Good oral health in children is important for eating, speech development, general health, and self-esteem. The C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents of children age 4-17 about oral health practices.
In reporting which oral hygiene practices their child does all or most days, most parents say their child brushes their teeth twice a day (64%) and brushes for at least 2 minutes (59%); fewer parents say their child cleans their tongue (35%), flosses (23%), uses mouthwash or fluoride rinse (22%), or rinses their mouth with water after consuming sugary foods or drinks (15%). Only 20% of parents say their child does 4-6 of these oral hygiene practices all or most days compared to 41% saying 2-3 practices and 38% reporting 0-1 practices. Parents report fewer oral hygiene practices for boys than girls.
Over one-third of parents (36%) report their child has experienced dental problems related to oral hygiene in the past two years, including cavities/tooth decay (29%), discolored or stained teeth (7%), tooth pain/sensitivity (6%), or gum problems (3%). These dental problems are linked to how often children perform recommended oral hygiene practices: of parents reporting their child does 0-1 oral hygiene practices all or most days, 44% report dental problems, compared to 31% when children perform 2-3 practices and 28% when children perform 4-6 practices on all or most days.
Over one-third of parents (36%) have noticed that their child has bad breath, which is more common for children who do 0-1 oral hygiene practices all or most days. Parents attribute their child’s bad breath to various causes: “morning breath” (77%), lack of brushing/flossing (47%), eating smelly food (23%), mouth breathing (19%), dental problems (8%), illness (6%), or side effect of medication (4%). Most parents (85%) addressed their child’s bad breath, such as by having them brush more often (82%), use mouthwash (36%), floss more often (23%), go to dentist/doctor (16%), chew gum/eat breath mints (15%), or change their diet (5%).
Most parents (89%) say their child’s most recent dentist visit was within the past year, vs 7% saying it was 1-2 years ago and 4% saying it was more than 2 years ago. Parents reporting their child does 0-1 oral hygiene tasks all or most days are more likely to say their child has not had a dental visit in over a year.

Highlights
- Only 3 in 5 parents say their child regularly brushes their teeth twice a day.
- Parents report that fewer boys than girls brush and floss regularly.
- 1 in 3 parents have noticed that their child has bad breath.
Implications
Proper dental health and hygiene are essential, especially in childhood when lifelong habits are formed. Poor oral hygiene can result in issues like cavities, tooth decay, and gum disease, which make it difficult for children to eat and speak clearly. Other oral health problems, such as discolored teeth and bad breath, can be embarrassing for children and cause low self-esteem.
Regular oral hygiene tasks are essential for good oral health. The core component involves brushing the teeth at least twice a day, for at least two minutes, to remove food and plaque that builds up after eating sugary food. Brushing also keeps the gums healthy. Over one-third of parents in this Mott Poll reported their child does not regularly achieve this basic level of oral hygiene. Other oral hygiene tasks are also important to prevent plaque build-up. Flossing at least once a day dislodges bits of food stuck between the teeth where a toothbrush cannot reach; if left, the food bits can harbor bacteria that cause tooth decay, gum disease, or bad breath. Similarly, regular cleaning of the tongue by brushing or scraping clears away bacteria that can cause bad breath or infections.
In many families, oral hygiene tasks are not a routine habit for children or parents. It’s helpful to build oral hygiene into a daily routine. Brushing typically is done in the morning and before bed; however, these are often hectic times as family members are rushing to get out the door in the morning or parents are encouraging children to get to bed. To ensure consistent oral hygiene, parents need to build in time every morning and evening for brushing and other oral hygiene tasks.
It is important that children have regular dental visits to check for and address any signs of tooth decay. Dentists can explain to children how tooth decay happens and point out where children are doing a good job with oral hygiene and where they need to improve. Often, this will motivate children to pay more attention to oral hygiene. Dentists can recommend services to prevent tooth decay, such as dental sealants, which are thin plastic coatings painted on the chewing surfaces of the back teeth.
Forming oral hygiene habits early in childhood is key to lifelong oral health. At first, parents will need to check that children are brushing and flossing correctly, but children can quickly assume these tasks. Parents can support the development of good oral health habits by allowing children to choose a toothbrush in a favorite color, by using reward charts to reinforce consistency, and by modeling their own good habits. Parents can also choose products that make oral hygiene easier, such as toothbrushes with tongue scrapers or different tools for flossing.
As children get older, parents are less involved in personal hygiene tasks but can still support oral health by reminding children about brushing and flossing, and being a role model in their own oral hygiene. In addition, parents can make sure children have the tools they need, including a toothbrush that is replaced every 3-4 months, as well as options for flossing. Oral hygiene can be particularly challenging when children have braces or other devices; the orthodontist may offer suggestions.
Even with consistent brushing in the morning and before bed, children can go through the day allowing food and sugars to build up on the teeth. Parents can teach children to limit the damage by rinsing their mouth with water after consuming sugary foods or beverages.
Finally, many parents have questions about fluoride. Fluoride has been shown to prevent tooth decay by making the enamel stronger and more resistant to the effects of plaque; this is particularly important during childhood when teeth are developing. Fluoride is found naturally in water, but at levels too low to prevent tooth decay; thus, in many communities, fluoride is added to the water supply. Fluoride is also found in some brands of toothpaste, in fluoride rinses, and in fluoride applications at the dental office. Parents may want to talk with their child’s dentist about making sure their child gets enough but not too much fluoride.
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