Prevention of Dental Caries Based on the Child's Age (Toothbrush, Toothpaste, Topical Fluoride Therapy)from Birth to Three Years of Age

1. The first dental visit should be within six months after the eruption of the first deciduous tooth and should not be delayed past 12 months of age.
2. Avoid kissing the lips of infants and tasting their food spoon to test its temperature because the cariogenic microorganism can be transferred from the adults to infants this way.
3. Avoid giving the child a milk bottle or a milk bottle containing sweetened drinks during the day and particularly during the mid-day sleep or sleep at night because saliva secretion decreases during sleep and self-irrigation of the teeth does not take place automatically. In addition, residual milk drops or syrups on tooth surfaces result in early childhood caries (ECC).
4. If giving the child a milk bottle during sleep has become a habit, the child should be embraced by the mother during feeding from a milk bottle, and his/her teeth should be immediately cleaned with a clean and soft piece of cloth after feeding, and the child should be placed in bed without a milk bottle. Concerning breastfeeding, the position and recommendation are the same. If further sucking is necessary, a pacifier is preferable to a milk bottle; otherwise, the bottle content should be only water.
5. The parents should always participate in the child’s toothbrushing activity because children in this age group have not yet acquired dexterity to properly eliminate the plaque and food debris from all tooth surfaces.
6. Clean the baby’s teeth at least once daily, preferably after meals and before sleeping at night.
7. To this end, embrace the child or use the knee-to-knee position for toothbrushing.
8. The minimum duration of toothbrushing is one minute.
9. A wet toothbrush with soft bristles and a small head is recommended.
10. A fluoride-free toothpaste or a very small amount of fluoride toothpaste (the size of a rice grain) should be used for a child who cannot send materials out of his/her mouth. The toothpaste should be pushed between the toothbrush bristles with finger pressure.
11. Children can undergo local fluoride therapy, such as fluoride varnish, in a dental office under the supervision of a dentist.
12. The use of fluoride supplements and fluoride tablets depends on the fluoride content of the drinking water in each area and is contraindicated without a dentists’ permission.

Three to Six Years of Age

1. The consumption of cariogenic snacks and foodstuff increases because of commercials on television and social media and encouragement by friends. In addition, children spend long periods away from their parents in kindergartens or other educational institutes, making it difficult to control children’s diet and orodental care. Therefore, consultation with a pedodontist might be a proper choice regarding children’s diet and introducing useful snakes to children and parents.
2. The parents should help children in toothbrushing and the use of dental floss because children’s motor skills have not adequately developed for the proper use of dental floss and a toothbrush.
3. Children are interested in becoming independent at this age and want to brush their teeth themselves. Therefore, it is recommended that the child brush his/her teeth after each meal under the parents’ supervision. However, the parents should clean children’s teeth at night.
4. Fluoride toothpastes are recommended under the parents’ supervision. A small amount of toothpaste (the size of a pea) should be placed on the toothbrush, and the child should be instructed to empty his/her mouth after toothbrushing.
5. The parents are recommended to use dental floss for their children’s teeth from three years of age.
6. Both manual and motor-driven toothbrushes can be used. It is recommended that toothbrushes with cartoon figures and colorful ones be used because they are more attractive and increase the acceptance of toothbrushing by children.
7. Fluoride varnishes are not recommended in children <6 years of age because most preschool children cannot avoid swallowing these products.
8. Fluoride therapy is recommended in the dental office 2-4 times a year, considering the caries risk in children.
9. The use of fluoride supplements depends on the fluoride content of the drinking water in each area and is prescribed by a pedodontist by considering the caries risk.

Six to Twelve Years of Age

1. At this age range, the child binges on snacks and chocolates. On the other hand, the permanent teeth begin to erupt. Therefore, more attention should be directed toward children’s dental health.
2. Daily use of fluoride toothpastes is recommended.
3. Although it is ideal to brush the teeth after each meal, it is not possible at this age range.
4. A proper recommendation is correct brushing of teeth with fluoride toothpaste and massaging the gingiva before going to bed at night and after breakfast in the morning. Rinsing the oral cavity with water is sufficient after lunch.
5. At this age range, the parents should remain an active supervisor in their children’s oral care.
6. Since fine motor activities are developing during this period, the parents should help children clean the buccal surface (the external surface) of maxillary molars and the lingual surface (the internal surface) of mandibular molars.
7. Larger toothbrushes are recommended with an increase in the oral cavity dimensions and the number of teeth.
8. Toothbrushes with soft nylon bristles are recommended.
9. Different motor-driven toothbrushes are available on the market, which might help clean children’s teeth. The advantages of power-driven toothbrushes include smaller brush heads, use of brighter colors, use of popular cartoon characters, and timers, which make them attractive for children and adolescents.
10. It is necessary to use dental floss. Parents should help children use dental floss at a young age. However, from 10 years of age, children acquire the dexterity to use dental floss. Improper use of dental floss, i.e., its sudden movement in interdental areas, might injure gingival tissues. Immediately after the tooth floss is moved past the interdental contact, it should clean one surface and then be applied on the other surface. The floss should be moved to the subgingival area (up to 1 mm) to clean this area.
11. When the deciduous teeth are shed and permanent teeth erupt, the gingiva might become tender or even swollen, decreasing children’s interest in proper cleaning of the mouth. Therefore, children should become aware that it is necessary to clean these areas with a toothbrush to maintain the health of gingival tissues.
12. Children susceptible to dental caries can use fluoride mouthwashes weekly.
13. Local fluoride therapy in the dental office is strongly recommended.
14. Fissure sealants are recommended for newly erupted teeth, especially the permanent first and second molar teeth.
15. Depending on the fluoride content of the drinking water in each region, fluoride tablets are prescribed by the dentist.
16. Xylitol chewing gums with anticariogenic effects are recommended.