Proper oral hygiene can be achieved and maintained by mechanical and chemical means at home. Tooth brushing skills must therefore be emphasized strongly and taught to children of all ages as well as their parents. It is important that parents are instructed to initiate tooth brushing from the eruption of the very first tooth and that a proper tooth brushing regimen should have been established when the first primary molars erupt. Parents should be shown a technique and be trained on how to use it. Since small children cannot keep up an effective oral hygiene by themselves, parents must perform tooth brushing at least up to the age of 6 years and thereafter regularly supervise the procedure.
The special problem associated with the cleaning of the first permanent molar should be underlined. A soft toothbrush of appropriate size and fluoridated toothpaste are the most effective aids for oral hygiene in the primary and mixed dentition. The use of disclosing tablets or liquids should be recommended when necessary. An electric toothbrush has a similar cleaning effect as manual brushing and may be a motivating tool for some children and an excellent help for disabled patients. Dental floss and toothpicks normally should be considered only for the fully erupted permanent dentition.
Some general recommendations concerning tooth brushing can be given:
- Tooth brushing should be initiated from the eruption of the first tooth and proper regular tooth brushing should have been established when the first primary molar is erupting.
- Brush the teeth twice daily: after breakfast and before bedtime.
- Select a soft brush with a small head and a large handle for the youngest children.
- Use a small amount of fluoridated toothpaste.