Dr. Valerie Woo grew up in the local Washington, DC area and received her undergraduate degree at University of Maryland, College Park. She went on to Harvard School of Dental Medicine where she received her DMD cum laude and completed her Pediatric Dental Residency at Children’s Hospital, Boston. Dr. Woo currently practices at NOVA Pediatric Dentistry & Orthodontics, in Ashburn, VA.
I had the pleasure of sitting down with Dr. Woo last week, to ask her LOTS of questions about caring for our children’s teeth. A tremendous thank you to her for taking time out of her very busy schedule to sit down with me and talk about pediatric dental hygiene. In fact, after our interview, Dr. Woo was heading out for a training run for an upcoming marathon. She’s also training for a triathlon. And did I mention that she has three beautiful children? Talk about an inspirational mother!
We also wanted to thank our readers who submitted interview questions via our FaceBook page. We hope you learn as much about pediatric dental hygiene as we did! Tomorrow’s post will be the second part of this interview and will cover “Going to the Dentist.”
When should parents begin to brush and floss their children’s teeth?
Parents should begin “brushing” their children’s teeth before they come in. Always use a washcloth and wipe the gums after a meal because it stimulates the child so that they don’t become orally sensitive. And it soothes the baby when they’re teething.
When their teeth come in, just the sensation (with water) is all they really need. And to make sure that debris is removed from their teeth. The non-fluoridated toothpaste is for flavor only.
Not everybody needs to floss. It’s only necessary when the child’s teeth are closer together. Around age 3 or 4, the 6 year molars are moving the teeth closer together. It’s really child dependent. A good rule of thumb is that you want to be able to clean every surface of the tooth. So if teeth are touching, they need to be flossed. There are also times when you have too much space, and food gets stuck, like corn on the cob.
How often should parents brush/floss children’s teeth?
You always want to develop good habits, even before the teeth come in. Brushing twice a day and flossing at least once a day (once they have teeth) is always recommended. With my kids, we always brush in the morning. I get each child into the routine of putting the toothbrush in their mouth. It’s about getting them more into the routine. As they improve their dexterity, they can begin brushing on their own.
When can children brush their own teeth?
A good rule of thumb is that they can start brushing their teeth on their own when they can tie their own shoes (around age 6, 7 or 8). Nowadays with all of the laceless shoes, some kids lack the dexterity until they’re about 8 years old. Let them have a turn first and then you, the parent, go in after. They tend to miss the spots in the back.
What kind of toothpaste should parents use?
I recommend Non-fluoridated toothpaste until age 2 ½, and then I recommend the toddler toothpaste, which has less fluoride (than regular adult toothpaste). Around age 6 or 7 the children can move up to normal toothpaste, once they perfect spitting. I like the fluoride rinse. The child can dip their toothbrush in and then brush their teeth.
Do you have any tips or advice for parents whose children refuse to have their teeth brushed?
Just like anything else, when you take them to have a haircut or give them a bath, try to make it as fun as possible. And switch it up. Switch up the location. You don’t have to brush their teeth in the bathroom, you can do it at the kitchen sink, or in the child’s bed. After breakfast, if your child doesn’t want to go back upstairs to brush their teeth, put a toothbrush downstairs. Use books or something other than food as a reward.
Is fluoridated toothpaste necessary/recommended? What if my water is fluoridated too?
The fluoride in the water helps strengthen the teeth that are developing. For example, a 3 year old, who has baby teeth, the fluoridated water is strengthening the adult teeth that are developing in their gums. The topical fluoride toothpaste helps strengthen the teeth already in the mouth, the baby teeth. Drinking fluoride water won’t help any weak enamel in baby teeth.
I see some kids with brown spots on their teeth. Their teeth start developing at 7 weeks when you’re pregnant. So the brown spots usually mean that mom was sick, took antibiotics, etc., when they were pregnant. But what is a mom to do if she gets sick when she’s pregnant? She’s not not going to take the antibiotic. The brown spots end up being markers of indicating when the “insult” occurred to the mom, and thus, the baby’s teeth. When we see white snow-flake spots or brown spots in their adult teeth we know that something systemic has happened to the child since they were born. That’s why sometimes parents think that it’s decay because it can all look similar. It’s called enamel hypoplasia.
What if my child swallows fluoridated toothpaste?
Research shows that even 8 year olds are still swallowing the toothpaste. Depending on your child’s weight, a normal 3 year old is 30-something pounds. In order for it to become toxic, a child would need to eat 3 large tubes of toothpaste. And it’s not cumulative. That’s why they don’t make larger tubes of toothpaste, because it’s regulated. You’d have to eat 3 large Costco size tubes of toothpaste before it gets toxic. Some kids are more sensitive to fluoride. If they swallow a little bit they’ll throw up. I don’t have a lot of that, but sometimes it does happen. Just makes them nauseous. But it’s not toxic.
What can parents do to ensure that their children have healthy teeth?
Brushing, flossing, healthy diet.
What brushing and flossing challenges do you face with your children?
-Heather
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Great interview! Teaching my kids good brushing habits was always hard for me as my kids (like many, I’m sure) don’t brush long enough, or they brush too hard. Flossing is a tough habit for them to take on as well. It’s still a struggle!
Christina Tinglof recently posted..Have Your Twins Ever Spent a Night Apart
I know what you mean, Christina! Mine love to ‘help’ brush, but we always have to go in after them. Dr. Woo convinced me during my 3 yr old’s last appt. that it was time to transition her over to toddler toothpaste, with fluoride. So we’ve been working on spitting the past couple of weeks.
And now that I know that it takes swallowing a LOT of toothpaste at one time before it becomes hazardous, I am more relaxed about it, too. So glad you enjoyed the interview!
Jennifer loves Dr. Val and her crew. The whole staff (receptionist-hygienists-dentists) is fantastic with children. She’s the one doctor whom my little girl does not fear to visit. The dental hygienists are also great with kids (very kind, patient, and gentle). We are so fortunate that Dr. Val opened her practice in this area.
You are right, they are all fantastic! I am always pleasantly surprised with how gentle and patient the dental hygienists are during their checkups. It must be hard for them sometimes, especially because kids always want to touch the tools, etc. (at least mine do). This practice take patience with children to a whole new level.
So what kind of toddler toothpaste do you use?!?! SOOOOO many kids to choose from!
I have bought Tom’s strawberry flavor, and my 3 year old won’t touch it. She doesn’t like the taste. So I buy her what Dr. Woo gave us at her last visit, Crest Kids. It has less fluoride than the adult version. What are you using now?