrush can help, once the willingness is there.
• Do not prolong the struggle. Short, thorough, done — daily matters more than perfect.

The toothbrush

Small head, soft bristles, a thick handle that fits a child's hand. It is replaced every eight to twelve weeks, earlier if the bristles are bent — with children that is often considerably sooner, because they chew on the brush.