CARE OF YOUR CHILD'S TEETH

Begin daily oral care as soon as the child's first tooth erupts.  Wipe off your baby's teeth and gums after feeding with a soft cloth diaper or washcloth.  When the molars begin to erupt, generally around age one, use a soft bristled toothbrush specifically designed for young children.  You may use a small pea-sized amount of non-fluoridated toothpaste, but continue  to wipe the toothpaste off with a soft cloth.  Children are not physically capable of spitting well until about age 4, so wipe off the toothpaste until this age.  You may use a small pea-sized amount of fluoridated toothpaste starting around age 3.  Wipe the toothpaste off of your child's teeth until you are sure that they are spitting well.  Fluoridated toothpaste has significant benefits in helping to reduce decay, but it is meant to have a topical effect.  If swallowed, there is a risk of dental fluorosis, a condition in which teeth have a chalky white discoloration and which occurs during tooth development. 

Parents should brush teeth for their children until they are about elementary school aged.  Children simply don't have the fine-motor development to ensure that they do a good job on their own.  Teeth should be brushed at least twice a day: once after breakfast and before your child goes to bed.  Proper brushing removes plaque from the inner, outer and chewing surfaces.  When brushing for a child, and when teaching a child how to brush, place the soft bristled toothbrush at a 45 degree angle; start along the gum line and brush back and forth.  Brush the outer surfaces of each tooth, upper and lower.  Repeat the same method on the inside surfaces and chewing surfaces of all teeth.  Finish by brushing the tongue to help freshen breath and remove bacteria. 

It is easiest if you position your child lying back with his or her head in your lap, until they can stand at the sink and actually spit.  This way your child's head is well-supported and you have better visualization of your child's teeth and mouth.  An additional benefit is better control, especially if your young child isn't well accepting of toothbrushing!  Drs. Enright and Piedad will demonstrate toothbrushing techniques to you and your child at your first visit and give you tips on making this an easy and effective daily activity.

Flossing removes plaque between the teeth where a toothbrush can't reach.  Flossing should ideally begin when any two teeth touch.  Parents should floss their children's teeth until children develop the manual dexterity to do it on their own.  Use about 18 inches of floss and tie the two ends together.  Hold the floss lightly between the thumbs and forefingers and work your way around the circle, using a clean part of the floss with each tooth.   Use a gentle, back-and-forth motion to guide the floss between the teeth.  Curve the floss into a C-shape and slide it into the space between the gum and tooth until you feel resistance.  Gently scrape the floss against the side of the tooth.  Repeat this procedure on each tooth.  Again, the easiest position to floss your child's teeth is to have him or her lie back in your lap so you can look directly down into your child's mouth.  You can actually turn this into a fun experience for you and your child!

ORAL HYGIENE FOR ORTHODONTIC PATIENTS

Interdental Toothbrush
A Proxabrush is an interdental (between the teeth) toothbrush that you may use to clean underneath and around your wires and braces. Use the Proxabrush gently to avoid damaging your wires. The Proxabrush will help you to clean your braces while maintaining healthy teeth and gums.

Electric Toothbrushes While some children and teenagers are very adept at brushing their teeth undergoing orthodontic care, the vast majority of children are less than proficient at doing so.  Many children simply don't brush long enough and the result is puffy gums and heavy plaque accumulation.  An electric toothbrush, such as the Sonicare, can significantly improve oral hygiene by the combined attributes of having ultrasonic action and a 2 minute timer on it.  For your convenience, the Sonicare toothbrush is available for purchase at our office.

 Floss Threaders
Several types of floss threaders are commercially available and can significantly help you to navigate your floss under wires and around brackets.  Although it takes longer to floss with braces, it is well worth the extra time taken to help keep your teeth and gums as clean as possible.  Gingival health is significantly compromised while you are wearing braces, so we encourage you to floss daily!

Topical Fluoride
We recommend that your child be placed on a fluoride rinse or topical fluoride gel while in braces.  This helps prevent tooth decalcification and decay while you are wearing braces by killing bacteria and replacing minerals in tooth enamel that have been exposed to harmful acids. The use of a fluoride rinse or gel does not replace daily brushing and flossing but should be done following your daily schedule at bedtime. Place a small strip of the fluoride gel on a toothbrush and apply it to your teeth for one minute and spit it out. Alternatively, if you have been prescribed a dental rinse, use about 2 teaspoons of the rinse and swish vigorously inbetween your teeth for about one minute and then spit out.  You may not eat or drink for 30 minutes after you use the fluoride rinse or gel. It is important for the active ingredient to stay on your teeth for 30 minutes, so do not wash it away by eating or drinking.

Antibacterial Mouthwash
Peroxyl, a hydrogen peroxide antiseptic mouth rinse, will reduce inflammation to your gums and cheeks. Peroxyl helps to prevent infection and decrease irritation that may develop from your braces. Rinse your mouth with two teaspoons of Peroxyl (half a capful) for one minute and then spit it out. You may use Peroxyl up to four times daily following your schedule for brushing: after meals (or after school) and before bed. Just like using peroxide for a scrape on your skin, Peroxyl helps the inside of your mouth heal. Peroxyl can be used for general irritation caused by your braces or for canker sores, cheek bites and other minor temporary injuries to the gums.

Cleaning Your Removable Appliance
Brush your removable appliance every day as a part of your regular brushing and flossing schedule. Because food particles and plaque can accumulate on your appliance just as they do on your teeth, soak the appliance daily. Dissolve a Polident, Efferdent or other denture-cleaning tablet in a glass of tap water at room temperature and soak your appliance once every day. Your appliance will taste better, and you will prevent plaque and bacterial accumulation.