Early Childhood Care (18-24 months)

Good Brushing Guidelines

This period is truly the formative time of your child’s oral health future. Good dental practices can help ensure that your child establishes a life-long commitment to their oral health, and develops the appropriate knowledge as to why ongoing oral health practices are so important.

For a child between 18 and 24 months, be sure to brush their teeth at bedtime. Additionally, it's recommended to also brush after breakfast to get into the routine of this post-meal cleaning and get them off on the right footing for the day. A good rule of thumb at this age is the “two and two” theory – brush twice a day for two minutes each time.

Some other recommended practices include:

  • Brushing too hard can cause gum damage, so brush gently with a soft-bristled toothbrush
  • Tilt the bristles at a 45-degree angle to the teeth, and slide the tips under the gums. Jiggle the bristles gently so that plaque growing under the gum is removed
  • Be sure to brush all sides of the teeth – the outside, the tongue side and the chewing surfaces. Tilt the brush, and make up and down strokes. The front part of the brush should go over the teeth and gum
  • Keep in mind that the toothbrush will only clean one or two teeth at a time. Change its position regularly to best clean each tooth (a good rule here is to count to five for each individual tooth surface area as you clean)
  • Replace the brush when the bristles begin to spread. A worn out toothbrush will not properly clean your child’s teeth

Reinforcing Good Snacking Habits

Limit a child’s snacking between meals, especially for sugary snacks. Sugar causes high levels of acid in the mouth, which can cause cavities. Try to avoid treats such as gum and hard candies that stay in the mouth for a long time. Even items that seem healthy – such as chewy granola bars and raisins – should be limited due to their high sugar content and propensity to stick on and between teeth.

We recommend giving your child snacks that are low in sugar such as vegetables, fruit, cheese or pretzels. Other healthy foods that are good for your child include breads, milk and milk products and meats. While we advocate the “two and two” approach to brushing detailed above, it’s even better to brush your child’s teeth after each meal.

Try to Avoid Surprisingly Sugary Drinks

Apple juice and milk are classic childhood drinks, but when provided in excess or at the wrong time, they could promote tooth decay. Watering down juices to a mixture of ¼ juice and ¾ water can substantially cut your child’s sugar intake. If it's a drink before bed, be sure to stick to water, since sugars in milk can linger in your child’s mouth overnight and feed the bacteria that can cause cavities. While many children in this age group derive comfort from bringing a bottle or sipping cup to bed, make sure to give them water, not a sugary alternative.

Early Signs of Tooth Decay

You should take your child to the dentist if you notice any of these warning signs:

  • Small white spots on teeth
  • Swelling of the face
  • Tiny holes in the tooth enamel
  • Pain in the mouth
  • Tooth sensitivity to heat, cold or sweets
  • Pain or sensitivity when chewing

Promoting a positive dental experience for your child

It's important to be positive when preparing your child for their dental visit every six months. Reinforce that the dentist’s job is to make their smile bright and healthy by cleaning and counting their teeth. Don’t talk to your child about pain or use the words “drill” or “shot.” Try to avoid having brothers or sisters convey dentist stories that might scare your child.