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Fluoride additives

For kids at high risk for caries and ones who always seem to have cavities, a fluoride additive to their routine is a must. Personally, I always start with recommending Act fluoride rinse (actoralcare.com).

When presenting this product, it is important to stress that the child must swish for at least 15 seconds before spitting out. Also, to get the best results the child should not rinse or eat for at least 30 minutes. When I explain the reasoning behind this, a lightbulb goes off with the parents. It’s one of those things they otherwise wouldn’t think about.

Sometimes after a few visits it may appear that a fluoride rinse is insufficient. In these cases, I ask the parent if the child is using the rinse daily. If the parent assures me the child is, then I will change my recommendation to a fluoridated toothpaste prescription such as Colgate PreviDent (colgate.com).

In discussing PreviDent, I give similar instructions as with the fluoride rinse: brush and then spit out excess toothpaste, but do not rinse or eat for 30 minutes. I explain that a pea-size amount is enough, and that if used properly the tube will last a good three months. Understandably, parents sometimes think “the more toothpaste the better.” They want to cover the toothbrush with paste—even for their own brushing. This is why it is so important to educate, because you never know the knowledge base each person has.

For patients who don’t brush…or for patients who do a quick scrub and swear they’re doing it twice a day…or for those who just plain won’t listen, I recommend Listerine Smart Rinse (listerine.com). I love this product for children. I use it for my niece and nephew when they stay over. They love it too—they think it’s a game!

I’ll share with you a success story in recommending this product. I told one parent to have her son rinse with Listerine Smart Rinse when he was done brushing. I explained that the color of the mouthwash would “stick” to the plaque, and her son would be able to see just how much he was missing. At the six-month follow-up appointment, it was amazing to see the difference in the child’s attitude toward brushing and the quality of his oral hygiene. What’s more, his mom said that this product had completely changed how they did their morning and night routines. What used to be a screaming match turned into a positive reinforcement game. Not only were his teeth cleaner, the at-home routine was much better!

As an aside, did you know Listerine Smart Rinse will also color plaque on the tongue? Given this, I think the product would be great in other settings. One idea is to use this product in group homes and nursing homes. Think about the settings in which you practice and get creative!…

Toothpaste

For toothpaste, I love to recommend Orajel Safety Toothpaste (orajel.com). It’s fluoride-free and safe to swallow. I always tell parents not to move to a children’s toothpaste with fluoride until these conditions are met: (1) the child knows that toothpaste can’t be swallowed and (2) the child knows how to spit the toothpaste out. Otherwise, the fluoride will make the stomach sick.

Colgate and Oral-B both have great toothpastes for children, too. If recommending, just reiterate to only use a small, pea-size amount. For patients who have multiple stainless steel crowns or orthodontic appliances, I recommend Arm & Hammer products (armandhammer.com/oral-care) to help neutralize the pH of the saliva and minimize caries risk and plaque retention.

When my patients leave, along with their goody bags I like to give them two-minute sand timers or recommend an app to help them brush longer…

*To read the full article go to https://www.dentistryiq.com/articles/2019/04/home-care-products-for-pediatric-dental-care.html