* This post was published on https://www.milowekids.com

Hygiene while sheltering in place

As a pediatric dentist, I didn’t expect to be entering so many people’s living rooms (and bathrooms) via telemedicine during these unprecedented and unusual times.

I have done telemedicine consults following traumas, had calls in the middle of the night during teething crisis’, have been asked to stay on and watch as parents floss and brush because goldfish and seaweed stains just weren’t coming off, and my favorite, have been asked to “scare (my) kids into brushing!” These are difficult times, parents, and we all need each other!

No matter how old your child is, whether an infant or a teen, it is never easy to maintain a home oral hygiene routine. Now that months have gone by, and our routines have changed, I’ve heard that nursing mothers are finding that their children are nursing more and falling asleep before brushing.

Mothers of toddlers are worried because their children aren’t always brushing twice a day (and some are getting less compliant in well, everything!). A mother of twelve and fourteen year old brothers called me screaming the other day “Their breath smells so rancid I don’t even want to stand next to them!

Their teeth are probably rotting and he doesn’t care!” Everyone’s concerns are valid: If our children don’t have routine oral hygiene at home, teeth will get stained, gums will get inflamed, and cavities can form. However, let’s be real, parents: we are all trying our best!

Below are a few home oral hygiene tips I’ve put together together for these uncertain times and I’ve divided them by age group:

Babies:

To maintain good oral hygiene for your baby, try to keep a wet 2×2 gauze handy (in a wipes warmer or BPA_free container) and wipe your child’s gums and teeth after every feeding. This includes right before bed. If you nurse or bottle-feed for the child to fall asleep and there are no teeth yet, my nighttime trick is to use a warm gauze to wipe the gums so as not to wake up the child.

If teeth have erupted, I always recommend brushing with a soft-bristled toothbrush at least twice a day, in the morning and at night, after the last feeding. You can keep a softbristled toothbrush right by where you feed so as not to disturb the child with the bright lights of a bathroom and then wipe down the teeth after brushing with a washcloth or gauze.

Toddler:

Floss (if there are tight contacts between the teeth) and brush your toddler’s teeth twice a day, every day. Yes, floss. Nobody needs food getting trapped in between teeth. It leads to inflamed gums and cavities. String floss works great; I prefer it over picks but use what is easiest for you. The goal is to get the job done.

If you’re the “brush before eating” type and brushed your toddler’s teeth in the bathroom in the morning, kudos! If you’re a “brush after breakfast” kind of family then you can brush in the kitchen after the meal. What, the kitchen?! Yes. The most common complaint I hear about AM brushing is that “I can’t get them into the bathroom to brush.”

Although it’s generally recommended to wait around 30 minutes before or after eating to brush, if this isn’t possible, then keep floss, a toothbrush and toothpaste in the kitchen. If you have a combative toddler, use a high chair or booster chair to your advantage: it keeps their feet under a table and you can keep their hands busy with a toy or mirror.

Also, it’s important to give your child water after snacks and lunch to rinse their mouth and… keep snacking restricted to designated times. Snacking on one bowl of cereal throughout the day is much worse for the health of the mouth than eating it in one sitting.

School Age:

If you keep hearing from child “I just don’t have time in the morning,” or “I forget to brush in the bathroom,” I really do love the brushing in the kitchen trick. When they clear their plate, their toothbrush and floss will be waiting right there for them. I have an extra electric toothbrush, toothpaste, and mouthwash at my kitchen sink AND a mirror in front of the sink so that my kids can watch themselves floss and brush.

Also, as for snacking, try to avoid “sticky” food if you can avoid it. Examples include gold fish, pirate booty, KIND bars and dried fruit. The best snacks are fresh vegetables and/or fresh fruits with a protein. However, regardless of what type of snack your child has, make sure to provide them with water to wash it down with.

Also, keep a water bottle by their work station at all times. I don’t think kids are drinking enough water at home because unlike at camp and school, there are no “water breaks.”

Teenagers:

Some teens have been obsessed with their oral and face hygiene due to it being “in shelter selfie season” and other just forgot all about it. I’ve basically told teens during telemedicine consults that if they don’t start flossing, brushing, and using mouthwash starting tomorrow, three times a day, they’ll get gum disease and well, it’s disgusting.

Also, water! Remind your teens to drink lots and lots of water throughout the day. At least the snacks can be watered down and their mouths won’t be so dry.
Also, I’ve had numerous TMJ emergencies during our time in-shelter. I attribute this to clenching and grinding during online sessions. Reminding your teen to take water breaks not only forces the jaw to relax but also hydrates the oral cavity.

Last but not least, don’t be afraid to schedule an appointment with your pediatric dentist as needed. If you think you’re doing a good job with brushing at least twice a day and eating well, then a telemedicine consult is fine to review home oral health and for your pediatric dentist to evaluate the gingiva and the developing teeth. If your child is experiencing any pain or you see any concerning teeth staining, food trapping, or problems with the gums, then schedule an appointment in office to evaluate because you don’t want anything to get worse.

Take home message:

  • Keep gauze and tooth wipes handy
  • Floss, Toothbrush, toothpaste, and mouthwash in the kitchen
  • Brush before bed (and no snacks or eating after)
  • WATER WATER WATER
  • And deep breaths.

As I mentioned. we are all in this together. And yes, my children have sprinkles (although dye free!) on their ice cream; we just brush and floss really well before bed on those nights. 🙂