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Tips Towards Good Oral Health | Overview

February is National Children's Dental Health Month. While the dental health of most Americans has been improving over the past few decades, tooth decay in children 2 to 5 years of age is on the rise. Untreated decay can lead to pain, infection, and difficulties with eating, sleeping, and learning. We asked Man Wai Ng, DDS, MPH, Chief of the Department of Dentistry at Boston Children's Hospital to share some tips towards good oral health.

Start early

Although the reasons for the increase in dental cavities among preschoolers are not entirely clear, tooth decay is largely preventable and more easily treated if identified early. "Even before the first primary tooth emerges, parents should wipe the gum tissues with a soft damp wash cloth after feedings and before bed," says Ng.

Tooth brushing

With the emergence of the first tooth, an adult caregiver should brush the child's teeth twice a day. In children younger than 2 who are at risk for cavities, a thin smear of fluoride toothpaste can be used safely. Older children may use a small pea-size amount. Adult supervision and assistance with tooth brushing, until a child is 7 or older, is important. Instilling positive tooth brushing habits at an early age is an essential step in preventing cavities down the road.

Dietary habits

Sugary foods and drinks should be limited to mealtimes. Children should not be offered more than four ounces of juice each day, and frequent snacking should be discouraged. "Parents should understand that there is a relationship between the frequency of consumption of sugars and carbohydrates and the risk of tooth decay," says Ng. In the mouth, the bacteria break down the carbohydrates and sugars, forming acids. Over time, the acids can destroy tooth enamel resulting in decay.

The texture of foods also matters. For example, the sugars in raisins and granola bars stick to the grooves and between surfaces of teeth for a long time. Instead, offer a variety of healthy foods as snacks, such as whole grain crackers, fruits, vegetables, and cheeses.

Bottles and cups

Frequent and prolonged exposure of the teeth to milk, juice, and any sugary liquids can increase the risk of tooth decay. Children should be introduced to a cup by about 6 months of age.

Sleeping with a bottle or a sippy cup containing anything other than water should be discouraged. During sleep, the flow of saliva decreases, allowing the sugars and acids to remain on the teeth.


Fluoride strengthens teeth and prevents tooth decay. Fluoridated water is recommended for drinking and cooking. Most brands of bottled water do not contain adequate amounts of fluoride. Charcoal filters, such as Brita® and Pur®, do not remove fluoride. In addition, using a fluoride containing toothpaste is a cost-effective way to prevent tooth decay.

Visit the dentist early and regularly

It is now recommended that children have their first dental visit by 12 months of age. At this visit, an examination is performed of the teeth and mouth, and the child's risk for cavities is assessed. Parents can expect to talk with their child's dentist about recommendations in terms of diet, oral hygiene, fluoride exposure, and preventing dental injuries.