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For parents struggling with daily tooth brushing duties for their children, Keith Jones, a pediatric dentist and owner of Small Bites Pediatric Dentistry, says good dental health ultimately starts with establishing a routine. 

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“Brushing at night before we go to bed is the most important. Brushing in the morning is for bad breath, but brushing at night is for preventing cavities,” he said. “But I think kids do really well with consistency and having that time set aside.”

Even small children need to get in the routine. 

“The American Academy of Pediatric Dentistry recommends their first checkup at 1 year of age,” he said. “Your child may not have a lot of teeth at that time, but it’s to educate the parents early on. The earlier I can educate you on how to take care of your kid’s teeth, the better chance they have of not getting a cavity.”

Toothbrushes don’t have to be fancy, although many now play music and have spinning brushes, but Jones does recommend a toothpaste with fluoride. Flossing becomes more important around ages 3, 4 and 5. 

“Another thing I like to tell parents is you don’t need a commercial swirl of toothpaste on your toothbrush. You can use a flouride toothpaste, but you just need a smear. It’s not going to hurt them if they swallow it,” he said. 

Also, don’t expect perfection. Don’t worry too much if your child loses steam before two minutes. 

“To me, the act of just brushing and starting at a young age is overly important. I’m all about the two-minute rule, but I would rather us just start to get in the habit of doing it. And then worrying about the time,” he said. 

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When it comes to how young teeth are growing and developing, the American Association of Orthodontics recommends children have a checkup from an orthodontist by age 7. Orthodontists can detect early problems with jaw growth and emerging teeth, even if baby teeth are still present. Early checkups and treatments can correct detrimental oral habits or help guide the teeth into a better position. 

Though orthodontist treatment to correct teeth alignment frequently means braces, early detection may call for other treatments such as expanders, clear aligners or temporary anchorage devices, which are surgical micro-screws that prevent teeth from moving. 

Braces are generally used to treat crowded teeth or gapped teeth, correct overbites or underbites, and affect impacted or missing teeth. Parents may be surprised to learn that traditional metal braces now come in ceramic and clear versions as well as lingual versions that can be worn on the back side of the teeth. Clear aligners are custom-sized, removable appliances, which gradually move teeth to the prescribed position. 

Other children may be prescribed expanders, which sit in the palate and gradually widen the upper jaw. The upper jaw develops as two halves, which don’t fuse together permanently until puberty. This treatment capitalizes on this development and takes the opportunity to add more space. Expanders are typically used to treat crossbite, crowding or impacted teeth. They are metal halves connected in the center with a screw, which is typically turned a little each day with a key. They are generally worn for three to six months. 

Today’s orthodontists can go beyond conventional dental X-rays to get a 3D picture of teeth as well as the entire jaw and bone structure. In addition, planning software can help doctors create a custom treatment plan for each patient based on their facial structure. Children can also see what their smile will look like after treatment is finished. 

When it comes to taking care of teeth, consistency and prevention are the best course of action, Jones said. 

“We see so much tooth decay that it doesn’t spare any social or economic status,” he said. “One in five children have an untreated cavity, so it’s not as baked into the routine for everyone as it should be. I think it’s the simple act of using a toothbrush, and toothpaste with fluoride, and the act of brushing that’s most important to me.”