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?