Dentistry for Kids. Ulrike Uhlmann

      Fig 3-1 Infant tooth brushing. (a) The child lies on the parent’s lap. With this positioning, really good brushing can be done, especially with little children. (b and c) Brushing an 8-month-old baby’s teeth on a changing table.

      Unfortunately, this phase comes to an end with some children or there are phases when oral hygiene is more difficult to carry out. Then parents all report the same thing: the little ones cry, resist, and thrash about. We should encourage parents in these phases to press on caringly but consistently with what daily oral hygiene involves. In the author’s opinion, giving up and skipping brushing cannot and must not be an option. We can be supportive with tips to simplify brushing and prevent possible refusal:

      • First, parents can naturally get babies used to mommy and daddy wanting to take a look in their mouth. Using fun gloves specifically designed for this purpose, they can massage the alveolar ridge, for instance, which also helps prevent teething troubles. There are also special dental wipes with xylitol that can be used from day 1 to wipe the baby’s mouth and accustom them to a routine. They taste good and reduce bacteria at the same time. The earlier children get used to it, the easier it will be to maintain this ritual.

      • Babies can be given toothbrushes as marvelous teething aids to play with (under supervision, of course). As soon as the infant starts walking, they should not be allowed to walk or run around with their toothbrush in their mouth. They can suffer serious injuries when they fall.

      • Once the first tooth actually erupts, it is advisable to have two toothbrushes: one to distract and occupy the child and one for the parents to brush their child’s teeth.

      • The teeth should be cleaned twice a day. Whether with fluoride toothpaste or without is dependent on the information provided by the parents in the fluoride history (see section “Fluorides”).

      • Parents should be cautious in the anterior dentition around the labial frenum. In nearly all infants this extends deeply. Hence, if parents clean the front teeth horizontally and bump up against the labial frenum, this might be painful for the child. The lift-the-lip technique can be used to avoid this. It involves gently pulling the top lip upward with one hand as the anterior teeth are being cleaned with the other hand (see Fig 3-2).

      • Of course, brushing the teeth can be accompanied by singing, little hand puppets, or similar distractions. There are no limits to people’s creativity.

      • It is important to establish brushing as a daily ritual. The earlier and the more confidently this is achieved, the faster more difficult phases can be overcome.

      • It is not about sticking to a schedule. In the author’s opinion, how long it takes with babies and infants is initially of secondary importance; much more important than time is that all existing teeth are thoroughly cleaned from all sides.

      • Often the first primary molar has already erupted when the primary canine starts to erupt. If the molar is brushed normally during this time, the eruption site of the canine might be painfully manipulated. For that reason, it is recommended that the primary molar be brushed crosswise.

      • The author recommends brushing children’s teeth while they are lying down. On the one hand you have better lighting for the maxillary arch and therefore a better view, and on the other hand this position is a good desensitizing method for future visits to the dentist.