Children’s Oral Health: Hygiene, Diet, Sealants, & Fluoride

Posted on March 30, 2021

Helping your children to have a lifetime of healthy teeth is an important part of basic health care, and it is possible… if you have accurate information and tools to help you on your way. 

When it comes to children’s dental health, you may already know that diet plays a role in cavity formation. But did you also know that what your child eats (or doesn’t eat) can even help to prevent or reverse dental decay? 

The American Dental Association’s National Children’s Dental Health Month is right around the corner in February. So, let’s talk about the key nutrients to include in your child’s diet to boost dental health and also some major things to avoid (like cavity-encouraging snacks, questionable sealant ingredients, and more!).

You’re probably wondering: How do I teach my child dental health? Teaching your child good dental hygiene begins with establishing a healthy routine as soon as their first tooth erupts. You can even start wiping their gums daily prior to tooth eruption.

As children get older, the work of brushing a child’s teeth transfers hands, literally, from caregivers to child. If the importance of pediatric dental health is established at a young age, children will see it as a non-negotiable part of their day. They’re also likely to take pride in their own ability to care for the health of their teeth and mouth.

Why is good oral health important for children?

How does a child’s oral health impact their overall health? Your child’s oral health has a significant impact on their overall health — if the teeth and gums are healthy, it’s more likely the rest of the body will be, too. 

When pediatric oral health is not optimal, it can cause problems throughout the entire body. There is a direct link between the health of our mouths and the health of our entire bodies (often called the mouth-body connection or the oral-systemic connection).

How can children’s poor dental health affect their health? The mouth is a gateway or “mirror” to the entire body. Cavities and gingivitis aren’t just oral health issues — they point to a compromised immune system, an unhealthy microbiome, and problems in the diet.

Deep, untreated cavities can eventually cause pain, infection, or more dangerous systemic complications. These complications can range from dental abscesses to perpetuating painful periodontal disease. 

Periodontal (gum) disease is associated with chronic health conditions including diabetes, Alzheimer’s, heart disease, and obesity.

Taking care of your child’s teeth and gums is not only a preventive measure when it comes to cavities and gum disease, but it can also ward off other major health concerns.

My Favorite Things for Great Oral Health in Kids


Once a child has baby teeth that are touching, flossing should become a daily habit. The number one place I find cavities in kiddos (adults, too!) is in between the back molars.

Not only does flossing help to prevent dental caries (tooth decay), it also helps to keep our gums healthy, which leads to better systemic health. As I like to say: Floss is 100% boss!

Vitamin D3 and K2

How can you strengthen your child’s teeth? To strengthen your child’s teeth (both the baby teeth and the permanent teeth!), try to incorporate the dynamic duo of D3 and K2 into their diet on a regular basis.

D3 and K2 (along with calcium) prevent cavities, benefiting remineralization of teeth, and can keep the oral microbiome in check.

Limit processed foods

Refined sugars and flours are not ideal for our teeth. They’re sticky and highly processed nature break down into sugars and acids quickly, increasing cavity risk. If they do that to your teeth, imagine what these sugary foods might be doing to the rest of your body?!

Many people think crackers, Goldfish, and similar foods are healthier for their kiddos than candy and sweets. 

In reality, crackers and other foods that contain processed carbohydrates are about the same for your child’s teeth as a pack of candy. In other words… they’re not good for strong teeth.


Water is helpful to every system in our bodies, including our mouths. Not only does water help rinse off food debris and leftover sugars and help to neutralize the mouth, but it also helps to keep our saliva healthy and enzyme-rich, protecting our teeth and oral structures.

If your child drinks some fruit juice, encourage a few sips of water afterward to clear away the sugar and acids. Also, make sure to only give plain water as a beverage after brushing and flossing before bed.

Nasal Breathing

Nasal breathing is a hot topic right now, and for good reason! Getting back to nasal breathing is critical for the well-being of the entire body. 

Mouth breathing leads to dry mouth and lowered pH (think dysbiosis or imbalances in the bacteria in the mouth) and can cause major issues. 

Often, when families are doing “everything right” and their child is still getting cavities, it is due to mouth breathing during the day and/or during sleep.

Oral Probiotics

Strains of probiotics specifically designed to support oral health are called oral probiotics or dental probiotics. 

These chewable supplements are loaded with commensal bacteria that your mouth’s mini-immune system uses to fight decay, bad breath, gingivitis, and even respiratory infections!

Children’s Oral Health Statistics

Tooth decay is the most prevalent chronic disease in children even though it is preventable, according to the National Institute of Dental and Craniofacial Research.  

Some interesting children’s oral health facts in the United States from the Centers for Disease Control and Prevention (CDC):

  • About 20% of children aged 5 to 11 years have at least one untreated decayed tooth.
  • Around 13% of adolescents aged 12 to 19 years have at least one untreated decayed tooth.
  • Children aged 5 to 19 years from low-income families are twice as likely to have cavities, compared with children from higher-income households.
  • Cavities left untreated can lead to pain and infections that cause problems with eating, speaking, playing, and learning. 
  • Children with poor oral health often miss more days of school and get lower grades compared to children with good oral health.

Tooth Decay in Kids

Why does tooth decay happen? In simple terms, tooth decay happens when your teeth are demineralized (broken down) more than they are remineralized (built and strengthened). The primary cause of demineralization is acid excretion by pathogenic bacteria in the mouth. 

When cavity-causing bacteria in your mouth find sugar molecules to eat, they gobble them up and “poop” out acid. The acid eats away at your teeth. When bacteria are allowed to gather on concentrated areas of your teeth, these acid excretions cause tooth decay.

Mouth breathing and diet (specifically, a diet high in carbs and processed foods, not just sugar) are 2 of the overlooked reasons why these bad bacteria flourish and children develop tooth decay. Those are also 2 of the big factors behind bad breath in children. 

What are the factors that may lead or contribute to tooth decay?

  • Poor dental hygiene
  • Dry mouth/mouth breathing
  • A diet high in sugar, acid, and highly processed foods 
  • A diet low in vitamins and minerals
  • Poor hydration
  • An unbalanced oral microbiome
  • Certain medications 
  • Genetic or developmental predisposition

What does a cavity look like? While cavities are not always visible with the naked eye, signs of a cavity include tooth discoloration, black spots, or holes. Toothache or tooth sensitivity can also be a sign of a cavity. Regular dental visits are a very important way to catch cavities early and possibly even reverse them.

A Tooth-Friendly Diet

To promote children’s oral health and prevent dental decay, limit processed foods as much as you can. 

I know this can be tough, but many packaged foods marketed to kids are truly terrible for their teeth. They are highly processed with many artificial flavors, coloring, refined flours, and sugar. And unfortunately, even many organic packaged foods are not ideal. Aim to eat unpackaged, whole foods as much as you can.

To encourage children’s oral health, there are also some specific nutrients you’ll want to make sure they get enough of, including vitamin D3, vitamin K2, calcium, and probiotics.  

Vitamin D is one of the nutrients responsible for delivering calcium to your teeth (along with vitamins A and K2). Many people are deficient in vitamin D, even in developed nations! Foods high in vitamin D3 are excellent for supporting tooth remineralization and protecting against cavities.

Some of my favorite vitamin D3 foods are:

  • Cod liver oil
  • Egg yolks
  • Sardines

The next lesser-known nutrient key to pediatric dental health is vitamin K2, which is vital to building tooth structure. Vitamin K2 is not the same as K1 (or just “K”), is found in very different foods, and has a dramatically different function in the body.

If you’re K2-deficient, your teeth and bones will become weaker over time. Plus, your risk of most chronic diseases goes up (not just cavities).

Foods highest in vitamin K2 include:

  • Natto
  • Cheese
  • Grass-fed butter
  • Egg yolks

Calcium is a nutrient your teeth need from the inside out. Plus, more calcium intake reduces your risk of gum disease.

Try incorporating these calcium foods into your child’s diet:

  • Chia seeds
  • Beans/lentils
  • Collard greens
  • Edamame

Next up is probiotics, which support both your oral and gut microbiome. Healthy bacteria are necessary for crowding out the bad stuff that leads to cavities and gum disease. They even keep your breath fresh! 

Start with probiotic foods like:

  • Fermented pickles
  • Kefir
  • Sauerkraut

I also recommend supplementing with an oral probiotic like Hyperbiotics Pro-Kids ENT. These mouth-friendly bacteria are great for supporting oral health.

Things like crackers, pretzels, cheese puffs, granola bars, dried cereals, and fruit snacks should be limited as best as you can. They stick in teeth and break down into sugars and acids very quickly, causing lots of dental problems.

What are some pro-dental health foods for kids? Try veggie sticks and hummus or guacamole, seeds and nuts, olives and pickles, cheese, seaweed snacks, fresh berries and fruit, or hard-boiled eggs.  

I try to meal prep on the weekends, including cutting veggies and fruits for ready-to-go snacks for the week ahead. It’s a pay-it-forward trick that I have found helps my family tremendously!

Dental Sealants

Dental sealants are thin, plastic coatings that seal over the narrow grooves found on the chewing surfaces of the back teeth.  When placed perfectly on these deep pits, sealants can prevent a significant amount of tooth decay (cavities) by protecting sensitive tooth enamel from the acid that causes cavities.

Children who benefit most from dental sealants include those:

  • With very deep grooves in their molars
  • At high risk for cavities
  • Who eat a diet high in processed foods, refined flours and sugars, and sugary drinks
  • With special needs that make dental hygiene and/or a healthy diet more challenging

Ideally, sealants should be placed immediately after the eruption of the first molars (around age 6) and second molars (around age 12). Sooner is better to ensure the grooves have not been affected by bacteria or early cavities.

Many parents are concerned about the possible negative effects of dental sealant material on their children’s overall health. Most dental sealants do contain BPA and/or bis-GMA. Both of these established endocrine disruptors should generally be avoided in developing children.

To avoid toxic sealant materials (even in very small amounts), ask your dentist what materials they are using for their sealants. Ceramic-based materials, rather than those with BPA, Bis-DMA, or bis-GMA materials, are associated with the smallest level of risk to overall health.

Should my child get fluoride treatments?

When it comes to the importance of pediatric dental care, fluoride is a controversial topic. 

Should you give your child fluoride treatments? My short answer: No. 

My long answer: Preferably not. However, if your child has special needs or can’t really eat a healthy diet and correct mouth breathing, then fluoride treatments may be a stopgap measure worth the risk.

Rather than fluoride toothpaste, I recommend hydroxyapatite toothpaste. Research demonstrates that hydroxyapatite toothpaste helps to remineralize teeth and also prevent demineralization. Additionally, it’s been shown to work just as well to prevent cavities as fluoride toothpaste.

When should my child see a pediatric dentist?

Around the time of your child’s first eruption of baby teeth is a good time to begin regular dental checkups with a pediatric dentist. Some dentists suggest waiting until their first birthday or even 2 years of age.

If you find that teaching dental hygiene to preschoolers is challenging, your pediatric dentistry of choice is likely to have some great tips. Thankfully, there are a lot of playful, yet non-toxic toothbrushes on the market today. Making dental care fun is one of the easy ways to make your child look forward to maintaining a healthy smile and mouth. It also makes your life easier, too!


  1. Koshihara, Y., & Hoshi, K. (1997). Vitamin K2 enhances osteocalcin accumulation in the extracellular matrix of human osteoblasts in vitro. Journal of Bone and Mineral Research, 12(3), 431-438. Abstract: 
  2. Motta, L. J., Bortoletto, C. C., Marques, A. J., Ferrari, R. A. M., Fernandes, K. P. S., & Bussadori, S. K. (2014). Association between respiratory problems and dental caries in children with bruxism. Indian Journal of dental research, 25(1), 9. Abstract: 
  3. Shakib, P., Rouhi, S., & Zolfaghari, M. R. (2020). The role of probiotics in preventing dental caries. Plant Biotechnology Persa, 2(1), 55-58. Abstract: 
  4. Campanella, V., Syed, J., Santacroce, L., Saini, R., Ballini, A., & Inchingolo, F. (2018). Oral probiotics influence oral and respiratory tract infections in pediatric population: A randomized double-blinded placebo-controlled pilot study. Full text:
  5. Adams, J. S., & Hewison, M. (2010). Update in vitamin D. The Journal of Clinical Endocrinology & Metabolism, 95(2), 471-478. Full text: 
  6. Rubin, B. S. (2011). Bisphenol A: an endocrine disruptor with widespread exposure and multiple effects. The Journal of steroid biochemistry and molecular biology, 127(1-2), 27-34. Abstract: 
  7. Pulgar, R., Olea-Serrano, M. F., Novillo-Fertrell, A., Rivas, A., Pazos, P., Pedraza, V., … & Olea, N. (2000). Determination of bisphenol A and related aromatic compounds released from bis-GMA-based composites and sealants by high performance liquid chromatography. Environmental health perspectives, 108(1), 21-27. Full text: 
  8. Amaechi, B.T., AbdulAzees, P.A., Alshareif, D.O, Shehata, M.A., et al. (2019). Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open, 5 (18). Full text:
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