Good Oral Hygiene from Birth and Beyond

For many of us, good oral hygiene consists of brushing our pearly whites twice a day. But dental hygienist Patti Bradley reminds us that truly good oral hygiene requires more than just a toothbrush, and it begins before we get any teeth at all.

Bradley, who works in the Division of Periodontics at MUSC's James B. Edwards College of Dental Medicine, says our oral hygiene care changes from infancy to adulthood. She advises parents to begin taking care of their little one's gums soon after birth and continue to instill good habits through the teen years.

Birth to 2 Years

"Before a baby's first teeth come in, it's important to wipe the gums with gauze or a soft cloth after their feeding," she says. "You can also clean the gums with a washcloth during bath time."
As baby teeth begin to come in, usually between 6 and 8 months, parents should continue to clean the gums and add a soft toothbrush. "A tiny dot of fluoride toothpaste can be used to strengthen the enamel. If the baby rejects the paste, a simple brushing will get the plaque off teeth," she says.

Bradley urges parents to resist putting a baby to bed with a bottle containing milk or juice. "Milk and fruit juices contain sugar and tend to pool around the gums and teeth, causing what's known as baby bottle tooth decay," Bradley says. "Give a bottle only at feeding time," she says.

As soon as your baby is able to sit up, introduce a sippy cup to reduce bottle time. And if your baby uses a pacifier, avoid dipping it into a sweet beverage or rubbing it with a sweet substance.

3-6 Years

Between the ages of 3 and 6, a child should have 20 baby teeth. Nearly half the children in this age group have cavities, Bradley says. This is when a child should brush, or have their teeth brushed, twice daily with a small dot of fluoride toothpaste. And don't forget the importance of diet. Avoid giving a child a lot of sugary or sticky snacks between meals and replace them with healthier options. Begin regular dental check-ups since this is a high-risk time for decay.

"Children at this age usually want to brush their own teeth, so encourage them to do so," she says. "Most like to chew on the soft brush, which helps get rid of plaque. Still, parents should finish the tooth-brushing just to make sure the teeth are properly cleaned."

6-12 Years

Children begin losing their baby teeth and getting their permanent teeth during these years, creating a "mixed dentition" with teeth closer together. This is a good time for parents to introduce flossing, particularly in those hard-to-clean areas in the back of the mouth, Bradley says. Brushing along the gum line where pesky bacterial plaque can build up is essential for preventing tooth decay and inflammation along the gum line.

"Dental visits are particularly important at these ages," Bradley says. As a preventive measure, a dentist or hygienist can apply a clear or white-colored dental sealant over the top of the permanent molars to cover fissures and pits that can trap plaque, which is responsible for 90% of tooth decay. When applied properly, dental sealants can last for several years before they start to break down.

A topical fluoride treatment to strengthen tooth enamel against decay can also be used as a preventive measure and can last up to four months.

13-18 Years

Between 13 and 18, almost all the baby teeth have been replaced by 28 permanent teeth, excluding wisdom teeth. The teen years are also when dental decay increases. "Lifestyle changes, eating habits, sugary drinks including diet soda and less time spent on good oral hygiene are the culprits," Bradley says.

"Educating teens during dental visits and reinforcing good home care along with preventive treatment are the best measures for setting up lifelong good oral hygiene habits."

Regardless of our age, we can't afford to give our teeth the "brush-off." A conversation with Bradley about the importance of oral hygiene and the harm that bacteria-laden plaque can inflict on our teeth and gums is enough to make anyone carry a toothbrush at all times.

Ever heard of an acid attack? It happens. After we consume sugary food and drinks, the bacteria in plaque react with sugar to produce acid that attacks out teeth, weakening the enamel, for about 20 minutes. The process is referred to as "a 20 minute-acid attack."

It's recommended to wait at least 20 minutes for the plaque to neutralize before brushing and flossing, Bradley says, because brushing teeth during an acid attack can potentially damage the enamel. On the other hand, leaving the plaque on the teeth too long can cause decay and inflammation at the gumline.

Although the battle against bacteria and plaque may seem epic, we're not defenseless, as Bradley reminds us.

"Prevention and education are the key," she says. "Brush regularly with a fluoride toothpaste, floss, get regular dental check-ups and avoid or cut down on sugar."

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The James B. Edwards College of Dental Medicine offers several dental clinics for the public. The Student Dental Clinic offers affordable, routine adult and pediatric care provided by dental students who work under the supervision of dental faculty. Call 843-876-7645 for more information. The Dental Faculty Practice Clinic provides comprehensive care for adults and children by skilled practitioners. For an appointment and information on services, call 843-792-3444.