Q&A: brushing a toddler’s teeth

Susan writes:

"Can we please talk about brushing teeth?  My son is 16 months old andbrushing his teeth is a major struggle.  Or, rather, if we were to
actually properly brush his teeth it would be a major struggle.  He has
7 teeth and has not yet been to a dentist.

We didn't actually start trying to brush until he was 12 months
(somehow we just didn't realize we were supposed to be doing this), and
he was and is very, very resistant to letting us put the toothbrush in
his mouth and actually get a good brush of the gums and teeth.  He is
the sort that really doesn't like much manhandling or manipulation —
he will scream and cry and writhe while we cut his fingernails as well.

In any event, we have not wanted to push the toothbrushing and pin him
down to do it.  I'm not even sure, technically, how we would accomplish
this.  I figured this would not only be really unpleasant, but might
create such bad lasting associations with toothbrushing that he would
always hate it.  So we've just tried to get him interested in the
toothbrush and the whole process by doing it all together as a family
while he's in the bathtub, showing him how Mom and Dad do it, and so
forth.  Now he's actually really, really interested in the toothbrush
and the toothpaste (we have the nonflouride kind that's safe for kids),
and insists on using every toothbrush in the house during his bath.
 But I can't actually say that he's "brushing" his teeth.  He is
sucking and chewing on the toothbrush.  If, while he has the brush in
his mouth, I try to grab the handle and actually move it in a brushing
motion over his teeth, he cries and clamps his mouth shut and turns his
head away.

But I'm really worried that we're neglecting him by not forcing him to
let us really, actually brush his teeth and gums.  But then I don't
know if pinning a kid down and forcing it on him is right, either.

So I wonder if our current method is sufficient for a kid with 7 teeth,
or if we should really force the brushing, or if we can wait until he's
older with more teeth and more communication skills, etc."

I am always in favor of doing the thing that traumatizes everyone the least. Unless there's no other option, it's better to choose the method that leaves everyone the most personal dignity. This is not a do-or-die situation, just one you need to keep improving.

So I'd continue to work on getting him to open up for you to brush his teeth, but not worry too much that it's not happening this exact week. We are supposed to still be brushing our kids' teeth for them until they're at least age 5 (and I think some adults I know still actually need help brushing their teeth), so you can't just give up the fight by letting him do it himself. But you can keep being gentle about it and making it a game.

I've known several people who got their kids to brush the parent's teeth, and then the parent would brush the kid's teeth. That way it turns into a funny game in which everyone lets someone else brush their teeth, so it's a game and not an invasion of his personal space. Once your son's older you can start getting the fun character electric toothbrushes, or the ones that play a song for the length of time you're supposed to keep brushing. If you can keep it fun it'll click in eventually.

I'd also make sure you've got toothpaste with xylitol (unless you or your child has fructose absorption issues that hedra talks about here), which is a sugar from birch trees that is really, really, REALLY good at killing the bacteria that cause tooth decay. If you are still nursing, you should start using products with xylitol (gum, toothpaste, etc.) yourself, as there's evidence that a nursing mother's use of xylitol helps protect her child's teeth for years, even after she's stopped nursing the child. I know some of the Tom's of Maine kids' toothpaste gels have xylitol, as do the Natural Dentist kids' toothpastes.

Or you could just temporarily give up on the toothbrush and wipe his teeth with the xylitol Spiffies tooth wipes that work for babies and toddlers who don't want a brush in their mouths. They have a very gentle natural grapey flavor that kids don't seem to mind at all. In another few months he might be ready for another try with letting you brush his teeth.

Lastly, make an appointment with a pediatric dentist. Ask other parents for recommendations (parents who have older children will definitely have them), and you'll be able to find a good pediatric dentist who won't freak your son out and who will be able to tell you how he's doing toothwise in general. It'll probably make you feel better about your progress.

Readers, how old were your kids when you started actually being able to brush their teeth? When you took them to the dentist for the first time?

82 thoughts on “Q&A: brushing a toddler’s teeth”

  1. So, I felt like this post practically shouted at me to share our story. I started brushing my daughter’s teeth when she was about 12 months old – nothing really serious, but a once a day sort of thing. At 18 months, I noticed a small black spot between two of her teeth and made an appointment with our dentist. The spot was a cavity between two teeth and the dentist cleaned/filled/capped them. For the next two years, we probably had to go back every 6 months to have the caps replaced as they fell off very easily. Then, when my daughter was about 3.5 (last October), she woke up one Saturday with a huge abscess above on of the problem teeth. We did antibiotics for a week and then the tooth was pulled. We had another cap replaced around Valentine’s Day and then about two weeks ago, she woke up from her nap at preschool with a slightly puffy lip. The next morning, we went to the doctor and dentist and she had another abscess – but this time over a previously healthy tooth. We did amoxicillan for 24 hours but the swelling and redness was getting worse and spread throughout her face up to her eye. At that point, we took her to the emergency room. She was admitted to the hospital and given IV antibiotics for a week.I’m streamlining this story but let me just say that by this point, my daughter had been completely traumatized by the dentist. If you even mentioned going to her, she would start to cry and whenever we would walk into the office, she would start to cry even more.
    After all this, my daughter still needed the abscessed previously healthy tooth (and the one next to it) removed, so we finally took her to an oral surgeon who removed them under anesthesia. She is recovering just fine, but as her mom, I feel really bad. She is now missing three front top teeth and she’s not yet four. I think she still looks pretty cute but I do worry about other kids giving her a hard time about her missing teeth.
    Having written this novel, I do realize that our experience is atypical. We live in a place where there is no fluoride in the water and where even the pediatric dentist, while very nice, maybe did not use the most low-trauma techniques available (things I wasn’t aware of until just recently). Beyond that, I think some kids just struggle with their teeth, regardless of diet or time spent brushing. My daughter gets her teeth brushed – by an adult – at least twice a day with fluoride tooth paste. I suspect most kids don’t need that much attention. However, I’m not positive that my daughter has bad teeth. She had *1* cavity at 18 months and is now missing three teeth as a result of that one tiny problem.
    I also have a son who is 14 months old. Nor surprisingly, I brush his teeth 2x a day as well. He has a regular toothbrush that I use on his teeth and he has a special sort of triangular shaped tooth brush that I got from his daycare. Because it’s a rounded triangle, it won’t choke him if he trips while using it. So, I let him walk around and chew on it while I’m brushing his sister’s teeth or mine. It seems to make it more fun for him and it’s safe.
    I’m really looking forward to see what others have to add since this is an area where I’m always looking for some small advantage to help my daughter.

  2. Oh how I hate toothbrushing. Both of my kids have slight enamels defects. Such that my older child had three teeth pulled in February (she’s 4.5). We first took her to the dentist when she turned 3. By then, she already had significant decay. We first took my younger right when he turned one. About a week later, one of his teeth (which we had been concerned about and were on the waiting list to see the specialist for) broke into a million pieces. He got a crown at about 14 months. We’ve always been extremely diligent about toothbrushing because my husband had caps on his baby teeth. Nevertheless, both kids lost teeth before 5, and in an unhealthy manner.My kids HATE having their teeth brushed (actually, though, the 4 year old is very compliant after the experience with the dentist. I think he scared her straight. now she brushes after all her meals and we brush her morning and night). The two year old still SCREAMS like we’re killing him every time we brush him. I feel like we have no choice but to sit on him. We pin his arms and hold him on our laps in a cradle hold and then just brush him as quickly and thoroughly as possible. (games, gimmicks, etc don’t fly with him. we’ve tried all of them). It’s awful.
    Also, background – one child was bottlefed from 3 weeks, on, the other is still breastfed. Food source didn’t seem to make a difference. We’re the hippy dippy type that eats everything local and organic and only drink juice on special occasions (birthday parties, etc).
    So, I don’t think I’m bringing anything positive to the table, but I guess I just want to point out that there is real potential for dental trouble, even at a really young age. Blah. I hate teeth.

  3. First, hey, don’t be kicking yourself about the brushing the gums thing. It’s not like it’s imprinted on our DNA.We have found the resistance comes and goes. We “brushed the trains,” naming them (Thomas series), and did other parenting tricks.
    Then somewhere around 2 years old I developed this pathetic routine where he gets to watch one YouTube video while I brush his teeth (this meant not a lot of rinsing and spitting, but hey) and gradually, although we ended up watching more horse jumping footage than I care to remember, and one memorable evening he clicked on a lego video that started with the word “dumbass” (sigh) he loosened up. We just started flossing about 3 months ago and that is going well.
    My dentist said not to bring him in for an actual check before he was over 3, but we have taken him in to watch videos and shake everyone’s hands. (Huh, we’re a bit behind, must schedule that.) She’s a special dentist who works with people who have dental phobias (like me) and exceptional kids who need anasthetic, etc., so she is pretty sensitive to balancing the need for checking teeth out with the ages when kids are fearful. Other dentists have different views I think.

  4. My son watched me brush my teeth from an early age – I remember holding him in a sling while brushing when he was about 4 months old. I think we got him a toothbrush at about a year and mostly let him chew on it. Around 2, he was prescribed chewable vitamins with fluoride, so our (implicit) deal was that he got the vitamin after he let me brush his teeth. Just recently (he is now 2 1/2), he has started actually holding his mouth open while I brush (before, he would open for a second and then I was brushing blind). So, finally, I think I am brushing his teeth well.No dentist yet…

  5. @Stephanie in PR — (Puerto Ricko? Really? Super cool! Soak up some sunshine for me today …) My BFF had/has a very similar tooth situation with her 6 y/o, going back to when he was about 3. He has also had abcesses, fillings and many, many teeth pulled. She was diligent about brushing properly the whole time — her dentist said it was genetic and his adult teeth will probably not cause so much trouble. We should be finding out if that’s true soon!Our approach to brushing sounds a lot like Susan’s. When it was time to start (1st tooth at 3 months), I did the little finger brush until about 12 months. Then I got 2 toddler toothbrushes — 1 for her to keep and play with and gnaw one, and one for me to use for actual brushing. I figured even when she was chewing on the bristles of ‘her’ brush, she was getting a little cleaning done.
    We only ever went through one tube of training toothpaste. Our ped. said to switch to regular flouridated right away and just use a tiny, tiny bit. So we now use Tom’s of Maine and a regular OralB compact head soft bristle brush. She still has her toddler brush to gnaw on and I use the regular one on her.
    We brush once a day (pm) and have our first dentist’s appointment in June. She wil be 2.5 (too old) but there is only 1 pediatric dentist in our area, so I have had this appointment for a year. Any of the ‘regular’ dentists I asked wouldn’t see her until she was at least 5. That’s REALLY too late!
    Also, WORD on Xylitol. Yay! An excuse for gum!

  6. My daughter was also highly resistant to teeth brushing, but we basically kept at it (holding her down and getting one good swipe) one time a day. Even on tired nights, where we skipped the bath, we did this rather cursory brushing. (And yes, we tried all the lower-trauma techniques, including songs, and games, and her brushing my teeth, special toothpaste, etc, and nothing worked.) Voila, one day she just opened her mouth and let me brush! I think it finally sunk in that she was going to get her teeth brushed, one way or the other, so she decided to cooperate. Pretty similar to what Sarah said above, only, it took less than a year- maybe 5-6 months.My only other suggestion/thought is that she prefers for me to brush her teeth with her lying across my lap (face-up) with her head sort of dangling down. She thinks this is sort of a funny way to lie, and it makes tooth-brushing funnier too.

  7. J is 18 months old, and we’ve been “brushing” his teeth once a day (before bed) for maybe 3 months now. Before that, he really wanted nothing to do with the toothbrush. Both his dad and I have pretty good teeth overall, so we took Moxie’s line and figured that lack of toothbrushing trauma was better than super-vigilant early dental care.At this point, J will let us stick the toothbrush in and wiggle it around a little bit, while singing through the “tooth brushing song” (a made-up ditty from some friends of ours). It’s nothing like a thorough brushing, but it’s better than nothing. We’re using the OralB baby toothpaste, which has xylitol, so we figure he’s at least swishing that around in his mouth: can’t hurt, might help. Then, once we’ve sung the song, he gets to take over and chomp and suck on the toothbrush; I think he really likes the taste of the toothpaste. (Also, he’s teething, so chomping on the toothbrush is probably quite satisfying.) I’m waiting until J is a little more verbal, probably closer to 2, to work on getting some actual effective brushing going on.
    Our ped said to take him in for a first dentist visit at 12 months, but we’re busy 2-career slackers, so that hasn’t happened yet. We’ve got a recommendation for a family dentist, but I suspect that he’ll say not to bother bringing J in until he’s at least 2.

  8. This is a big issue here as well. We use the safe kid toothpaste in some horrible flavor that she likes. I let her brush for one tooth brushing a day, I do the other. Sometimes she screams and cries and tells me “My do it, my do it” with a dainty 2 year old little hand up in the international sign of STOP. I still maintain that I do it once. Sigh. It worries me because all officially now she wakes up with morning breath. No obvious cavities but… what to do, what to do?I called the pediatric dentist in my area, and they told me not to bother bringing her in unless there was a problem- but the interweb says differently and I am UTTERLY CONFUSED. I don’t want to neglect her dental hygiene, but where do I take her if they say not to bring her in?

  9. My son is 13 months and I brush his teeth morning and night.We made it a game where we sing a song my son loves about a tiger who roars, and then open his mouth to roar like the tiger in the song … and then I brush. He loves it. After that, we let him have a suck and a chew on the brush for as long as he likes.
    I think Moxie is right, it works best as a funny game!

  10. My son screamed every time we brushed his teeth for about a year. We tried games, we tried singing, we tried letting him brush his own teeth, we tried everything recommended in all the books, but he still screamed. I would literally lie him on the bed, grab his hands and force brush his teeth. It sounds worse in writing than it was — yes he was crying, but it’s all of 30 seconds, and his breath was getting stinky when I let him do it himself. In any case, he’s two now and he asks to get his teeth brushed! I ask him which song he wants me to sing, and he tells me, and then I brush as I sing. When the song’s over, the brushing ends. He’s happy, I’m happy, it’s fun. So, worst case scenario, keep at it and eventually the trauma passes.

  11. My son isn’t old enough enough for brushing since he has no teeth, but I thought I would recommend Biotene mouthwash for us adults. It’s got xylitol in it. It’s marketed as a “dry mouth” mouthwash, but you don’t need that diagnosis to use it. In fact, a doctor recommended it to a family friend when he was going through chemo/radiation to prevent and treat mouth sores.

  12. My son will be 3 in 2 weeks and it is still not easy. Like Susan’s son, he also does not like to get his nails clipped (we use TV for that).There was always a lot of crying and struggling; recently he acquired a Thomas the Tank Engine toothpaste and is willing to let me in there until the count of five. I count really slowly.
    Unfortunately he’s not letting me do a good job. I wouldn’t care so much, but he doesn’t have the greatest teeth genetics–and he has a very wet mouth (lot of drooling, thumbsucker) so builds up plaque on his front teeth about six days after he’s seen the dentist.
    I am really easy about stuff like (non)matching clothes, messy hair, etc., but tooth brushing is kind of non-negotiable–I had a lot of cavities as a child and would love for him to avoid that. He’s starting to get to an age where he understands that food gets stuck in his teeth (we talk about getting that out), but I really don’t know where that will lead.
    My daughter used to be able to choose a song that I’d sing when I brushed. She was a breeze, in comparison.

  13. Such a pertinent topic in our house. I am still struggling to brush my 2 year old son’s teeth. I have a short period of success everytime I introduce a new strategy (electric toothbrush, songs, taking turns etc) but it doesn’t last long before we are back to a big screaming fight.The most recent method is to let him watch a DVD of a certain favourite train – but the DVD only goes if he has his mouth open and lets me brush his teeth (he is not allowed to watch much TV ordinarily so this is a big treat). If he shuts his mouth, the DVD turns off until he opens his mouth again. You do need a second person to operate the DVD. So far so good (in as much as some brushing happens and there is no screaming – we do have to turn the DVD off about 15 times per session). I’ll be looking out in the posts for the next strategy to use when this ones fails.

  14. My girl got teeth early, and my mom instilled in me the extreme importance of dental hygeniene since she had to have serious work on her teeth over the years. So we started early (maybe 8 months?) with that thing that goes over the adult’s finger with bristles on it.We have had very little struggles, so I can’t help much with those who truly are having problems. But we do get resistence in that she often wants to do it herself. Of course, she’s not too good at it herself.
    Over the past month or two (when she was 22 or 23 months old), I’ve been working with her on “taking turns” and “sharing” so I decided to use that with the teeth brushing. I let her have her turn first, then it’s mommy’s turn, and then she can have a turn again. It seems to help her know that I’m not just taking over but taking a turn and then she gets a turn again. She loves to stand on the step stool in front of the sink and look in the mirror while I sing a silly brush-your-teeth song. Now, I’m working on helping her learn to brush back and forth (instead of just sucking on the brush) with lots of praising and doing it together.
    My friend who is struggle with this now with her 2 year old has her husband use a puppet book while he talks about clean teeth and brushing, while she brushes his teeth. Another distraction/making it fun technique.

  15. @MrsHaley – yes, we live in Puerto Rico (and I wouldn’t feel bad about the typo 🙂 and it is very sunny. We are leaving in about 90 dys and I’m trying to enjoy the sun as much as I can before we go.Oh, and I meant to add that when we finally found a good pediatric dentist (in New Mexico. Dr. Martinez. Love that guy) his demeanor and that of his staff went a long way in making the experience pleasant and not-traumatic for my daughter. We are moving to Colorado but I’m considering driving down to see him twice a year during family visits for my daughter’s sake.

  16. At my daughter’s 18mo checkup, my pediatrician suggested getting 2 toothbrushes for my daughter – one for her to use, and one for me to use. This works kind-of-well; I get a “turn” brushing her teeth by getting in a few swipes while she’s sucking on the other brush. I haven’t done the forced-brushing, because I think that would be bad in the long-term of trying to establish brushing as a routine.

  17. My son (2 1/2) will not let me use a regular toothbrush in his mouth. He will put it in his mouth and chew on it, but he won’t let me do it. He WILL let me use the finger brush they sell with infant toothpaste – so I do that, he “brushes” his own teeth, and I finish the job. Our doctor also said once a day is enough for now, we try for evening.Our dentist recommended a first visit to the dentist at age 3, unless there are problems prior to that.

  18. My 4 year old was just as the OP described. I tried the works to get him to brush and a couple of times actually forced him down on the bathroom mat and brushed to cries and shouting, but the only thing that really worked was time. Lot’s of explaining why it was important to brush, lot’s of shopping for fun toothbrushes and toothpastes. Getting him to ‘start’ and me to ‘finish’. Now, he tends to brush his own teeth once a day, and dh or I does it the other time. At least that way, he gets one decent brush a day.My 2 year old has always been a sinch to brush in comparison, but then she sees my son having his teeth brushed and thinks it’s fun.
    My boy’s first visit to the dentist was around 3 when he chipped his front teeth in a fall. He wold not have a bar of the dentist’s chair. I think the visit scared the beejesus out of him ( as my first visit did to me), ‘cos whe I mintioned the dentist again, he went white in the face. The dentist said there was no need to come back until he got permanent teeth (unless he complained of tooth pain).

  19. The current advice is to do an initial visit at a year (if there is at least one tooth present), which gives you the chance to spot real issues starting if there are any. If the pediatric dentist says not to bother, just say you want an initial check because there’s no way you have enough professional expertise to tell IF there is a problem. (For the early checks, you will just hold them on your lap for the checkup, and they may not even do a cursory cleaning, just look around and ‘count the teeth’.)My kids have multiple overlapping issues, and I’ll list them so you know some risk areas for considering doing an earlier-than-3-year-old visit. These are the risk factors we dealt with – just one is mostly a shrug, but if you see a lot of them, being more assertive with dental care is important.
    1) Reflux or silent reflux. The fumes can dissolve the enamel on the back sides of teeth. Mr G’s first visit at the ‘usual’ almost 3 years old found FIFTEEN soft spots (pre-caries) and caries. He also had almost no enamel on his teeth, likely at least partly to do with the undiagnosed reflux.
    2) Mouth breathing. Whatever the reason, mouth breathing changes the condition of the mouth, making it more likely to harbor the worst bacteria.
    3) Ropey saliva. Again, bacterial favorite.
    4) Hand-in-mouth behaviors. Thumb or finger sucking again changes the conditions to favor the worst bacteria.
    5) Favoring either salty/starchy snacks (chips, goldfish, crackers) or fructose-rich snacks (gummy fruit, fruit leathers, dried fruit, or even a lot of fresh fruit). The starchy snacks tend to create a film accumulation at the gum line and between teeth that is harder to get rid of, and is one of the reasons noted in a Swedish study for caries associated with extended nursers (they tend to prefer starchy/salty snacks for some reason); fructose is used by the strep mutans bacteria to bond itself to the surface of the tooth, making it very hard to clear up by brushing. Sticky fructose sources are the worst (gummy candy, gummy fruits, raisins). Both tend to produce a lot of gum-line and chewing surface and between-teeth caries.
    6) Family history of soft teeth. However, family history does not need to include the parents – aunts, uncles, grandparents also count. My teeth are rocks, ep’s teeth are rocks, my brother’s teeth were so soft they practically melted in contact with sugar. My kids teeth are more like my brother’s than like mine.
    7) Oral health of the mom, especially if she shares utensils or food with the child. There’s nothing like having a lovely strep mutans colony thriving in mom for it to pass to baby. Dads also, but for some reasons moms are more likely to swap spit with their babies in some way, or do it more often.
    My kids have all those things going (though my oral health is pretty good, it tended to be less good in the first year or so of any child’s life, partly due to hormones). Miss M and Miss R have particularly ropey saliva (doesn’t show now, but they were the grossest mouth-booger babies in the first few weeks).
    For checking the teeth yourself, if you can do a good brushing job espcially around the gumline and then in daylight look at the teeth (backs are harder, but try) to see if there are any whiter spots (soft spot that is starting to decay), or brownish spots, then hie thee to a dentist. Topical application of something like the fluoride mouth rinse (using a q-tip dipped in it) on the soft spots may firm them up a lot, too. (These usually have sorbitol and/or xylitol, which my kids shouldn’t swallow, but we walk the line for that, since we have huge dental issues as it is…).
    If you are unsure if your child has fructose malabsorption, you can just watch for an increase in instances of diarrhea, mood swings/rages, anxiety, or constipation after introducing a xylitol-containing dental product.
    For getting the kids to brush – because of the severity of tooth issues (Miss M had two root canals at 2 years old, Mr B’s teeth shattered, literally, if he banged his face, etc.), dental care was a MUST MUST MUST. And we did have the fairly typical freak-outs on that. The hard part with the freakouts is that they make the process feel so much longer, and so the brushing ends up more half-assed. I swore for the longest time that I brused Miss M’s and Miss R’s teeth the same duration, but the dentist seemed unsure about it – and Miss M’s gums are quite sensitive, so she freaked super-loud/hard. I clocked it, and sure enough, while the whole process took the same length of time or longer, the actual duration of toothbrush contact with her teeth was shorter. So part of the dental work she faced was probably related to that reduced brushing time.
    Various things we’ve done to make it work ‘better’ (which means sucky until about 3 years old, then slight improvement from there, to where it’s not usually a fight, but there is still resistance at 4 1/2):
    1) Make it impersonal – the clock says it is time to brush teeth, or the picture (that we drew) on the wall says you must brush teeth before bed. We have also said the doctor says or the dentist says, but we have to be careful with dentist-says because of the already-negative associations. Still, a non-direct authority figure or source of the instruction helps. Some.
    2) Changing locations. We brush in the most comfortable possible location, often on the bed. They spit into a towel or washcloth, which can also be used to wipe their mouth or even their teeth. At my mom’s, they do it ‘old-fashioned-style’ with bowls with a little water in the bottom, the way my mom did when she was visiting her aunt’s farm (limited indoor plumbing). The bathroom just has never been the most comfortable place to do it, especially if someone isn’t happy about doing it in the first place.
    3) Letting them brush my teeth ‘back’.
    4) Letting them use one brush on their teeth, and me use another.
    5) Using cool brushes – we have more toothbrushes than any family I know, in part because I will buy them any damn brush they like if it makes brushing more pleasant for them. Right now, Miss M is alternating between the Ariel brush she got at the dentist (NO CAVITIES! WOO!) and the fire truck spin brush that has the flashing lights (she loves trucks). Miss R has a Hello Kitty spin brush, but also likes the Disney Princess brushes. I will not buy Barbie, High School Musical, or any other branded product for almost anything else, but if they want it on their toothbrush, go for it.
    6) Same for toothpaste flavors. There aren’t many that are even close to safe (Toms of Maine has some with no polyols, Colgate has one very minty one with no polyols), but we do our best. At the moment, they each have a separate paste they prefer, and honestly, if it makes brusing feel better to them, I would buy another half-dozen flavors to cycle.
    7) Play dentist, either at the time, or at other times (role-playing, essentially).
    8) Praise and encourage effort, not results. They’re more confident if I work on ‘I can see you are really trying hard at this’.
    9) Be patient and don’t take it personally – it really IS weird and uncomfortable for many kids. If your family has hypermobility at all (very flexible joints), that can translate to very sensitive gums, too (we have that as well), which makes brushing just really freaky feeling, if not outright painful. Being patient and kind about it (while also being clear, direct, and serious) makes it less awful. (SOme people with hypermobility also have very soft teeth, because the collagen issue also affects tooth enamel formation – this may play a role with my kids’ teeth as well.)
    10) Yes, hold them down if I have to. It usually takes two people do do that, though. It’s the last-ditch thing, but it still happens, often for spans of time (months on end). It sucks. Holding them in my lap with their legs around my waist, tipped backwards onto a pillow on the other person’s lap keeps me from being kicked (the brusher has the head-end, the lap person holds the hands). With refluxy kids, being tipped back too flat is scary (because it triggers the reflux), so aim for a recline more than flat. Sometimes that position wasn’t good, either, so we did what we could, when we could. And there were definitely days where it just didn’t happen.
    If it were any less important in our family, I’d have been more okay with ‘we’ll try again tomorrow’ and focus on just gaining step-by-step cooperation (open mouth, tolerate texture of brush, learning to spit, etc.), but we were already past that point by 18 months old, for all the kids but Miss R (whose teeth are the sturdiest of the lot – fortunately, Mr G’s soft teeth are being replaced by adult teeth that are much harder, phew! Fingers crossed that the rest of them get better adult teeth than their primary teeth were…). And Miss R now has issues with flossing, but that’s due to the shape of her teeth (pocket gaps at the gumline) than anything else.
    Whee. (I’m with sueinithica, on the ‘I hate teeth’ thing – bonus, we’re dealing with orthodontia, too. Joy. I think one of the things I will like best about my kids growing up and moving away is that I don’t have to be responsible for their dental health anymore.)

  20. My 15 year old started going to the dentist in elementary school, when we found some brown spots. He ended up having a silver tooth and a bunch of fillings, etc. But once that initial work was done, things have been pretty smooth.My 6 year old started going when she was 15-18 months (at one of the big bro’s checkups we asked when she should start going).
    My 15 month old started going when she was 12 months old.
    The first several visits are “lap visits” where they really are just checkups. But by age 3 or 4 the kids are willing and ready to go back by themselves for more thorough checkups/cleanings. And, as a data point, the three of them go to a pediatric dentist. Once we got a name (from my regular dentist?) it turned out that he was highly recommended by just about everyone we ran into.

  21. We took Mouse for the first time at 3 (her doctor did a quick check of teeth at every checkup and said there was no need to go early). She was also a late teether. We’ve never held her down, but we’ve used a lot of bribes (the toothbrushing song, special brushes, whatever). At almost 5, the trick we’re supposed to be working on is her brushing her own teeth, and also introducing flossing as she has a crowded lower jaw (from both me and Mr. C, woo!). Brushing own teeth happens sometimes, she really hates flossing so we’ve been gentle with that. Need to find some cute, branded flossers, but man those seem environmentally crummy. Anybody get their under-6 to floss successfully (or allow flossing?)For kids with sensitive gums, have you tried a Radius toothbrush? It has a giant head and really soft bristles–I’ve used one for a few years because my gums need extra care, and they make a kids’ version. Mouse likes it a lot.

  22. Wow, I am just amazed at all of the pediatric dentists who are saying to wait until your child is 3! Yes, these are baby teeth, but decay and injuries in baby teeth can affect the adult root. Please, please don’t wait until 3. Like Hedra says, just schedule it so they can get used to going to the dentist, sitting in the chair (on your lap) and having someone other than you poke around in their mouth.Our son saw his pediatric dentist when he was 18 months because he fell and we thought he had injured his tooth. He hadn’t, but it was worthwhile to get in there, anyway. We go every 6 months because, while he has become a pro at letting us brush and floss his teeth (yes, they’re supposed to begin flossing as well…there are special flossing “sticks” that work very well), he isn’t so keen on the dentist.
    When we see the dentist, we always start with the least invasive techniques, but usually end up with him straddling my lap, me holding his arms down, with his head in the dentist’s lap. Yes, he cries, but no, he’s no traumatized, and will easily talk about it 5 minutes after it’s over.
    I’ve had serious dental issues in my life (all of which came about after we moved to a state with unflouridated water), so I’m very conscious of my son’s dental health.
    Please, please don’t wait on this and don’t give up on brushing techniques. Dental health is at least as important as any other kind of maintenance.
    What has worked for us over the years:
    – pretending there’s an animal in my son’s mouth and I have to brush him out (the animal varied to keep it interesting)
    – musical toothbrush
    – letting him take a turn first
    – having him vocalize the sounds he needs to make to shape his mouth (AH and EEE)
    – we all brush/floss together at the same time
    Basically, it was a struggle for probably 12 months, but we never gave up. Now he *rarely* fusses about it. It’s as part of his routine as anything else is.

  23. We introduced the toothbrush as a toy to hold in the bath and chew on…Our son is 17 months…also watching us brush our teeth seems to inspire copycat toothbrushing ….It doesn’t need to be a crazily thorough job according to the nurse practitioner at his pediatricians. A bit of novelty, a tooth brushing song perhaps?

  24. we blow bubbles during tooth brushing time. alternating brushing her teeth with blowing the bubbles. i found some easy to use bubble blowers in the target birthday party section.when that doesn’t work, i pretend one of her stuffed animals is going to get her tooth brush and use it. this approach appeals to her 2 year old sense of everything being mine and then she wants the toothbrush.
    when neither of those works (worst case scenerio), we force her to let us brush her teeth. she has a big fit, but when it’s over she’s totally fine.

  25. I really wish that there was some consistency in recommendations for first dental visit. Our ped said three, and so did my dentist, but my sister was floored because their ped and dentist says 12 months for first visit.I have bad teeth, so I jam the brush in there, but I also use the Baby Buddy silicone brush that brushes up to 6 tooth surfaces at once if he chews it, or 3 surfaces when I actually brush his teeth for him.

  26. @Kris,I suppose for the majority of people who have good genetics, waiting until 3 would be no big deal. What I don’t get is waiting until your kid is that age to go to a brand new situation, with a stranger messing around in his/her mouth. What’s the harm in going beforehand so they can get used to someone else in their mouth? (I’m not directing that question at you, I’m just shocked that peds and dentists are making the 3 recommendation.)
    Particularly with our son, who is highly sensitive and needs lots of practice in new situations, waiting until he turned 3 would have been disasterous, I think.

  27. I struggle to take this as seriously as I should… but we do brush our almost 2 year old’s teeth. We started with the finger brush before she was a year, and then moved up to a regular brush when she started biting our fingers. We let her brush first (she likes to do this, and usually insists Mommy and Daddy brush, too- its family tooth brushing time!) and then one of us takes over and makes sure the teeth actually get brushed.I remember her fighting us pretty hard when we’d brush her teeth for her from about 18 months until just a little while ago. I had a rule that we had to get a good brushing in once a day (she brushes twice a day). Now she doesn’t fight so much and we usually help her brush both times. I also remember her just chewing on the brush at this time. I later came across a brush designed to work when they chew, which seems brilliant. Maybe I’ll try that on baby #2. I saw it in a catalog called One Step Ahead.
    We live in a city that doesn’t add flouride to its water, so we use a toddler flouride toothpaste one of the two times we brush.
    When she was fighting really hard, we tried signing (Raffi has a tooth brushing song), funny noises, and brute force. Nothing worked that great, but then she just stopped fighting us on it. This happened during the early first trimester of my current pregnancy, when I had to leave all bath time routines to my husband because I felt too crappy to do anything. So I don’t know how he did it.

  28. a quick note that the gerber baby toothpaste has xylitol as well…i just checked!we let the bean use a baby toothbrush as a teether the way the pnut did. our ped said wait til she’s 3 (oops) to bring her to the dentist, honestly, i’ve been terrified to do it since i can only imagine the way she will freak out and i hate the idea of traumatizing her. *BUT* her preschool had a pediatric dental hygienist come in and get them all super jazzed up about going to the dentist, so i have their # and will probably go ahead and set that up.
    btw, we don’t have dental insurance. and i can’t begin to describe how much that sucks.

  29. This post just reminded me that I’ve been thinking about DS’s first dentist visit lately. I just called two seperate pediatric dentists in the area, and they both recommended age 2 unless a problem was suspected. Maybe that’s a Canadian standard?We brush twice a day and hope to hit all of the teeth well at least once a day. My nanny works on top teeth in the morning (of course, if it’s going well, she’ll also do the bottom), and I do the opposite in the evening. We’ve tried all the same tricks as above, songs, taking turns, letting DS brush my teeth, etc, etc. Sometimes it’s only a mild struggle. Sometimes its a major struggle complete with pinned arms and big tears. I’ve never had a cavity despite patchy dental care – I’ve always just brushed twice a day and flossed once in a while when I remembered. So I am really just hoping that DS will get my good tooth genes (although that will probably mean major orthodontics bill in my future).

  30. Oral B training toothpaste has Xylitol too, so that’s what we use on my 20-month old. We’ve been brushing since he was about a year, with the little finger thing before that. He goes in cycles of very difficult/somewhat easier, but it helps to have two toothbrushes and I let him pick which one he wants and which one I use. My dentist also recommended laying him back so he’s upside down to brush. He loves it, gets him giggling, and then I can get some good swipes in. I’ve also had the toothbrush talk to him “I want to brush your teeth! I need to get in your mouth!” which he finds hilarious and then complies.

  31. Not a huge tip, but I haven’t seen it mentioned. I have better luck brushing my son’s teeth (18 months old) while he’s in the bath tub or sitting him on the counter with his feet in the sink. He likes to turn the water (cold knob is the only one he can reach from there) on and off while I brush. I always let him ‘brush’ when I’m done. I find that once I get the brush in his mouth I’m fine, even when he fights that first step.

  32. Our daughter HATED letting us have anything to do with her teeth at that age. She would suck on the brush, but we were not allowed in. Any attempt resulted in screaming and flailing. I just held her head and brushed quickly. My husband refused to have anything to do with it, but I figured it was worth it to avoid getting cavities and having a dentist drilling in her mouth. (I have really bad teeth and have had lots of trauma at the dentist)A few months ago, at about 20 months, I bought some strawberry flavored Tom’s toothpaste and she LOVED it! It was finally okay for me to brush her teeth. It’s strange because she clearly did not hate the old toothpaste, since she would suck on it by herself for hours if we let her. Just another example of the insanity of toddlerhood…
    Now, I talk to her teeth as I brush them. I ask each tooth what they ate for dinner and if they liked it or not (“Hi back teeth, what did you eat for dinner? Mmmmm, apples. Taste good?”). For some reason this cracks my daughter up and she laughs and lets me brush around in there as long as I please.

  33. Just a note, the research showing that mothers who chew xylitol-containing gum reduces the colonization of children’s mouths is not restricted to nursing mothers…ALL moms, regardless if they are still nursing or not or ever nursed, can help reduce the transmission of mutans streptococci – the bug that causes cavities – to her children by chewing xylitol-containing gum, since we tend to share food & drinks with our kids, lick things like pacis off to clean them (not that I’ve ever done that, no way, not me…ahem 🙂

  34. My boy sounds exactly like yours. 16 months old. Will NOT allow us to brush his teeth. (Also hates having his fingernails clipped, as yours does.)He also has a “fused” front tooth – that is, essentially, two teeth that fused in development below the gumline and emerged as a single tooth with a gap in its center. Fused teeth are apparently common, but they are more prone to decay because bacteria collect in the gap.
    So I took him to a pediatric dentist at 14 months. The dentist was NOT helpful. He said the usual: Brush twice a day. Floss (does ANYONE floss babies’ teeth?). No bottles, no dried fruit.
    So I simply squirt xylitol toothpaste onto a clean washrag at bathtime and struggle to wipe off his teeth with it. Then I put a bit more toothpaste on his own brush, and he happily chews on it. That way his teeth are sort of getting clean, and he’s also not developing bad associations with the toothbrush itself. (Letting him “brush” my teeth is fun for him, but he won’t allow me to brush his in return.)
    When he is older I will try a musical or cartoon electric toothbrush. He’s still too young for those – I bought him a musical “Thomas the Tank Engine” toothbrush a few weeks ago, and it actually scared him.
    Anyway, I think his teeth are getting clean enough. I don’t think we can shoot for perfect dental hygiene at this point, at least with our strong-willed boys, without setting up later power struggles.

  35. Stephanie in PR – Ugh! That’s sounds so awful for your daughter (and not fun for you either). I hope that she can overcome her (justified) fear of dentists.V is now 20 months old, and while we don’t hold her down to get her teeth brushed, we do cajole and occasionally make things less pleasant until the job gets done. I.e., she goes in her crib for about 30 seconds and then she’s pretty amenable to getting them brushed. Now she usually just needs to hear me mention the crib and she will sit in my lap to get them brushed.
    I guess I need to get some children’s toothpaste.
    We started brushing at 12 months, and V has a mouthful of teeth; everything was in by about 18 months except for her two-year molars.
    We do also do the ‘brush mommy’s teeth and brush Puppy’s teeth’ trick. Puppy is her lovey. We also have 2 toothbrushes so that she can choose if she wants Elmo/Cookie Monster and yellow/green, etc.
    Good luck everyone.

  36. We too started with a toothbrush at a year. He would play with it in his mouth which maybe cleaned them slightly himself, but wouldn’t let us do it. Finally we decided that morning was toothbrush practice time and he could do it any way he wanted (chewing on it) and bedtime was our time. We’d get it in his mouth and quickly pull it out, congratulating him before he’d had a chance to refuse it. Gradually he’d endure it longer. We always tried to stop before he forced us to so he could be “successful”. At age 7, I still try to do the nighttime brushing and he’s still free to chew on it in the morning.His little brother does best if I examine the teeth as I go: “I see bagel here from breakfast… Oh! some clementine from lunch! Over here is pasta and some red sauce… some carrot…Hmm, think I got it all!”

  37. As far as taking kids to the dentist, I had two dentist books in my house with the rest of them- a Little Critter one and an Arthur one. Neither series is in my favorites by far, but the kids liked the books and were eager- truly excited- to go to the dentist the first time, and still love to go.

  38. We do the bathtime tooth brushing as well. When he started liking the flavor of the toothpaste he would get excited to brush his teeth. Now I tell him that I have to brush is teeth first then he can have the toothbrush. This works for us. I can usually get the top teeth one day and the bottoms the next day. I have to move fast though b/c he only tolerates this for a few moments… then he wants to chew and suck on it.When he started falling in love with Thomas the Train then we bought Thomas toothpaste and that brought a whole new level of excitement to tooth-brushing. I think this is just one of those things that gets easier with time… and then harder when they get older:)
    I’m interested in these tooth wipes that Moxie mentioned… my pediatrician just recommended wiping his teeth with a bit of cloth when I could wrestle him down BEFORE he started cooperating with the brushing.

  39. Ooh, forgot to mention…there is actually a sugar-free lolipop that fights tooth decay. It was developed by a UCLA microbiologist. He found that an extract of licorice root targets and kills the primary bacteria responsible for tooth decay.They taste good (my husband and I suck on them, too), and you can buy them under the name Dr. John’s Herbal Candy (http://www.drjohns.com/herbal/index.html).

  40. Just a note – the Dr Johns candies are primraily polyols and also have an artificial sweetener (re the polyols/sugar-alcohols, see: http://en.wikipedia.org/wiki/Hydrogenated_starch_hydrosylate ).They will work in a similar way to the xylitol, I presume, but they also are a big Not Safe for fructose malabsorption (and excess consumption will result in the exact same symptoms as Fruct Mal even in non malabsorbing individuals, because polyols block absorption of fructose).
    Don’t go ‘unlimited’ on the Dr. Johns candies, in other words.
    We were hopeful on those (a dentist gave out samples at school for the kids), but even where the dye is not an issue for allergies, we don’t do the artificial sweetener, and the core ingredient is a catastrophic (for us) blend of polyols… sigh. It’s like all the things they can’t eat all in one package.

  41. Yeah, I think there are specific instructions on the package that explain the usage. They’re not an every day kind of deal. I think if you have no existing caries, you can use them once a month or something. If you have existing caries, you can do them more often. It’s definitely not something we use all the time.

  42. It’s been a bit of a struggle here. My daughter is getting better at 23 months. I’ve had success with saying, “Say AHHHH.” We say it together, “AHHHH.” And we say, “Mommy hold. Then Madison hold.” But she still usually has some milk before bed after she brushes her teeth. Oh, the mommy guilt.

  43. Use a timer! My son also hated brushing his teeth, but we now use a fancy digital timer (that he gets to set). He gets his “turn” first (although I always ask. We set the timer to one minute and he watches the count down. His efforts are sometimes good, sometimes bad. Next, it’s my turn. I also get one minute and he usually is very cooperative. Again, he watches the count down and I narrate everything that I’m doing and play to the clock. I LOVE that timer.

  44. We started w/ a toothbrush as soon as that first tooth broke through at just-turned eight months. We use a baby toothbrush from the dollar store and Earth’s Best/Jason brand toddler toothpaste. My husband and I do not have the best teeth, so this is something I have drawn a hard line about. I started right away so that dd would get used to it and not fight, and it worked. I brush all of her gums, too, so she is used to having her whole mouth done, not just her 2 little teeth. She really likes it b/c she likes the taste of the paste.If it came down to it, I would rather pin my kids down and brush than to deal w/ the worry and possible decay. I hate teeth and dental work, so pinning would be the least traumatic for our family as a whole. Many many many other things, I am/will be lax about; tooth brushing is not one of them.

  45. In a word: Elmo. (Or “ELLLnoOO” as she calls him.) I brush my 18 month old’s teeth and she brushes Elmo’s teeth, with her Elmo tootbrush and Elmo toothpase….I know, sell out, right? But this seems to be the ticket to harmonious brushing. So, just keep trying until you find that magical currency that really interests him in the process.I admit I have held her down on occasion and just gotten it done quickly. Not pleasant for all involved and she seems to prefer the other way and is much more agreeable about it after one of those rare incidents. But Elmo is key.

  46. We originally started wiping DD’s gums with a wet washcloth during her evening bath and as part of her morning dressing routine. When she turned 1, she only had 4 teeth, so we just continued with the washcloth.At around 19 months, we changed over to a toothbrush with toddler toothpaste, and it’s gone pretty well. In the mornings, we brush after breakfast but before I get her dressed. I brush her teeth first and then hand the toothbrush over to her for a turn. She says “Mommy brush,” so I brush my teeth while she is working on hers. Also, she has two toothbrushes to choose from, which adds to the excitement for her.
    As for age for first dentist visit, we took her along for my husband’s last checkup (she was around 21 months), just to get her used to the office. But our dentist and pediatrician have both said 3 for the first official visit. Almost every baby care book I’ve read says 1 year. I wish I knew what the *right* answer is to this.

  47. just had time to skim, so I’m probably repeating here:- we’re anti-commercial-character around here – except for the fact that T. has had toothbrushes featuring Elmo, Snoopy, and now Pokemon (aka “Pointy Bunny”). Whatever works.
    – Brushing got a lot easier at 2, once we’d visited the (awesome) kids’ dentist. Now we play “going to the dentist” every night – I’m almost always the dentist, and there’s usually some talk along the lines of “are you T. S.? I’ve heard about you – they say you have *incredible* teeth – shiny and white and sooo beautiful! May I see these legendary teeth? Oh, my, the hygenists have got to see this!” Or, “A mountain lion – wow. Let’s hear a roar – wooh, those are the *sharpest* teeth I’ve ever seen! Do you sharpen them yourself?” Sometimes he’s a frog and contorts his tongue trying to catch a fly, and I follow it around with the brush. Etc.
    – Flavor matters. T. didn’t like minty toothpaste (too strong) or most kid-targeted flavors (too sweet). Tom’s cinnamon – in tiny amounts – was Just Right.
    – Several brushes – he likes to choose. Sometimes in the mood for batter-operated, sometimes for sparkly, and so on. We keep no more than 3 out at once, though.
    That’s about all I’ve got. Sometimes we still have to chase him for 5 minutes first, but at least the brushing happens…

  48. We gave both our kids toothbrushes at around 10 months so they could get used to them. (We had previously used the finger gum brushes.) Our daughter loved her “toofie” so much she took it to bed with her. Letting us brush her teeth however, was still a daily battle (“NO! MY TOOFIE!!”). Honestly, we just skipped it when it started to become an issue. Of course I was nervous about letting it slide sometimes, but after having my husband pin her down while I tried to pry open her jaw for the 200th time, I just couldn’t see how this was the way to go. So we’d lay off and try a new tactic a few days later. So it was patchy until she hit 2, when she became much more receptive to brushing songs, games and/or bribes.The thing that worked best for us was asking her who she wanted to brush her teeth (birds, ladybugs, giraffes etc.) and we would pretend we were the little animals cleaning the “slimmies” off her teeth.
    Our pediatrician checked her teeth at visits and said as long as there were no obvious problems we should not see a dentist until she was 3. This really confused me because ALL the literature I had read said seeing a dentist at 1 year was crucial. I called our dentist and they said the same thing- they don’t want to see them til they’re 3. Fine. I took her after her 3rd birthday, where she did a great job in the “space chair” getting her chompers counted and polished. Everything looked good so they didn’t want her back until she was 5- which makes NO sense to me. Why shouldn’t she get her teeth cleaned every 6 months? We’re paying for the insurance anyway and I know her baby teeth will fall out but is that a reason not to keep them clean and healthy? I was/am flummoxed.

  49. We used a wet cloth on our son’s gums from the beginning (it helped soothe him when he was colicky) and upped it to wiping his gums several times a day when he began teething. He didn’t get actual teeth til almost 10 mos. old, so we started with a toothbrush then. He LOVES it. After his bath each night, he lies on the bed with his toothbrush. We have his say “aaaah” and brush his teeth, then let him keep “brushing” while we slather him with lotion and put on his diaper.

  50. @Amanda- what is it about toddlers and Elmo? Ours loved him even before we started letting her watch Sesame Street. She must have seen books or something at day care (its a center- they don’t do TV). Its sort of freaky how devoted that age group is to him.

  51. @rkmama, the ADA says that the first visit should be when the first tooth erupts, or at the latest, at 12 months. It is considered a ‘well visit’, and also provides the parents with information about what to look for regarding ‘something wrong’, techniques for how to brush, etc.The family dentist I saw at first said ‘3 years’ but the pediatric dentist said ’12 months’ – and frankly, I’m going to trust a specialist over a generalist. It’s like the pediatrician saying ‘oh, the speech development is fine’ but having ZERO training in how to do a speech/language assessment. They do this all the time, and it drives specialists crazy. If there’s any concern AT ALL, it’s worth jumping to the specialist for a baseline evaluation.
    I’m going to assume that the ADA is not crazy, and that a well-visit at 12 months is a good idea. I know that if we’d been in at that point, we likely would have known Mr G was in trouble already, and could have saved him a lot of dental work (maybe, anyway). We got in earlier with the others. My kids still have horrible teeth, but at least we didn’t wait and find that out much later.
    At the same time, I also know that non-pediatric dentists do not have a clue at all about what to do with a toddler. At least the pediatric center had a ton of strategies in place for managing the emotions, expectations, and needs of toddlers and preschoolers (they do things like have the same hygenist assigned for all visits, so that the child has a relationship with someone who is not as intimidating as the dentist might be…). They are also willing to consider the Whole Child and the future relationship with dentists/dentistry (they intend for kids to not grow up scared of the dentist). For example, they have held off on dental work until a better age at times, and will end an appointment before it gets to the limit for the child (we may go in for two fillings but only have one done because the child was Done, reschedule for the other), etc. It takes a different mindset to handle that in the under-3 set, I think.
    It was really important especially with Miss M (who had severe anxiety before we got her off excess fructose) to handle the dental visits well. She doesn’t LIKE the dentist (actually calls the dentist The Bad Woman) but is neither apparently traumatized by nor super-resistant to going, and I think that was in large part due to working with her and the dentist on proper management. Miss M is clear that she does not LIKE the dentist, but she is not afraid of her, which is a very important distinction, IMHO.

  52. We have a fairly cooperative 3-year-old. We built up to brushing by first having her do it herself. (Maybe around 12 months? I can’t remember). We went through SO many toothbrushes as she chewed them. We’ve been talking about how important it is to keep her teeth clean so we don’t get cavities. We brush our teeth together, mostly because I kept forgetting to brush hers, but always remember to brush mine!What currently works for us is that I get to brush her teeth first, and then I ask if I “missed any spots”. She then gets to brush those spots herself, and feel like she’s the expert.

  53. Susan, I totally feel your pain. The thing that works great for my daughter is the electric toothbrush.My husband and I both use the Oral B Professional and I just put a different head on for her. We put toothpaste on and she brushes one or two of her teeth well (because she keeps it spinning in the same place), then I use my finger in my mouth, showing her to move the toothbrush around and then she finally does. Finally (if she’s willing), I do a swipe of the rest of her mouth to get her gums and the backs of her teeth and call it done. She only has 6 teeth at this point (16 months) so it’s not too hard to get them since they’re right up front. She’s been brushing her teeth since she was about 12 months this way and before that it was a struggle with the manual brush but I’ve been brushing her teeth in one form or another since a month or two after the first came in. Works great for us and might be worth a try. (They sell MUCH less expensive electric kids’ toothbrushes, btw, but I don’t know if they recharge in anyway). I’ve also wiped her mouth with wipes at different times in between if I feel I can get that in.
    I totally agree with you on not pinning the kid down because I can’t imagine how this wouldn’t cause a negative association and only make things worse. I know it will be a different scenario when kiddo has the manual dexterity, understanding, and communication to make good tooth brushing possible, but it’s just tough with a toddler. I say work with what you can get, try some of the ideas above that appeal to you and somewhat work for you guys and call it a day. Best wishes!

  54. What worked for us was repetition, repetition, repetition. We brushed our teeth in front of our daughter and let her get used to the idea, then introduced a toothbrush when she was 13/14 months. (We did the same thing with potty training.) It was initially a struggle with her (much easier if daddy did it for her) then eventually she just got used to it. This was one issue where we would not compromise. It’s part of our nightly routine. She brushes first, then mommy brushes her. We started flossing around 21/22 months. Her dad made a game out of it so she likes to do it. Some nights she protests but we just get on with it and do it, no compromise.She chipped her two front teeth at around a year old and by the time she was 2 yrs one tooth started to look gray. A mom I met at our local park said her daughter had the same thing and turned out to 8 cavitiies at 3.5 yrs!!! YIKES!!! Their pedi dentist said it was due to night nursing. (I’m not so certain I agree with this assessment, but what do I know? I’m no dentist.) I spoke to my own dentist about the graying tooth and he had us bring our daughter in and x-ray’d the tooth/nerve. Every thing was fine with her tooth/nerve and still is a year later.
    My dentist had suggested early on when my daughter was an infant to bring her to cleaning appts to get her used to being in the dentist’s office. She was terrified of it at first, but eventually got used to it. I didn’t actually start to bring her in until she was about 1 yr. In fact, she sat on my lap during my last cleaning was so enthralled by the entire procedure that she asked the hygienist to clean her teeth as well. The hygienist was great with her. She explained that there were little “sugar bugs” on our teeth and we needed to brush our teeth so that the sugar bugs wouldn’t eat our teeth. Now my daughter asks to go to the dentist.
    I do hope this is helpful, Susan. It will get better, just like with everything else. He will get used to the brushing in time. Just make it a non-negotiable issue and ultimately it won’t be an issue.

  55. @ hedra -Talk to me about hypermobility. Links, sources, etc. I’ve never heard about the link between hypermobility + collagen formation + tooth enamel development. Holy moley this might explain a lot about L. (the 4 year old whose OT is working on hypermobility issues and who has already had 12 fillings and 3 teeth removed despite dental hygiene and diet control that approaches – passes? – neurotic on my part). I might just jump over to your blog and comment. I’m so excited that there might be some explanation for all this. (of course, she also had reflux, which may also play a role).

  56. We have one howler at tooth cleaning time. We started around 12 months with a damp cloth. Lots of yelling. Then it just stopped. We started actually brushing round 15 months, and it was still OK. The hollering has started again with the toothbrush, although she’s OK with the wiping. In fact, I can get at parts of most of her teeth with the toothbrush, just not everything every time, and a few parts (top front) seldom. I work really fast, and I try to wipe and brush 3x/day, thinking that frequency will make up for quality. Like mama-t I think this falls into the non-negotiable category, so I’m trying to make it as easy as possible, but it’s still in our routine. I need to make appts with the pediatric dentist soon (17 months) to be on the safe side. DH has had lots of tooth issues. Thanks for the suggestions from the other posters–they give me some things to try.

  57. @Hedra- Thanks. I had read that the ADA recommends a 1 year visit, which is why I called the family dentist, thinking they would follow it’s mothership’s guidelines. Wrong. I totally agree that a specialist would know what is best but most of the population trusts what their pediatrician and regular dentist advise them on, so it just seems to be a road block where there shouldn’t be one.In our case it turned out to be just fine. Rowan had great teeth and sat surprisingly well for the visit. I was, however, very disappointed at how ill equipped our office is for kids. They didn’t even have a Highlight’s magazine, let alone a kids’ table and they looked at me like “What the heck are you doing bringing a 3 year old in here”. Maybe I just need to shop around for a pediatric dentist but it just seems like a waste when she doesn’t have any dental issues. Interesting and frustrating stuff.

  58. Give him a “daytime” toothbrush that he can carry and keep with him all day throughout the house – encourage him to suck on it and keep it in his mouth. Once he gets really used to it (even after a few days), brushing will be a piece of cake.

  59. I’m almost afraid to ask this, but at what age do people attempt *flossing*? Mine’s 5 and I briefly experimented with this before throwing in the towel. I’m sure her dentist would give me one answer, but I’m interested in what everyone here thinks…

  60. @Shelley:We just had another visit with my son’s dentist (he’s 3), and she asked us to start flossing now. He has pretty crowded teeth and she could tell that food was getting trapped.
    They gave us a flossing stick similar to the ones we use (we nicknamed his “Officer Flossy”, from the Richard Scarry books), and he’s pretty good about it.

  61. My kids are 8 and one of them is still wildly resistant to tooth-brushing. This has been going on from baby-hood, and who knows when it will improve. That child does a very poor job of it and accepts that parents will do an extra brushing job at least once in the week. We think it’s an oral-aversion thing: this child also has a very strong gag reflex and has thrown up in the dentist’s chair before. (And yes, the dentist has tried a million tricks to overcome this. No joy yet.)Our kids are also not great flossers so I try to do it once a week or so. They lie back on the bed with their heads on a pillow on my lap while I floss. Maybe I’m being over-involved but I’d rather offer extra help than pay for lots of cavities.
    We took our kids to the dentist for the first time at age 3. One had 5 cavities, needed two caps, had to have the work done at the hospital under general anesthesia, and has not had a cavity since. The experience converted me, though, to the wisdom of a good pediatric dentist or friendly family dentist starting at 18 months. It can’t hurt (other than the pocketbook) and it might make a big difference.

  62. Hmm. The nurse that taught our baby care class said no toothpaste, not even natural stuff, until they are old enough to spit.We have made the tooth brush off limits for our 18 month old to hold. She has another, very different, one she can play with. We started tooth brushing at 12 months. When it’s tooth brush time mom or dad does it and the trick is to load it up with water every few seconds. She likes it when it’s wet. We also once or twice had dad brushing mom’s teeth and vice versa.
    My dad force brushed us as kids. It was awful, but none of us have cavities.
    Good luck!

  63. My son’s pediatric dentist gave us the best tips for brushing his teeth (he was 18 months at the time): Have toddler stand and adult stand behind him with two toothbrushes. Ask toddler to look up at you, which causes him to open his mouth. Wedge the end of one toothbrush in between the molars on one side, and use that toothbrush to keep his mouth open while you use the other toothbrush to brush the opposite side. Then switch. It sounds a bit brutish as I write it, but really my son doesn’t mind at all. We usually all brush our teeth together and then I “finish up” his brushing job.Picture demo here: http://bumpslife.blogspot.com/2008/09/i-see-me.html
    Also a tip for finding a good pediatric dentist: I asked a friend who is a special education teacher. She mentioned that all her students went to a particular dentist. He’s great! Super gentle and patient – there is no holding or restraining, he just somehow talks toddlers (and older kids) into opening their mouths. Its amazing.

  64. @hedra- are you saying that pediatric dental would be covered under our regular health insurance as a well-child visit? that thought had never occurred to me at all…

  65. @pnuts mama, dental coverage will vary – all you can do is ask.@sueinithica, the connection between collagen formation of teeth and hypermobility is one that is still being fought out by specialist and researchers. It is known to occur in some of the severe forms of EDS and osteogenisis imperfecta, but is variable in other types, just the way bruising is variable in the standard hypermobility type, to the point that it isn’t even used as a diagnostic criteria for the general hypermobility type, but people with that type still have a pattern of easy brusing quite often. It’s another area where the research is still ‘leading edge’. Have you checked into Hypermobility.org? It is a UK site linked to a research center, and there have been some good discussions about the dental fragility/excessive caries issue.
    The gum sensitivity is thought to be the major player by some researchers, but there have been a few who cited the collagen structure that forms the matrix on which the teeth grow (explaining why it is just the baby teeth affected for some individuals, the adult teeth for others, and for the unlucky, both). I will see if I still have the information I sent to our dentist. The Candian Dental Association used to have a handout for dentists on hypermobility and dental fragility, but it is no longer available (probably because the research keeps swinging back and forth on the topic), and when I queried them they asked me to ask my dentist. ARGH. The collagen disoprders clinic said they consider dental softness a separate trait and not related, because it only shows up sometimes (but they still put it on their assessment forms as a diagnostic criteria item. Er, huh?). However, the UK center has told their patients that it is a collagen structure issue, and they’re the leading experts so far, research-wise. I just haven’t been to that center (though our family doc said that it might not be a bad idea to consider a medical vacation, just to get to the best in the world, since we’re in the ‘zebra’ range and don’t fit the usual scenarios… maybe another year.)

  66. Oh wow, you guys all rock! My son was of the screamy, you-must-hold-me-down-to-come-close-to-me-with-that-toothbrush variety of 19 month old, and yesterday I made up a song. This morning he actually ASKED to bush his teeth. I declare it a miracle!

  67. This thread is making me check back with my husband about the first dentist date we were given. I remember thinking we should go early, as many of you said, and then being told by both pediatrician and dentist that we didn’t need to bring him until year 2 or 3–but I don’t remember which, and he’s just hit 2 years!Our son didn’t even get teeth until around a year, so we started a bit late. I think we were lax about brushing until around 15 months when the pediatrician told us we needed to get more serious about it.
    For a while he was very averse to brushing. These days (24 months) it depends on the week, sometimes no problem, sometimes more of a fight. These are the things that have helped us:
    –like another commenter, we use Tom’s of Maine strawberry toothpaste. I think many adult toothpastes are really unpleasant and highly flavored to a child. (My husband uses Tom’s of Maine mint, which *I* find it too harsh. He accidentally put it on my son’s brush once and my son cried because it burned!)
    –it’s always done during the same part of our bath routine; after he gets his gummy bear vitamin, before we go put his pajamas on for bed.
    –for some reason it never occurred to us to do the “brush our teeth” thing (a great idea I am going to keep in reserve). But we always give him the brush first, and let him chew for a bit; then we insist that one of us must have our turn. He gets to choose which of us does it. You know how toddlers love choices.
    –sticker chart! We have one in the bathroom anyway, and also use it for potty stuff, and for getting out of the bath on his own. It’s especially helpful to let him take the sticker he chooses off the sheet himself–occupies his hands and mind while we brush his teeth.
    –sometimes he has fun with looking at the animals on his kids’ toothbrush, and that warms him up to it. Maybe Thomas the Tank Engine is next.
    –he’s beginning to find it fun to say “Ahhhh” sometimes on good brushing days, so I am trying to introduce that lingo (“Open wide!”) and idea for future dentist visits. It worked for our doctor’s visit the other week! He even let the doctor use a tongue depressor to look at his molars.
    –if all else fails, we too hold him down. I don’t feel too bad about it. Nobody’s getting hurt, it’s important, it’s a standard part of the routine, and it’s never our first resort.

  68. @ hedra -Thank you SO much for the link to hypermobility.org. Quite honestly, it never occurred to me (why not?) that there would be other people with the same issues who may have actually *posted information* about it. I’ve always had a fair amount of hypermobility, particularly in my elbows and knees, and I suspect my hips as well (they don’t stay put. the chiro is always having to put them back because they shift in a way that one leg gets a couple of inches shorter than the other. plus, they pop out of joint, painfully and inconveniently).
    I’ve always, always been like this, and just figured it was just another reason to get teased in elementary school.
    My daughter also shows hypermobility – especially in her elbows – hadn’t thought to ask her to bend over with her hands flat or stretch her thumb (both of which I could do as a kid, but am now old and creaky, apparently). I’m going to play with that tomorrow. 🙂 Anyway, she also has sensory integration issues (which is why the OT and Speech). I never connected the two. One thing they’re really working on is trying to teach her where her body is in space.
    When I read the bit about lidocaine on the website I almost jumped out of my chair. I’m always having to explain to dentists that I need a LOT extra, and then screaming when they still don’t give enough.
    Hmmm….new avenue to explore. L.’s issues are fairly mild (as are mine) but it’s interesting to find out about the connections between the various issues we’ve had (both of us).
    I wonder – do you know of any therapies that can help strengthen and/or mitigate the effects of hypermobile joints? I’ve asked her OT, and the only thing she recommends is doing exercises like wheelbarrows and other activities she feels will strengthen the joints. I haven’t done any of that because I remember those activities as being VERY uncomfortable as a child, and I don’t want to push her to do it unless I know there will actually be a benefit. I’m cringing just thinking about volleyball (oh the Pain! of spiking a ball and having my arm snap backwards).
    Off to troll for research – thank you thank you.

  69. Hi everyone –I’m Susan, the OP. I was out of town when this was posted and just read through all the comments. Huge thanks to everyone for all the great tips and suggestions. I’m going to try doing xylitol wipes (he is more receptive to wiping than brushing) and keep working on making brushing fun until he’s a bit older and we can communicate better. And in the meantime I’m going to see if I can find a pediatric dentist to see him at 18 months. My DH has good teeth in his family, but my family’s teeth are pretty bad so I don’t want to take too many chances.

  70. @sueinithica, there is apparently a protocol for OT/PT for hypermobility that is used for EDS patients. I have yet to find out what it is (we just got the OT/PT coverage, so I’m still in the process of trying to locate someone who will know what to do). However, the general advice has been supporting the small muscles around the joint with more complex exercise, and also doing a lot of (strangely enough) weight training – apparently the degree of strength plays a big role in the joint stability.My sister does dance (middle-eastern) and horseback riding as therapeutic processes. I also did middle-eastern dance for a long time as a therapeutic (and fun) activity. I can say that while it didn’t improve everything to zero, my back didn’t slide around so much when the muscles were there, and the knee-flexed (rather than locked) leg positions produce a lot of support/exercise for the small muscles around the joint.
    Tai qi is also really good (not the extreme forms, maybe, but the overall rotation and balance shift and constant movement type). Impact not so good (tai qi being low impact is good). I’ve heard swimming also recommended, but I didn’t go there.
    And yeah on the lidocaine thing – I have forever burned in my memory the ER doc saying (almost plaintively) ‘But he CAN’T FEEL THIS!’ as Mr G squealed when she tried to stitch his ear back together – uh, no, apparently he CAN feel it, thanks, despite the extra that was given and the extra wait time for it to take effect… If he made a noise and flinched when you poked him it was because he *did* feel it, not because he’s psychic. ARGH.
    Er, anyway, glad to help! We can all inhabit the gray zone of ‘not bad enough to be EDS, but bad enough to be a problem’ together.

  71. Since there are quite a few comments that deal with worst case scenarios, I feel compelled to share.I was nervous before my daughter’s first dental visit. The thing that really scared me was her chocolate milk in the middle of the night habit. We routinely brush her teeth before bed, but were inconsistent in the morning and never brushed after meals. And, even though we made the effort at night, I have never felt like I had a technique down. Her diet is pretty average — she eats well, but gets a lot of treats.
    Anyway, she went to the dentist at 3 years old, and they think her teeth look great. They told me to just keep doing what we had been doing (they didn’t know about the chocolate milk). So, while I don’t recommend ignoring the prevailing wisdom, it does seem like some luck is involved.
    Also, my daughter is a thumbsucker. I have always heard that saliva is a good defense and I wonder if thumbsucking has helped keep her mouth moist. Of course, the thumbsucking may lead to other oral problems down the road.

  72. I am so glad I checked out this post! Our son is 21 months and was doing good about letting us brush his teeth until his last dental visit scared us. The dentist told us we were doing a poor job of it (we had been wiping with a rag and then brushing with Orajel Children’s toothpaste 1x per day but I guess we weren’t being firm enough). After brushing I was nursing to sleep. The dentist said between the poor cleaning and night nursing he had some pre-cavity spots. Now we have switched to a flouride containing kid’s toothpaste and a firmer technique, causing his gums to bleed (the dentist told us this would likely happen due to the bacterial inflammation). It is awful, he is in pain and we have to hold him down. I tell him it will get better soon, that every time it will be less ouchy. I am definately going to try to add in some distractions to the routine. I am also going to try to brush DS’s teeth on my own in the AM (DH helps at night) as well since we are not ready to give up the nursing to sleep yet.

  73. Susan, there are a lot of parents who experience the same difficulty. It can truly be a challenge to teach a child to brush. Some of them often have tantrums. But if you’re patient enough, you will be able to find the drill that would work best for your son or daughter.My daughter Sarah, usually brushes with her siblings. That way, she would feel that it is not an activity that we are imposing on her. So far, that works for our 3 year old girl.
    Hope you would find the best brushing ‘setup’ for your child. Good Luck!

  74. I was having trouble with my son too. When I took he and my daughter to the dentist, they had these great dental teaching aids that my son just played with the whole time. He brushed the Alligators teeth with the hygienist and she got him to successfully brush his. I found out that they sell smaller versions at starsmilez.com I ordered him the small alligator and he has been doing so much better! We brush the alligators teeth and then his.

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