An element of tooth protection, plaque removal, should start as early as possible. Initially clean the incisor teeth with a cotton wool bud or a small baby's toothbrush, with only a tiny smidgen of toothpaste. But as the baby develops hand-to-eye coordination it is a good idea to give it a small toothbrush to play with at bath time, providing always that you also clean the teeth properly. Do remember to clean both the inside and outside of the teeth. An adult cleaning a child's teeth at night is not an optional task. Like cleaning the face it has to be done, and is best accomplished by standing behind the small child, in the way that the dentist works from behind you in the surgery.
Using a fluoride toothpaste is always a good idea, providing it is only a smear until the child is capable of spitting it out rather than swallowing it. There have been cases of small children swallowing too much, and getting fluoridized mottled teeth. Always keep tooth-paste out of the reach of children, as they have a habit of eating it given half a chance. By the age of 6 or 7 most children should be able to clean their teeth adequately, even if the results still have to be checked by adults.
Fluoride can enter the tooth in two other ways. It occurs naturally in the water in some places in the UK, where it has been known to create the mottled teeth referred to above. It can also be added to the public water supply, as it has been in the West Midlands. Fluoride can also be administrated personally in the form of tablets or drops. The tablets, which have pleasant flavors, are either crunched or allowed to dissolve, the drops are added to water. Children should not use either of these if they are also using fluoride toothpaste – it must be one or the other.
Although these fluoride additives not only protect teeth against decay but also repair very slightly declined areas of tooth, they should only be used after consultation with your dentist or doctor. And you must always check on the local water supply to find the level of fluoride before embarking on a personal dosage course. You should not use them if the water contains more than 5 parts fluoride per million. And, if the family drinks a reasonable amount of bottled water, the contents bought to be scrutinized for fluoride levels as well. In any event the drops should not be used until the baby is over 6 months old, and the tablets delayed until the child is over 2 years old, and again neither of them should be used if the child is already using fluoride toothpaste.