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My little guy gets a bottle as the last thing before we put him to bed, it greatly helps him to wind down and relax for sleep. As the teeth start coming, we realize it's important to brush his teeth, but this wakes him up and makes it difficult to put him to bed afterward.

It would probably be easier to brush his teeth before giving him the milk, but I know we'd be trading dental hygiene for a bit of convenience for the parents.

How do we handle this dilemma?

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How old is he? If the teeth only started to come it might be much too early to even brush teeth. –  Guillaume Oct 14 '13 at 9:03
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@Guillaume: He's around 1 year old, but the advice generally is to brush any teeth that are there. So it's not too early. –  Torben Gundtofte-Bruun Oct 14 '13 at 10:25
    
and you have tried giving him sweet water with a sugar substitute instead of milk? Does that not work? –  TheIndependentAquarius Oct 14 '13 at 11:05
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@user462608: Why in the world would I want to give him sugar before sleep? No, he's getting 180mL food so he can sleep through the night. –  Torben Gundtofte-Bruun Oct 14 '13 at 12:09
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My niece is 3, and we have exactly the same question. (Well, sippy cup instead of bottle, but same idea.) It doesn't help that this child and sleep are mortal enemies. –  Martha Oct 15 '13 at 15:02
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3 Answers

This might make your life simpler (or possibly more worrying, considering how long you may have been doing this wrong): You're supposed to brush before meals. It's technically harmful to brush immediately after, as it removes acid softened enamel.

Brushing removes plaque, not food, so you actually want to brush the plaque off before eating, as it immediately produces acid when the food hits it, so most of the damage is done to your teeth well before you brush... the softened enamel of your teeth away, increasing the damage.

So, there you go, you simply get him to brush at the start of his bedtime routine, then story, then bottle, then sleep.

Sources: The Dental Hygenist magazine and the NHS guidance on teeth cleaning.

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Wow, this is interesting! –  Torben Gundtofte-Bruun Oct 16 '13 at 9:51
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It's also worth noting (and this is anecdotally from a dentist) that for 3mths - 1year, all they're really looking for is a decent coating of flouride on the teeth, as the chances of you managing to properly brush an 1 year old's teeth the way you're supposed to are Zero. –  deworde Oct 17 '13 at 12:38
    
@deworde I knew that about ingesting acid beverages (like sodas, some juices), that you should wait some minutes allowing your saliva recompose the pH inside your mouth. –  woliveirajr Oct 17 '13 at 13:26
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@deworde Wait, what?! You give 3-month-olds fluoride?! We were told to wipe the teeth with a wet clean washcloth. –  Charles Oct 17 '13 at 14:47
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The simple answer is, you don't. The more complex answer is that the levels of fluoride in toothpaste are well below the toxicity level in the pea-sized quantity on a toothbrush and will get excreted out. Obviously you monitor your child for ill-effects and consult a paediatrician in the event of illness. Also, children's toothpaste has less fluoride (assuming legitimate company, use judgement) That said, if they down a tube of it, emergency room, so keep it out of their reach. –  deworde Oct 17 '13 at 18:53
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With the baby teeth, we did morning and evening brushing, whenever we could. If they had a bottle later on at night (eg 2am) we wouldn't try and wake them to brush.

Once they would sleep for a good portion of the night we would play a game at bedtime that included brushing after their night time bottle.

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If you brush before, the milk will be on his teeth all night and that is the best time for breeding plaque. Brushing after is far better.

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We all know this, but how do you reconcile it with the practicalities? I don't know about you, but I certainly can't brush a child's teeth without waking her up. –  Martha Oct 15 '13 at 15:01
    
Apparently the truth is a bit more complex: parenting.stackexchange.com/a/9173/147 –  deworde Oct 17 '13 at 12:35
    
Martha - I must admit, i never had to ... My son didn't get teeth till 1 year old and by then he would want a story after bottle but before bed. We cleaned his teeth in between. –  Peter Jamieson Oct 25 '13 at 15:13
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