Oral Health

​Everyone

Routine - practicing good personal oral health is all about establishing and keeping a daily oral health routine, following the instructions below.

• Brush- teeth and tongue twice a day (morning and night at least) for two minutes, with fluoride toothpaste and a soft toothbrush that is the right size for you. Children need adult help and supervision to brush their teeth until about age 8. Click here to learn how to brush teeth. Watch this video to learn more about how to teach your child to brush their teeth.
• Floss- at least once before bedtime. Click here to learn how to floss correctly.
• Eat foods and drinks low in added sugars. Too much sugar in the mouth for too long can cause tooth decay and gum disease.
  • Snack on healthy foods and drinks at specific times, not all throughout the day.
  • Fluoridated tap water is one of the best public health tools we have to improve our community’s oral health. If available, drink clean fluoridated tap water. If you or your family regularly drinks bottled water, be sure to let your dentist know, so they can make sure you are getting enough fluoride to protect your teeth. Click here for more information about the safety and importance of fluoride for oral health.
• See the dentist at least twice a year for a check-up.
  • Click here for tips to prepare for your / your child’s dental visit.
  • If you take medications, ask your doctor or dentist if they may increase your risk for oral health problems. For example, some medications cause dry mouth or oral yeast infections. Take the steps your doctor and dentist recommend to best care for your oral health while on these medications.

Pregnancy

• Healthy teeth and gums are especially important during the prenatal period-  Pregnant people and families with healthy mouths pass on helpful bacteria to babies. But, if there is untreated oral disease in the family, germs can pass from the mouths of parents or other family members to the baby’s mouth.

  • According to the Centers for Disease Control and Prevention, children of mothers who have high levels of untreated cavities or tooth loss are more than 3 times more likely to have cavities as a child.

• Dental checkups are safe during pregnancy-  it is safe to have dental care when you are pregnant, including dental x-rays, local anesthesia, certain medications, cleanings, fillings and other dental treatments. Do not put it off until after you have the baby. Having a healthy mouth yourself will help your child to have a healthier mouth too.

  • Health Plan of San Mateo Dental covers dental services while you are pregnant and after you have the baby. Click here for more details about coverage.

  • Some dental offices will request a referral from your OB/GYN to schedule a dental appointment. Talk to your doctor if you need help getting dental care or making an appointment. Tell the dental office staff that you are pregnant and your due date. 

• Changes to the body affecting oral health during pregnancy - changes to your body during pregnancy may make your gums more sore, red, or likely to get a mild (reversible) form of gum disease called gingivitis. According to the Centers for Disease Control and Prevention, nearly 60 to 75% of pregnant people have gingivitis. This is why it is important to brush and floss everyday and visit the dentist. If your gums are sore, you can use a softer toothbrush. If gingivitis is not treated, it could lead to a more severe gum disease that could cause tooth loss. 
  • Morning sickness and oral health- if you have morning sickness and vomiting, protect your teeth from the acid that can cause teeth erosion by rinsing with tap water or a teaspoon of baking soda and a cup of water. Before bed, rinse with an alcohol free mouthwash with fluoride.
  • Chew gum or mints with “xylitol“- this is recommended during pregnancy and until the baby is about two years old, because it can reduce the amount of bacteria in the mouth.
• Practice good oral health habits during pregnancy- continue to practice good daily oral health habits
  • Brush- twice a day with fluoride toothpaste for two minutes. Use a soft toothbrush. Click here to learn how to brush teeth. 
  • Floss - at least once before bedtime. Click here to learn how to floss correctly.
  • Eat healthy foods and drinks- these are good for your health and your baby’s health.
  • Quit tobacco use and smoking- See here for help.
• Download brochures in English and Spanish about oral health and pregnancy- English | Spanish 

Babies​

• Healthy baby teeth are important! Baby teeth are just as important as permanent teeth, even though they fall out - see the video at the top of this page or click here to hear a doctor explain why healthy baby teeth matter. Children need clean and healthy baby teeth to eat, talk, smile, and feel good about themselves. Baby teeth give the face its shape and hold space for adult teeth to come in the right way. Baby teeth can get cavities more easily because the enamel (hard outer layer) is thinner. Cavities in baby teeth can also spread quickly to other teeth, and lead to cavities in permanent teeth.

  • Your child will get a full set of 20 baby teeth or “primary teeth” starting around 4-10 months old, but they can come in as late as 12 months old. The last of the baby teeth come in when they’re about 2-3 years old, but this timeline will vary for each baby. 

    • You can learn when baby teeth come in and when they fall out using these teeth charts. 
  • Teething can cause discomfort, and your baby may have different symptoms associated with teething, which are normal. To help your baby feel better, you can gently rub your baby’s gums with clean, wet gauze, your finger, or a small, cool spoon. Give them a clean, chilled (not frozen) teething ring- but don’t dip it in anything sweet or in other foods. If you have concerns about your baby’s symptoms call their dentist or pediatrician.
    • Learn more about teething here! Is it teething time for your baby? English | Is it teething time for your baby? Spanish
• Pediatrician appointments: according to the American Academy of Pediatrics, when your baby is 6 months old,your pediatrician can start to do oral health checkups and apply fluoride varnish. Fluoride varnish is used to help prevent or slow down tooth decay. It is painted on the top and sides of each tooth and hardens quickly. Then, it is brushed off after 4 to 12 hours. It is recommended that children have varnish applied 2 to 4 times per year until they are 5 years old. These fluoride varnish applications are covered for free by public (HPSM Dental) and private dental health insurance plans.
• Dental appointments, starting with 1st tooth or 1st birthday: take your baby to their 1st dental appointment when their 1st tooth comes in, or by their 1st birthday. This two minute video explains more about the first visit, what to expect, and how to prepare. The dentist will check for decay and other problems. They can show you how to properly clean your child’s teeth, and may offer advice on your child’s diet, pacifier and bottle use, and oral care products for your family. Schedule regular dental visits every six months for your child. These twice yearly visits are covered for children ages 0-20 by Health Plan of San Mateo. Click here for more information about covered services. Click on the video above or here to learn more. 
  • Before the first appointment: 
    • Have dental insurance information ready- Find and bring both your dental insurance plan member identification card and (for Medi-Cal members), the Medi-Cal BIC cards. 
    • ​Prepare to talk with the dentist:
      • ​Prepare a list of questions or concerns for the dentist.
      • Bring a list of any medications your baby is currently taking in order to give a complete medical history.
      • Be sure to brush their teeth prior to the appointment.
  • Getting to the appointment - if you do not have any way of getting to the dentist for a visit covered by Medi-Cal, Health Plan of San Mateo offers transportation assistance to the dentist. Click here for more information about the ride benefit.
  • Language assistance - if your dentist does not speak your language, and you need language interpreter services at your dental appointment, Health Plan of San Mateo has free interpreter services. Click here for more information about HPSM’s free language services.
• Healthy foods and drinks- breastfeed your baby for 6 months or longer if you can. See our Family Health Services’ webpage about breastfeeding here for more information.
  • Drinks- Babies should not be given juice to drink. If juice is introduced, it should not be introduced until after your child turns one year old (even 100% juice). It is recommended to add an equal amount of water to juice if giving juice to children.
  • Foods- When your baby starts eating solid foods, choose foods with no added sugar. 
• Importance of good oral health for parents/ caregivers: babies naturally pick up bacteria from their surroundings that builds the immune system. Families with healthy mouths pass on helpful bacteria to babies, but if there is untreated oral disease in the family, germs can pass from the mouths of parents or other family members to the baby’s mouth. After the baby is born, it is important for parents and families to brush teeth twice daily with fluoride toothpaste. You also need to floss, eat healthy foods, and get dental care. When your mouth is healthy, your baby is more likely to have a healthy mouth, too.
  • ​Use separate utensils: do not share eating utensils with your baby. If your baby has a pacifier, clean it with water, not your mouth.
• Clean your baby’s gums after every feeding- use a clean, damp washcloth. This will wipe away germs and sugars that can cause cavities. It will also help get your baby used to having their mouth cleaned. 
• Brushing: start brushing your baby’s teeth with a small smear (grain-of- rice sized amount) of fluoride toothpaste when their first tooth appears with a soft toothbrush, or a rubber finger brush. Fluoride is an important mineral for oral health that is safe to use. It helps make teeth stronger and protects them from cavities and decay. You can sit down and place the baby in your lap with their head against your stomach, or cradle them in the crook of your elbow. You can tickle their lips with the toothbrush to get them to open their mouth. Brush twice a day.
  • ​Use a grain -of-rice sized amount of toothpaste for babies and toddlers under 3 years of age. Once they are 3 years old, switch to using larger pea sized amounts of fluoride toothpaste.
• Flossing: start flossing their teeth when they have two teeth that touch. You can use floss picks if they are easier to use. Click here to learn how to floss correctly.
• Bottles: Bottles should only have water, formula, or breast milk in them. At nap times or nighttime, if you put your child to bed with a bottle, it should ONLY contain water. Do not put your child to bed with a bottle filled with breast milk, formula, juice or sugary drinks like fruit-flavored drinks or soda. The sugars from these liquids can stay on their teeth and gums and cause decay, called “Baby Bottle Syndrome.” If your child falls asleep while feeding, remove the bottle as soon as you notice they are no longer sucking. During nighttime feedings, keep a bottle with water in it nearby and give them a little water after the feeding to rinse their mouth
  • Wean your baby off their bottle by age 1 by getting them to drink from a cup by their first birthday. Babies can start using a cup around the age of 6 months. Training cups should be used for only a short time.
• Pacifiers: Keep them clean, and do not dip them in any other type of food or liquid. If your child uses a pacifier or sucks their fingers, talk to your dentist about how to get your child off this habit. Sucking habits usually stop between the ages of 2 and 4. If the sucking continues, ask your child’s dentist or pediatrician other ways to discourage sucking. These habits can cause problems as your child’s teeth and mouth develop, like crooked teeth and changes to the shape of their face and mouth.
  • Pacifiers, bottles, and oral thrush (oral yeast infection): oral thrush is a common infection in babies, but you can help prevent it. If you bottle feed your baby or use a pacifier, thoroughly clean the nipples and pacifiers in hot water or a dishwasher after each use. 
• “Milestones for Mini Mouths” infographic, from American Academy of Pediatrics – English | Spanish

​

Toddlers and Kids

It’s all about establishing and keeping to a daily oral health routine! Do not skip the daily oral health routine, even when it gets hard. Brush and floss together as a family. See our books and songs page for ways to make the routine more fun.

• Healthy baby teeth are important- baby teeth can stick around for 10-12 years! They are just as important as adult teeth, even though they fall out - see the video at the top of this page or click here to hear a doctor explain why healthy baby teeth matter). Children need clean and healthy baby teeth to eat, talk, smile, and feel good about themselves. Baby teeth give the face its shape and hold space for adult teeth to come in the right way. Cavities in baby teeth can lead to cavities in adult teeth.
• You can learn when baby teeth come in, fall out, and when permanent teeth come in using these teeth charts. 
• Twice yearly dental visits: kids should see the dentist twice a year, and get fluoride treatments and sealants to protect their teeth.
  • Before the first appointment: 
    • Have dental insurance information ready- Find and bring both your dental insurance plan member identification card and (for Medi-Cal members), the Medi-Cal BIC card. 
    • ​Prepare to talk with the dentist:
      • ​Prepare a list of questions or concerns for the dentist.
      • Bring a list of any medications your child is currently taking in order to give a complete medical history.
    • Prepare your child: 
      • Schedule an appointment at a time your child will be the most comfortable, such as in the morning after breakfast, after a nap, or after a meal. 
      • Tell your child about the appointment and what to expect. Play games to familiarize your child with the experience. ​Have them sit in a chair and pretend to be the dentist by counting and brushing their teeth. Then let your child pretend to be the dentist with a stuffed animal or doll. Have your child bring their favorite stuffed animal or toy for comfort. Read books or watch videos about going to the dentist with their favorite characters. 
        • See our books and songs page for more resources.
    • Be sure to brush their teeth prior to the appointment.
  • Getting to the appointment - if you do not have any way of getting to the dentist for a visit covered by Medi-Cal, Health Plan of San Mateo offers transportation assistance to the dentist. Click here for more information about the ride benefit.
  • Language assistance - if your dentist does not speak your language, and you need language interpreter services at your dental appointment, Health Plan of San Mateo has free interpreter services. Click here for more information about HPSM’s free language services.
• Healthy foods and drinks: kids should drink lots of water, and should not drink juice, sodas, and other sugary drinks. If they have juice or a sugary drink, it should only be about 4 ounces (half a cup) or less. Kids need a healthy diet of the recommended amount of fruits and vegetables, and need to stay away from sugary snacks and foods. If they have a sugary snack or drink, they should eat or drink it all at one time, not slowly throughout the whole day.
  • Learn more about the CalFresh Healthy Living program here.
• Brushing: 
  • Toothbrush - Brush with a soft bristled toothbrush that is appropriate for your child’s age. Check the toothbrush to see what ages it is for, or ask your dentist. If using an electric toothbrush, make sure not to brush too hard, because that may damage your child’s gums. A new toothbrush may be needed every 3 months because bristles can get worn down or broken. A worn toothbrush doesn’t do a good job of cleaning the teeth.
  • Toothpaste - Use toothpaste that has fluoride in it. Fluoride is an important ingredient (mineral) in toothpaste and is safe to use. It helps make teeth stronger and protects them from cavities and decay. Click here for more information about the safety and importance of fluoride for oral health.
    • Use a grain-of-rice sized amount of toothpaste for infants and toddlers under 3 years old. You can also use a rubber finger brush for infants.
    • Use about a pea sized amount of toothpaste for children ages 3-6.
  • Parental help with brushing: kids need their parents/ caregivers to help them brush and floss their teeth until they’re about 8-10 years old, and have the skills to do it themselves. Even after your child starts to brush their own teeth, you should still watch while they brush. This helps you make sure they are cleaning their teeth the right way. By around age 10 or 11, most children should be able to brush their teeth without supervision.You can model good habits by brushing your teeth with them when they brush theirs.
  • Brush twice a day for two minutes- consider using a two minute timer.
    • How to brush - ​click here to get information about how to correctly brush teeth.
    • ​Monthly toothbrushing calendar- download and fill out daily with your child to make sure your child is brushing twice a day. Brushing calendar-English​ and Brushing Calendar - Spanish / Actividad de Calendario- Español
    • Books, songs, and games- Click here for books, songs, games, and apps to use to help make brushing and flossing fun for your child. 
  • Spit don’t rinse- Teach your child to spit out all of the toothpaste, but don’t rinse after with water or mouthwash. “Spit, don’t rinse.” This allows the fluoride in the toothpaste to stay on the teeth, which helps protect them and can reduce the chances of decay by as much as 25%!
• Flossing -  As soon as your child has two teeth that touch, begin flossing every day, at least at nighttime before bed.
  • Click here to learn more about how to floss correctly.
• Mouthwash- Children may start to use mouthwash once they are at least 6 years old, or not at risk of swallowing it. Choose alcohol-free mouthwashes for children that contain fluoride. Choose a mouthwash that has the “American Dental Association (ADA) Seal of Approval” (or logo) on it. This website from the ADAlists mouthwashes that have their seal of approval.
• Check for tooth decay at home- “Lift the lip:”  One easy way to check your child’s teeth for early signs of tooth decay is to lift or gently push the upper lip so the teeth and gums are visible. Look at the upper teeth- the front and back of the teeth—for plaque on the gum line, and white, brown, chalky, or black spots on the teeth. Repeat the process with the lower teeth. If you see spots or anything unusual, have your child’s teeth checked by a dentist or medical provider as soon as possible. Your child may fuss, cry or wiggle while you check their teeth. As you both get more comfortable with the process, it will get easier.
  • Click here for these “Lift the Lip” instructions from Cavity Free Kids.
• Fluoride varnish - according to the American Academy of Pediatrics, it is recommended that children have varnish applied 2 to 4 times per year until they are 5 years old. Fluoride is an important mineral for oral health that is safe to use. It helps make teeth stronger and protects them from cavities and decay. These fluoride varnish applications should be covered for free by public and private dental health insurance plans. No part of the cost should be shared by patients or families.  Click here for HPSM Dental’s covered services information.
• Sealants- you should schedule an appointment with your dentist for your child to get molar sealants when their permanent back teeth have grown in. This happens as early as five years old, but usually around 6-7 years old. School-age children (ages 6-11) with sealants have almost 3 times less molar cavities than those without sealants! The sealant material flows into the pits and grooves on the surfaces of the molar teeth and acts like a barrier, protecting the teeth from bacteria and bits of food that can cause cavities and tooth decay. Sealant applications should be covered for free by public and private dental health insurance plans. No part of the cost should be shared by patients or families. Click here for HPSM Dental’s covered services information.
• For children ages 4-6 (TK/K grades) in public schools: in California, public school kindergartners need to see a dentist for a checkup and complete the Kindergarten Oral Health Assessment (KOHA) to turn into their school at the start of the school year.
  • ​ Click here for more information about the Kindergarten Oral Health Assessment
• Orthodontics: the American Dental Association recommends that every child have an orthodontic evaluation by 7 years of age.
• Protective gear for the mouth: ask your child’s dentist about what protective gear they should wear in their mouth if they play sports.