In order of decreasing importance:
1. Fluoride: Our best medicine to prevent cavities is fluoride in water, toothpaste, in the dental office or as a daily diet supplement. Fluoride strengthens the enamel of teeth and makes them more resistant to germs. If fluoride is not in your water supply, as in almost all of the Portland metro area, then a daily supplement is needed. It should be taken from age 6 months through the teen years to strengthen the teeth already in the mouth and the adult teeth as they grow.
Fluoride toothpastes should be used on children over the age of two. Use only a small rice size smear into the bristles, encourage spitting out the bubbles, and no swallowing (hard for young ones so you must control the amount used).
2. Flossing: Many parents are surprised that flossing is even more important than brushing. Flossing cleans the germs off between the teeth where the germs like to hide and where cavities are hard to see. The germs (bacteria) are the real problem with cavities. They grow in every mouth but when they are allowed to rest on the tooth for more than a day, they start dissolving away the tooth and forming a cavity.
3. Brushing: Cleaning away the germs from the gum-lines and in the deep grooves of teeth will prevent them from attacking the enamel and making cavities. Brushing under the flap of skin that covers the teeth is difficult so you must spend extra time and attention on these areas.
4. Check-ups: Regular check-ups with your dentist every 6 months are the best way to keep your child comfortable with the dentist. This also keeps track of facial growth and orthodontic development, will reinforce home cleaning abilities, and check for cavities or gum problems.
5. Sealants: Sealants are plastic coatings that protect the rough biting surfaces of back teeth where toothbrush bristles may not reach. The first molars erupt at about age 6, most of the other back teeth come in by age 12. Although sealants are a great preventative help, they do not guarantee that sealed teeth will not get a cavity; brushing, flossing, and regular check-ups are necessary to make sure the sealants are working well.
6. Diet: Starches and sugar, even natural sugars in fruit or juice or milk, feed the germs on everyone’s teeth and they in turn make acid to dissolve the teeth. The more often you eat or drink sugary or starchy foods, the more acid is made and the more cavities you will get. Eating a lot of candy at one time is healthier for your teeth than sipping soda or snacking all day.