Two Year-Old with Brown Spot – Hates Brushing!

Hi Dr Ellie,

I just visited your website after doing a google search, and was very impressed with the level of advice and attention you offer those in dental need!

I am living in a remote town in Alaska with my husband and 2 year old son. There is one old man in town who does dental work (when he’s not commercially fishing for salmon), but he won’t see kids under 6. My son seems to have a brown spot on one of his back molars. I’ve been monitoring it, and think it needs attention. 

Recently, on a short layover in San Francisco I left the airport in search of a pediatric dentist and found one to take him to. It was a horrible place, cracked chairs, peeling paint, and absolutely no kid-friendly decorations or anything…..and they prescribed MI Paste for my son’s brown spot. They said it did not yet look like a cavity, but could be soon if I didn’t pay close attention.

I’ve been using the MI Paste on his brown spot now for about 2 months, and am really concerned that I’m not doing everything I can to prevent this from turning into a cavity. He absolutely hates having his teeth brushed, and every day it is a huge struggle for me to even get him near a toothbrush. My husband and I are at our wits end, as we know how important dental hygiene is – especially for his baby teeth (‘placeholders’ as you call them). We have even gone so far as to have one of us pin him down on his back, and the other brushing his teeth. It’s a horrible routine, and we don’t know what to do. I have given him about 10 different toothbrushes to choose from (electric, matchbox cars, Disney, one like Mommy’s), and tried to get him to do it himself, but he just sucks the toothpaste off the brush. Usually I can get about 6 wipes of the brush across his teeth in before he clamps up altogether and starts screaming. It is so frustrating, because we want him to realize it’s important. We’ve tried brushing our teeth at the same time…brushing the dogs teeth at the same time….brushing his teddy’s teeth….and he still hates it and clamps his mouth shut.

He does like the MI Paste, and let’s me put that in.

Our local Public Health Nurse prescribes fluoride drops for all babies here as there is no fluoride in the water. We give him that every day. I’ve heard mixed reviews about fluoride intake so am not sure what to do here.

Also, we use ‘sugar free, fluoride free’ toothpaste, as we know he ingests a lot of it.

Do you have any advice for our situation? Should we just keep doing what we’re doing? Your zellies look good do you think they would work for our son?

Also, an FYI I breast fed my son until he was 19 months, and that included a LOT of night nursing. Is there any correlation between night nursing and the brown spot/cavity?

I really appreciate you taking the time to read this, and look forward to any advice you can offer.


Dear RV,

Tooth decay and cavities are caused by a bacterial disease. Brushing and brushing may be helpful but this is not be best or most effective way to stop the disease particularly in a situation like yours.

Imagine if you had a rock in your garden covered by ants. Your could brush them all away but as soon as you had finished, the ants would return and cover the rock again.

What we need to do is remove the infection from your child’s mouth. This can be achieved in different and much easier ways:

FIRST make sure that every toothbrush in the house is cleaned every day. You can swish the brushes in Listerine, rinse off and store dry (but away from the toilet area of the bathroom).

SECOND make sure that everyone in the family eats at least 7 grams of xylitol each day for six months. This seams like a lot but it is really only a teaspoon and a half and it does not matter how you consume the xylitol. It can be in granular form dissolved into solution as breath mints or chewing gum.

It is best to space the “dose’ throughout the day and the best time to consume xylitol is after meals. At the conclusion of a meal, harmful bacteria in your mouth double or triple in numbers.
If you eat some xylitol at this time you can begin to reduce the harmful bacteria in your mouth.

I would also suggest using ACT mouth rinse in place of toothpaste for brushing your child’s teeth.
Just put a drop on a toothbrush. The bubblegum flavor is really nice for kids. You child is too young to use it ACT as a mouth rinse but the fluoride in the rinse will be helpful and healing.

Most of all I would try to let the whole tooth brushing thing be quiet and sort of optional at this time. Huge fights are not worth the effort!

The use of xylitol will be more effective. The US military know that when troops cannot clean their teeth xylitol will help to take care of them. You should be able to feel like this about your child’s teeth.

So please be comforted. You can continue with MI paste at other times during the day, but I would put my confidence in xylitol and getting rid of the infection. Remember that your family share mouth germs and that it is important for you all to make sure that your mouth is healthy from a bacterial point of view.

Let me know if I can help you in any other way.

Ellie Phillips DDS
Dental Health for Everyone!

Categories: Uncategorized


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