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Healthy
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Toothbrushing in Childcare
Children often learn habits for life during their toddler and preschool years. One important habit that young children should learn is regular tooth brushing. Good oral health has lifelong benefits, and the key to good oral health is prevention. Proper tooth brushing combined with regular visits to the dentist can help prevent dental caries (cavities) and other oral diseases.
Toothbrushing should be a part of every child’s daily routine from an early age. With 75 percent of children under the age of five spending four hours or more a day in childcare, it makes sense to help them learn good habits while they are in your care.
Tooth Decay/Gum Disease
Tooth decay can lead to gum disease. If gum disease is not treated, the gum tissue that holds the teeth in place may be destroyed and the teeth eventually lost. Tooth decay and gum disease results from the build-up of plaque on teeth.
Plaque is a clear, thin, sticky film of bacteria that lives on teeth and gums. The germs in plaque slowly eat away at the teeth and gums. If teeth are not brushed on a regular basis (at least twice a day), plaque will build up and calcify (harden), making the prevention of decay and gum disease almost impossible. Once plaque is calcified, it can only be removed by a dentist or dental hygienist.
Brushing Techniques
Children (and adults) should brush their teeth at least twice a day for two minutes each time. In most cases, they should use a toothpaste that contains fluoride to help prevent decay and to keep teeth hard and strong. In some cases, there is enough fluoride in the public water supply to prevent decay, making fluoride toothpaste unnecessary. Ask your dentist whether children in your community need fluoride toothpaste.
Children more than three years of age should use a tiny smear of toothpaste and should rinse well after brushing. When teaching children to brush, keep the following guidelines in mind:
- Use a soft, child-size toothbrush.
- Brush the top of the tooth using a back and forth motion.
- Angle the toothbrush in a way that allows the bristles of the brush to clean out the plaque at the gum line between the teeth and gum.
- Brush the lingual side of the teeth (the side nearest the tongue).
- Brush lightly; brushing too hard can damage the gums.
- Brush and rinse completely. Teach children how to spit using water before attempting to spit toothpaste.
- Brush the tongue and rinse again to ensure fresh breath and a clean feeling in the mouth.
Toothbrush Care
For preschool children, choose child-sized toothbrushes with soft bristles. Label each toothbrush and its individual storage case with each child’s name. Store toothbrushes in a manner that prevents cross-contamination; one child’s germs can be transmitted to another child’s mouth via the toothbrush.
Consequently, toothbrushes must not be allowed to touch each other, either during use or during storage. Store toothbrushes in individual containers or in a rack in which brushes stand upright and do not touch each other. Be sure to return each child’s toothbrush to his or her own storage container or storage space each time.
Store toothbrushes in a manner that allows them to air dry. To prevent bacterial growth, toothbrushes should not remain moist during storage. Do not wrap toothbrushes in plastic wrap or place them in containers that have inadequate ventilation. Store toothbrushes in a cabinet or container that allows air flow, but can be closed to prevent access by roaches or other insects.
If possible, store toothbrushes with the bristle end up. This keeps bacteria on the handle from running back onto the bristles during storage. Periodically wash toothbrush storage containers and allow to air dry. Over time, as individual containers are used on a daily basis, they may build up material from the toothbrush. Most of this is dried toothpaste.
Replace toothbrushes every three-six months or more frequently if they show signs of wear.
Prevent the Spreading of Germs
Do not allow children to share toothbrushes. After each use, rinse and air dry toothbrushes separately. If a toothbrush is contaminated by contact with another toothbrush, both should be discarded and replaced with new ones.
Toothpaste should be dispensed onto a clean paper towel, wax paper, or craft stick before applying it to the brush so germs cannot be spread by the toothpaste tube. Always wash your hands thoroughly when assisting children. If a child has been ill, such as with strep throat, replace the contaminated toothbrush.
Getting Children to Brush
Make brushing fun! Create a song and make it a group activity as part of your daily routine. Have the children brush their teeth after snacks and/or meals.
The following can be sung to the familiar Wheels on a Bus:
This is the way we brush our teeth,
brush our teeth, brush our teeth,
This is the way we brush our teeth, after every meal.
This is the way we brush bumpies (top of the teeth),
brush bumpies, brush bumpies,
This is the way we brush bumpies, after every meal.
Continue the song while covering all sides of their teeth. Include the inside, outside, and tongue. Another good way to get young children to brush is to have them brush the teeth of a toy animal. For example, using a toy alligator that has lots of teeth and a large toothbrush, you can have the children practice their brushing techniques and sing some songs while brushing the alligator’s teeth. Remember that creating positive habits is the key to preventing tooth decay and gum disease.
Mark Campbell, Health and Fitness Specialist, Child Care Health Consultant Trainer, Head Start Health Manager
Resources
National Children’s Dental Health Month, American Dental Association, 211 E. Chicago Ave., Chicago, IL 60611;312-440-2500; www.ada.org
National Institute of Dental Research, National Institutes of Health, Bethesda, MD 20892-2190; 301-496-4261; www.nidcr.nih.gov
Internet Resources
All Family Resources, www.familymanagement.com/childcare/practices/toothbrushes.practices.html
Colgate Bright Smiles, Bright Futures, www.colgatebsbf.com
International Child Resource Institute, download a Toothbrushing poster, www.globalhealthychildcare.org
National Institutes of Health, www.nlm.nih.gov/medlineplus/childdentalhealth.html
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