At what age do kids start viewing brushing their teeth as an onerous chore they must try to avoid? In my household it started around age 7. According to the American Academy of Pediatric Dentists (AAPD), the U.S. Surgeon General has identified tooth decay as the most common childhood disease — five times more common than asthma.

From the time a child gets his first tooth, he is at risk for tooth decay if proper care isn't taken. Tooth decay can have impact a child's long term health. AAPD reports that in a comparison of the dental health of Americans from 1988-1994 and 1999-2002, there was a 15% increase in cavities among two- to five-year-old children. Sadly, only three out of five kids see a dentist once per year. If this is done to save money, it tends to backfire. According to AAPD, children who have their first dental visit by their first birthday have 40% lower dental costs in their first five years compared to children who don't visit the dentist.

Here are a few of tips to get your toddler brushing:

• Parents should start dental visits by age 1, or after the appearance of the first baby tooth. The dentist will check for proper oral and facial development.
   
• For infants, parents should clean their mouths regularly with a very soft, infant toothbrush, or simply use a wash cloth and warm water.
   
• Children older than six months will need to take fluoride supplements if their drinking water does not contain enough fluoride, which is usually the case with well water. Fluoride supplementation in infants has been shown to reduce tooth decay by as much as 50%.
   
• Use a soft, moistened gauze pad to clean the gums of infants after each meal. Start using a soft baby brush after the first tooth comes in. This way, he grows accustomed to someone feeling around in his mouth, which will make brushing easier and make dental exams less traumatic.
   
• Babies should be weaned from the bottle by 12-14 months of age.
   
• Show tooth brushing as fun and not a chore. Allow your kids to brush your teeth. Laugh a lot. Next, let them brush their own teeth, and then end with you brushing their teeth.
   
• Have your child practice tooth brushing on their favorite doll or super hero.
   
• Have your child practice spitting out toothpaste by spitting out a few mouthfuls of water. Have them try to hit something in the sink. (It's important to not swallow flouridated toothpaste, as it can cause fluorosis, which will leave spots on their teeth. Children over age 8 are at less risk for this.)
   
• Use a mild-flavored, fluoride-free, toothpaste alternative at first.
   
• For truly resistant kids, make tooth brushing seem like a fun game that they're missing out on. Enthusiasm is contagious.

It's worth the time and effort to find a pediatric dentist in your area. Ask your pediatrician or other parents for referrals, or use the locator at the AAPD website.