Even your smallest patients have a big need for proper oral care instructions. While largely preventable, childhood caries remains a prevalent disease worldwide1. Oral care habits develop early, and it’s imperative that your patients have the tools necessary to keep their mouths healthy.
Small children are unique as they have limited dexterity and tiny mouths, and they require their parents and caregivers to help them to brush properly2. Children may also present additional challenges for optimal oral health as they may eat sugary foods and drinks, engage in frequent snacking, and/or have behaviors that may prevent their caregiver from helping them to brush.
When these challenges are present, it is important to use a toothbrush that helps to remove plaque quickly and efficiently for healthier teeth and gums. This can be achieved by introducing an electric toothbrush to your patients ages three and up, as well as by instructing caregivers how to incorporate the brush into their child’s daily routine.
We know electric toothbrushes are great for adults, but how do we know if they’re great for children?
Evidence supports that using an electric rechargeable toothbrush reduces plaque and gingivitis in adult users3,4. In addition, electric rechargeable oscillating-rotating toothbrush users are 7.4 times more likely to transition to a healthy gingival state compared to manual brush users3. Moreover, an 11-year cohort study showed that electric rechargeable users had 20% less tooth loss when compared to manual users5.
Considering all these amazing benefits for adults, shouldn’t we encourage power brush usage for our pediatric patients as well? A recent study showed that children’s oral health is influenced mainly by toothbrush type (with oscillation-rotation toothbrushes associated with better outcomes versus manual), starting age for brushing, and twice daily brushing6.
Furthermore, children who used an oscillating-rotating toothbrush were more likely to have less plaque and gingivitis and be caries-free versus manual brush users6. Children as young as 3 years old can benefit from an electric toothbrush. Evidence shows that in children ages 3 to 9, an oscillating-rotating toothbrush removed significantly more whole mouth, interproximal, buccal, and lingual plaque when compared to a manual brush control7.
Some caregivers may push back and say that since primary teeth are temporary, they do not need to be cared for. However, you can share with them the issues that may arise from poor oral health in children.
To begin, children with decayed, missing, or filled teeth are more likely to experience pain, anxiety, and functional limitations8. Also, it’s important to communicate to caregivers that primary teeth are important for speech development, chewing, and jaw development9.
In addition, children with caries in their primary teeth are more likely to have not only caries in their permanent teeth, but a higher rate of caries as compared to children who were caries free10.
How do we encourage children and their parents to use the electric toothbrush?
For your pediatric patients, an electric toothbrush can be introduced in a stepwise approach. While there may be several barriers to regular electric toothbrush usage, proper communication from the dental professional can help to overcome these issues to achieve optimal oral health. With the pediatric population, the tell-show-do approach can be applied:
• Tell: Explain to the caregiver and child a few of the previously mentioned benefits of electric toothbrush usage. Recommend the best brushing options, including brand recommendation if you have one. You may consider dispensing at your office as a quick follow-up to your recommendation. You can also ask the parent to bring in the child’s electric rechargeable toothbrush if they have one at home to ensure proper usage. Explain to the child that you will be practicing brushing their teeth with a special toothbrush that is fun to use.
• Show: Show the patient and their caregiver the brush and make them aware of the various features to improve their child’s brushing routine. For example, the Oral-B Kids 3+ electric rechargeable toothbrush has a small, round brush head that helps to adapt to tooth surfaces for a great clean. The fun colors and characters may even please both the child and the caregiver. Additionally, the brush has a two-minute timer built in to help ensure brushing time compliance. If you want to make the brushing routine even more fun, you can couple it with Oral-B’s Disney Magic Timer app, which will play music while you brush, and an image will appear during the two minutes. Explain to the child that the brush will make noise when you turn it on because it’s different than a manual brush since it will help do the brushing for you. Personally, I will run the brush on the child’s fingernail briefly to show them that the brush may feel “a little silly, but it’s just tickling your teeth to make them nice and clean.”
• Do: Have the child hold a hand mirror so they can see what you’re doing while you brush their teeth. Explain to the child and their caregiver all the different areas to brush and how brushing with an electric rechargeable brush is different from using a manual brush. From there, give the caregiver a turn to brush so you can make suggestions as needed. You can let the child try to brush as well, but make it clear to the caregiver that children need help brushing until they are about 7 years old. I tell caregivers that if the child can’t tie their shoes on their own, then they can’t brush their teeth on their own.
Finally, encourage the caregiver to be adamant about incorporating the brush into their child’s daily routine. The caregiver should be brushing their child’s teeth twice daily for two minutes with a fluoridated toothpaste. It may take time for them to get used to the new electric rechargeable brush, but it will be worth it in the long term for their improved oral health. As stated previously, while largely preventable, childhood caries is still pervasive in our society. But with proper communication and encouragement from dental professionals, together, we can conquer cavities.
References
- Phantumvanit P, Makino Y, Ogawa H, Rugg-Gunn A, Moynihan P, Petersen PE, Evans W, Feldens CA, Lo E, Khoshnevisan MH, Baez R, Varenne B, Vichayanrat T, Songpaisan Y, Woodward M, Nakornchai S, Ungchusak C. WHO Global Consultation on Public Health Intervention against Early Childhood Caries. Community Dent Oral Epidemiol. 2018 Jun;46(3):280-287. doi: 10.1111/cdoe.12362. Epub 2018 Jan 30. PMID: 29380407.
- Nowak AJ, Skotowski MC, Cugini M, Warren PR. A practice based study of a children’s power toothbrush: efficacy and acceptance. Compend Contin Educ Dent. 2002 Mar;23(3 Suppl 2):25-32. PMID: 12789956.
- Grender J, Adam R, Zou Y. The effects of oscillating-rotating electric toothbrushes on plaque and gingival health: A meta-analysis. Am J Dent. 2020 Feb;33(1):3-11. PMID: 32056408.
- Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM. Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD002281. DOI: 10.1002/14651858.CD002281.pub3.
- Pitchika V, Pink C, Völzke H, Welk A, Kocher T, Holtfreter B. Long-term impact of powered toothbrush on oral health: 11-year cohort study. J Clin Periodontol. 2019 Jul;46(7):713-722. doi: 10.1111/jcpe.13126. Epub 2019 May 22. PMID: 31115952; PMCID: PMC6619286.
- Davidovich E, Grender J, Zini A. Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study. Int J Environ Res Public Health 2020;17(22); 8595. https://doi.org/10.3390/ijerph17228595
- Davidovich E, Ccahuana-Vasquez RA, Timm H, Grender J, Zini A. Randomised clinical study of plaque removal efficacy of an electric toothbrush in primary and mixed dentition. Int J Paediatr Dent. 2020 Nov 22. doi: 10.1111/ipd.12753. Epub ahead of print. PMID: 33225464.
- Alsumait A, ElSalhy M, Raine K, Cor K, Gokiert R, Al-Mutawa S, Amin M. Impact of dental health on children’s oral health-related quality of life: a cross-sectional study. Health Qual Life Outcomes. 2015 Jul 7;13:98. doi: 10.1186/s12955-015-0283-8. PMID: 26149439; PMCID: PMC4491877.
- https://www.eapd.eu/index.php/post/prevention-is-effective-when-it-starts-early
- Hall-Scullin E, Whitehead H, Milsom K, Tickle M, Su TL, Walsh T. Longitudinal Study of Caries Development from Childhood to Adolescence. J Dent Res. 2017 Jul;96(7):762-767. doi: 10.1177/0022034517696457. Epub 2017 Mar 6. PMID: 28571506.
Dr. Gans graduated from the Ohio State University’s College of Dentistry in 2013 and advanced her training by completing a general practice residency at Saint Vincent Charity Hospital. She practiced dentistry in her hometown of Cleveland, Ohio, prior to joining Procter & Gamble in the fall of 2018. She is currently a P&G Professional and Scientific Relations Manager for Crest + Oral-B. Her goal is to teach dental professionals about the recent advances in paste and power brush technology to help improve oral health. In her free time, she enjoys spending time with her friends and family. She has five siblings including an identical twin who is also a dentist. She also enjoys swimming, running, scuba diving, and boating.
Crest + Oral B also offer continuing education courses via Dentalcare.com, including Smiles for Tomorrow and Using an Evidence-Based Approach to Making Patient Recommendations for Power Toothbrushes.
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