Winter 2016 Health Link Online

HealthLink Online

Uniting Children, Parents, Caregivers, and Health Professionals

Dental Decay in Young Children-Prevention Strategies

Dental Decay in Young Children-Prevention Strategies

The Centers for Disease Control and Prevention (CDC) estimates that 44% of young children less than 5 years of age have already had tooth de-cay.  Tooth decay causes eating, speaking, learn-ing and behavior problems for young children.  Yearly, children in the United States miss over 51 million hours of school due to dental pain.

Here are some practical strategies to prevent dental disease:

  • Have toddlers and preschool children do “Classroom Circle Brushing” after meals: With the children seated as a group at a table, supervise them brushing their teeth with toothpaste for 2 minutes. No rinsing of the mouth is needed.  
  • Teachers can demonstrate for the group how to clean all tooth surfaces while brushing their own teeth or while helping a different child do good tooth brushing each day.  
  • All children should brush with fluoride toothpaste. Use only a rice grain-sized “smear” for children less than 3 years of age, and a “pea-sized” amount for children older than 3. With such a tiny amount of toothpaste, children can safely swallow it. 
  • Staff can ask their own dentists to donate sample toothpaste and tooth brushes. Ask community service organizations, e.g. the Rotary Club or Kiwanis to donate the cost of supplies. 
  • Consider using the Head Start poster, “Classroom Circle Brushing” at View the richly populated Health section of the Head Start Early Childhood Learning and Knowledge Center website at This website has many materials and activities to use in the program and to share with parents.  
  • Use the following method for tooth brushing in the program:
    • Choose toothbrushes with soft, rounded, polished nylon bristles and handles that fit the storage rack. Put the child’s name on the handle with permanent marker. 
    • Rinse toothbrushes with water after each use, then store them upright to air dry. Space them so they don’t touch or drip on each other. Use a commercial rack or a well washed and sanitized Styrofoam egg carton, closed and placed flat-side down. Write children’s names on the egg-shaped protuberances after making holes in the protuberances for the toothbrush handles.
    • Replace toothbrushes every 3-4 months -sooner if the bristles are worn or splayed. 
    • Give each child toothpaste on a square of wax paper or on the edge of a paper cup. Children can scoop up the toothpaste with their tooth brush.  
  • Limit juice to no more than once a day. Give juice only when children are sitting down at a meal. Offer no more than a total of four to six ounces per day, combining amounts the child drinks at home and in  school. 
  • Use only 100% juice or don’t serve juice in school at all 
  • Give children a regular cup to drink from (not a sippy cup) - just start with a few ounces in case the cup spills  
  • Offer only water between meals; make wa-ter freely available. Ideally use tap water with fluoride. 

Share information with parents about preventing dental disease. Urge them to take their children to the dentist within 6 months of the first tooth, or by 1 year of age at the latest.

  • Starting at a year of age, children should get fluoride varnish applied to their teeth in the dentist’s or their primary health care provider’s office, every 3 to 4 months.
  • Emphasize these reminders:
    • 1st dentist visit by 1st Birthday! 
    • 1st tooth, 1st toothbrush!
    • 2 X 2 or “two times two” – Brush twice a day for two minutes!
    • Children need adult help with brushing twice a day for two minutes until they are 7-8 years old. 

ECELS hosted an Oral Health Webinar in October 2015 with the PA AAP’s Healthy Teeth, Healthy Children program and the PA Head Start Associa-tion’s Healthy Smiles initiative.  Access the ECELS website for the  audio recording of the webinar, the presentation slides and the evaluation form. Submit the completed evaluation form to claim PA Key and Act 48 credit. Go to Select the Professional Development tab, then Webinars, and then scroll down the alphabetical listings to “Oral Health.”

Article Contributed by Amy Requa, MSN, CRNP, State Oral Health Coordinator, PA Head Start Association

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