Parents Center: Tooth Care (age 2 to 4)

What's the best way to brush my child's teeth?
While your child's early teeth are still coming in, you can clean them with a wet washcloth or a piece of gauze. By the time her back molars have come in (around 18 months), you can switch to a soft nylon-bristle child's toothbrush. Using a pea-sized amount of toothpaste, gently brush the teeth on both the outside and inside surfaces twice a day. Brush her tongue as well (if she'll let you) to dislodge the bacteria that can cause bad breath. Replace the toothbrush as soon as the bristles start to look worn or splayed out.

When should I let my child start brushing her own teeth?
As soon as she is willing and able, it's a good idea to let her try to brush her own teeth, even though she probably won't be able to do a good job of it until she's about school age. Brush your teeth while she's doing hers, and then "check" each other's teeth to see if they're clean. If her teeth sparkle and reflect light, she's done a good job. If not, tell her you think she "missed a spot" and finish the job for her. Most children do not have the coordination to brush their teeth adequately until they have mastered using a knife and fork.

What should I do if my child won't brush?
If your child fusses every time it's time to brush, it might help to buy her a toothbrush or paste with a special cartoon character on it. According to Liz Birka White, a mother of three in Diablo, California, this worked well for all of her children: "Adam, my firstborn, really hated brushing until I bought him an Elmo toothbrush. From that day on, he couldn't get enough. It was just the ticket I needed to interest him in brushing." You can also let your child have several brushes in different colors so that she can choose the one she wants when it's time to brush.

When does my child need fluoride and how can I tell if she's getting the right amount?
Developing teeth can certainly benefit from a little fluoride. This mineral prevents tooth decay by strengthening tooth enamel and making it more resistant to acids and harmful bacteria. Most municipal water supplies are fortified with fluoride. (Call your local water authority or ask your dentist about yours.) If it isn't, or if you get your water from a well, consider buying a test kit from a hardware store to determine the fluoride level in your water supply. If it's less than .3 parts per million, ask your pediatrician whether you should give your child a supplement (the amount recommended for children under 3 is .25 milligrams per day). He can prescribe a fluoride supplement in the form of drops or chewable tablets.

A little fluoride is a good thing for your child's teeth, but swallowing too much of it over time can lead to a condition called fluorosis that can cause white spots to show up on her adult teeth. If you live in an area with fluoridated water, your child is most likely getting plenty of fluoride. Bottled water and fruit juices may also contain fluoride, although the amount is rarely listed on the label. If your child is using a fluoridated toothpaste, you should let her use only a pea-sized drop each time. This is because young children tend to swallow their toothpaste rather than spit it out. Swallowing too much toothpaste over time can lead to fluorosis.

When should I start taking my child to the dentist?
The American Academy of Pediatrics and most pediatric dentists say it's a good idea to bring your child to a dentist around the time she turns 1. If you haven't yet taken her for a dental checkup, consider making an appointment soon, especially if you notice any signs of tooth decay such mouth pain, particularly while eating.

source from http://parentcenter.babycenter.com