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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Oral Hygiene

Brushing
Before teeth erupt, caregivers should wash the gums and tongue with a wet washcloth after feedings.

With eruption of the first tooth, begin brushing with a soft-bristled, small-head brush using a smear (grain of rice sized amount) of fluoride toothpaste. On the third birthday the amount may be increased to pea-sized.

The most important time to brush is at night, after the last feeding.

Parents should brush the child’s teeth at least twice a day (morning and night) once teeth erupt.

Children should not be allowed to consume any sugary liquids such as milk or juice after brushing at night (water only).

Caregivers should position themselves behind the child.

All the surfaces of every tooth should be brushed.

Caregivers should lift the lip to brush the top gum line, pull down the lip to brush the bottom gum line, and brush the top of all the molars.

Toothbrushing should be performed or assisted by the parent until the child is 7 or 8 years of age.

Toothbrushing should be supervised thereafter until the child can do an adequate job of brushing alone.

Flossing
Parents should begin flossing the child’s teeth as soon as the surfaces of the teeth touch one another.

Flossing should be done once a day, preferably with the evening brushing.

Flossing should be assisted by a parent until the child is 10 years old.

 
Fast Facts
 
With eruption of the first tooth, parents should begin brushing with a soft-bristled, small-head brush and a smear of fluoride toothpaste.
 
The most important time to brush is at night, after the last feeding, with children being allowed to consume only water afterwards.
 
To prevent fluorosis, parents should make efforts to minimize the swallowing of toothpaste.
 
Parents should begin flossing the child’s teeth as soon as the tooth surfaces touch each other.
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