Ask the doctors: Good oral hygiene is important even for babies

Q. Our daughter is only 4 years old, and she has had her first cavity already. What can we do to make sure that things go better at her next visit to the dentist and for her new baby brother?

A. Tooth decay is common in young children. Their small mouths can make thorough brushing a challenge, and a wriggling and impatient child only adds to the difficulty.

Studies show one-fourth of all children have had at least one cavity by the time they turn 4. Fortunately, consistent dental hygiene, good diet and regular visits to the dentist can prevent tooth decay.

Our mouths can play host to hundreds of different types of bacteria, some even useful. But among their number is a bacterium known as streptococcus mutans, a sugar-loving organism responsible for the formation of cavities. Every time we eat, this bacterium gets a meal. As it devours the sugars that linger in our mouths, it produces an acidic byproduct that gradually erodes the tooth’s enamel coating.

That’s why brushing and flossing and a diet that limits sugar are crucial.

Even before an infant’s first tooth emerges, you should gently wipe your child’s gums and mouth with a clean, damp cloth after feedings. The first tooth should be greeted with a soft infant toothbrush for a gentle cleansing after each meal. Brushing with plain water is fine. If you use toothpaste at this point, make sure it’s a tiny amount, about the size of a grain of rice.

As soon as your child has two teeth that touch each other, it’s time to begin flossing. Be very gentle so as not to cause discomfort, pain or bleeding.

Children 3 and older should brush twice a day and floss once a day. Young children are often not coordinated enough or lack the attention span to do a thorough job. If so, continue to brush until you’re sure your child is up to the task. Most kids need help brushing, at least close supervision, until they’re 7 or 8.

Sugar increases the risk of cavities, so diet is important. Limit sweets, sugary drinks and snacks between meals. And when kids do indulge, get them into the habit of brushing their teeth afterward. Set a good example yourself. Be sure your kids see you brushing your teeth after meals, just as you’re asking them to. Ditto for daily flossing.

And don’t forget about the dentist, who will be an important lifelong ally in maintaining good oral health. The Itasca-based American Academy of Pediatrics recommends kids see a pediatric dentist within six months after their first tooth appears or by 1 year old.

Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.