That is the big question around our house these days.
I do have a confession to make. Evan's teeth get brushed maybe once a week or couple of weeks. Jeremy and I feel horribly guilty about this... Evan is quite the little calculus (tartar) former--which, ironically enough, is pretty common with tube fed kiddos. His teeth get scaled about every 6 months or so, but the buildup on some of the lower teeth is still really bad.
It's not because we don't think it's important to brush--we know it is. Here is our dilemma: we think it makes him sick. Because Evan's swallow is so uncoordinated, all the toothpaste foam, saliva, and gum bacteria pool in his throat and then get regurgitated out his nose, and we theorize up into his eustacian tubes. We have noticed a pattern--the nights that his teeth do get brushed before bed, his breathing sounds really "junky." The last few times he has gotten an "ear" infection or sinus infection were preceeded a few days prior by teeth brushing or eating orally.
Here is what we have tried so far:
--Brushing teeth in the morning (still sounds junky, and seems to have the same pattern in terms of illness)
--Brushing teeth with Evan sitting up (he is so squirmy, I can't effectively get in there to brush anything)
--Brushing without toothpaste (the bacteria are still being released from the gumline, and then he's not getting any benefit from the "tartar control" in the toothpaste)
--Brushing with the suction machine (tried that once--led to a super-freak-out-melt-down)
--Letting Evan brush his own teeth, aka "chew the toothbrush" (aside from the questionable effectiveness, this still leads to lots of pooled secretions that regurgitate out of his nose)
--Finger-tip toothbrush (the last time I used this, Evan had only 3 teeth and bit me with such force that I cringe to think of how badly it would hurt with the mouth full he has now)
I hate the choice we are faced with--tooth decay and gum disease in one corner, combined sinus and "ear" infections that preclude hearing aid wear in the other. Evan has one of these infections right now, and you guessed it--we brushed his teeth three nights ago.
What to do??? If any parents out there have any suggestions, I would LOVE to hear from you.