Q&A with Dr. Ellie: Toddler Teeth

Every month Dr. Ellie Phillips will answer your oral health questions as part of the Ultimate Oral Health Guide.


Q: I have a 20-month old daughter. She has an upper lip tie (which I read can lead to a greater chance of cavities) and she is still nursing at night. It seems to me that her upper 4 baby teeth have been rough and discolored almost since they came in. I’m brushing her teeth 2-3 times a day now with natural child-safe toothpaste because I fear they are decaying. It is a traumatic event, where we have to hold her down to get to all her teeth, so we used to brush them once before bed (without paste when she was younger) and allow her to “brush” her teeth any other time she wanted to try.

I’m concerned about some the artificial colors and ingredients in the products you recommend, but I’m willing to use them to protect her teeth. What would you recommend for a toddler in this situation?

I have read good things about breast milk actually being protective for teeth, and we won’t be night weaning soon. I’d like to know what to do during the day and if you recommend rubbing xylitol on her teeth several times a day. I also worry about giving her too much fluoride in toothpaste form. -B


A: Dear B,

There is no science that show brushing or flossing can stop cavities. Also, brushing is an inefficient way to remove plaque from teeth – especially for a toddler. You will have far more success implementing xylitol into your child’s life.

The only purpose for brushing baby teeth is to transport a solution or paste to teeth – something that will help them. Brushing or wiping healthy baby teeth with a solution of xylitol can stop cavities, but brushing and flossing with “unhelpful” toothpaste will not achieve anything.

Xylitol promotes ideal conditions to protect baby teeth from cavities. You have a choice to wipe or brush a solution of xylitol over teeth, or give your toddler 1/8th teaspoon of granular xylitol from a spoon, or a ZellieBear to eat before bed. The outcome will be the same, and usually consuming xylitol is easier than brushing teeth at this stage.

I only ask parents to brush toddler teeth with toothpaste if a child has cavities, or is at high risk for cavities. In this case, I suggest brushing with a drop of bubblegum flavor ACT on the brush, sometimes with an additional rice-grain amount of Crest regular paste. The brush transports the sodium fluoride and silica (from the ACT and paste) to work along with xylitol to help strengthen these teeth and prevent cavities.

I never suggest “child-safe” toothpastes (even from health stores), because these pastes are not formulated to improve mouth health. Many unbalance mouth chemistry, some are acidic, and some contain products that grow harmful plaque.

I wish ACT was colorless and without unnecessary ingredients – but I believe the more important wish is to help children avoid cavities. If your child is at risk for cavities, this routine can help. The alternative will be plastic sealants (containing BPA) caps (containing base-metals) or filling (often mercury fillings) to fix the damage. A child with perfect teeth only needs xylitol for protection, but a child with damaged, discolored, or rough teeth, needs the integrated use of xylitol (during the day), silica (in Crest paste), and a little, very dilute sodium fluoride (Crest and ACT).

Always be sure to limit juice to mealtimes. Toddlers tend to drink a lot – and if you are using anything sweetened or acidic this can be a big problem. Xylitol is ideal before sleep or nap time, and after sugary or sticky foods and drinks.

Best wishes,
Dr. Ellie


For more information, please visit all of Dr. Ellie’s web-sites:

Dr. E Oral Health Coaching – articles, resources and videos to help you learn more
Zellies.com – learn more & order your Zellies Xylitol & the Complete Mouth Care System
Dr. Ellie.com – a great resource for learning more about oral health & Dr. Ellie

Join the conversation online on the Zellies Facebook page!

About the Author Dr. Ellie

My passion is educating people about oral health. For decades I’ve worked with patients of all ages, in different countries, in high and low-risk communities, and from every walk of life. I’ve seen the same results over and over again –people who transformed their oral health – sometimes in days or weeks, even after they had suffered years of pain and frustration. It’s never too late, and my ways will give you the key to a lifetime of improved oral health.

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