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Help Your Child Have a Healthy Mouth! Here’s How

Closeup of very young child holding toothbrush in mouth. A healthy mouth starts with good habits formed in childhood.

For children, a healthy mouth often starts with parents and caregivers modeling and encouraging good oral care habits. Beginning at a young age makes it easier for children to maintain good oral health as they get older. How can adults best help children with this? Donna Greco, DMD has answers.

Before my child is 12 months old, what are the easiest things I can do to help her have a healthy mouth?

There are two simple things you can do right away to help your child set good lifelong habits. First, as you introduce solid foods, help your child maintain good nutrition by introducing natural foods and foods low in sugar and added ingredients. Second, establish and maintain a mouth cleaning routine as early as possible. Before your child’s first teeth arrive, use a damp washcloth to gently clean his or her mouth and gums twice each day.

Happy baby girl showing a toothless smile.

When my child’s first tooth comes in, how frequently should I brush it?

When teeth begin to arrive, brush them twice a day with a baby toothbrush. The baby toothbrushes have soft bristles specially made for young children’s mouths. If you can’t brush your young child’s teeth, you can still clean them gently with a damp washcloth.

When should I begin using toothpaste on my young children’s teeth?

For children older than four months, you can introduce fluoride-free training toothpaste. Use just a tiny amount so that if they swallow it, it won’t cause harm. You can introduce fluoridated toothpaste when your child can spit—usually around two or three years of age. Even then, just use a tiny amount of toothpaste—a tiny smear on the bristles—which is just enough for some flavor and a few bubbles. These are important early steps for a healthy mouth.

What should I know—or ask—about fluoride in my home’s water supply?

You can check with your city or local government or water authority to find out if your water is fluoridated. If it is, then you don’t need to give your child fluoride supplements. If your water is not fluoridated, you may or may not need to provide fluoride supplementation. Children can sometimes get fluoride from other sources—canned goods, fluoridated water at school or day care, or bottled water. If you need fluoride supplements for your child, they are available by prescription as chewable tablets or as drops. Ask your dentist for specific advice.

When should I floss my young children’s teeth?

You can introduce flossing as soon as children start to have multiple teeth that touch each other, usually at about 18 months of age. Use whatever is most comfortable for you and your child—either regular dental floss or children’s flossers with bright colors and animal shapes. Whatever you choose, the most important thing is to introduce the concept of flossing and make it part of your child’s oral care routine.

When should children begin flossing on their own?

When children are age 3 and older, they can begin to try flossing on their own. Be patient—it will take them some time to get used to it! They can start by watching their parents or caregivers. By starting young, children learn the necessary motor skills and become accustomed to good oral care routines.

Keep in mind that young children won’t develop the best motor skills for this until about age 12. After they’ve made a good effort, you can finish up by brushing and flossing their teeth to be sure they are thoroughly clean. An easy way to do this is to have them lie on a couch or a bed with the top of their head toward you. You’ll be able to see everything in the mouth, and you can then do a good, thorough job. Helpful hint: you can also distract your children with music, a video, or an audio book while you finish up their brushing and flossing.

Should children use water flossers?

Water flossers aren’t recommended for very young children (younger than age 7). For older children, especially orthodontic patients age 7 and up, a water flosser’s irrigation can be good for removing debris from around dental appliances, but remember to use the water flosser in addition to regular dental floss. It is not a flossing substitute. The primary goal with children should be to introduce regular flossing and reinforce it as a daily habit for the best chance at a healthy mouth.

Sugar also plays a big part in oral health. How can I manage my children’s sugar intake?

There are three important things to remember regarding sugar and a healthy mouth. First, offer healthy food choices at mealtime and snack time. Avoid processed foods and instead offer fresh fruits and vegetables, lean meats and fish, whole grain foods, and dairy foods without added sugar. Second, avoid juice and carbonated beverages; just water and milk are fine for children. Finally, remember that a big contributor to dental caries (cavities) is the frequency with which children eat and drink acid-forming or sugar-containing foods and beverages. A child sipping on juice from a sippy cup over the course of an afternoon negatively affects the bacteria in the mouth by favoring the cavity-causing bacteria. It’s better to finish a meal or drink at mealtime, and then not sip or munch on anything sugary between meals. Also, if your young child takes a bottle to bed, be sure it contains only water. Anything other than water overnight can contribute to dental caries (cavities).

Young child in blue outfit with pink pacifier in mouth.

How do pacifiers and sippy cups affect my children’s teeth?

If your child uses a pacifier, discontinue its use between the ages of 9 and 12 months. Shift from a sippy cup to a regular cup between 12 and 15 months. These recommendations come from the American Academy of Pediatric Dentistry. Children should be drinking from a regular cup on their own by the age of 18 months or so. There are a few important reasons for this. The delivery method of a sippy cup does not encourage a mature swallowing pattern, and this affects the muscle development of a child’s mouth and face. When a child constantly sucks on a pacifier or a sippy cup, it can negatively affect the development of the shape of her jaw bones. Weaning your child away from a pacifier and a sippy cup this way helps to promote a healthy mouth.

A child should have a first dental visit by her first birthday. When should my child’s dentist evaluate her possible need for orthodontic treatment?

Early orthopedic orthodontic treatment can be crucial for some children. As early as age 1, it is often possible to recognize adverse growth and adverse facial or jaw development in a child. As a general dentist who sees many children, that kind of orthodontic evaluation is something I always do for young pediatric patients. I take a quick look for abnormalities of development caused by a negative habit, or caused or aggravated by airway problems, congestion, or recurrent infections. I also look for children who are tongue-tied. For those who are, we recommend a frenectomy to release the tongue. We can do this right in the office, and it is a simple procedure with tremendous developmental benefits. The child’s mouth is numb for the treatment, which we perform with a laser. Most of my patients report absolutely no pain afterwards.

What can I do about my child’s thumb-sucking?

For children who suck on their thumbs or fingers, we can construct appliances to help them break such habits, usually starting around age 3 or so. The Bluegrass appliance is one of these. It has a rotating bead that spins in the roof of the child’s mouth, preventing the child from putting their thumb or finger in their mouth. For children, this is fun and non-punitive. The appliance replaces the thumb or finger sucking habit with an exercise to strengthen the child’s tongue and mouth muscles, which helps promote a healthy mouth.