I was recently asked the following question: Our five-year old refuses to brush his teeth—almost every night my wife and I end up screaming at him (and each other) and he ends up in tears. We’re thinking about bagging the whole idea. Does he really need to be brushing his teeth at this age? If so, what can we do to make the process a little less miserable for all of us (and our neighbors, who probably think we’re torturing our son)?

Okay, here’s something you probably didn’t know: dental caries (better known as tooth decay or cavities) is a disease, not just a hole in a tooth. Actually, it’s the single most common chronic childhood disease—far more common than asthma and obesity, according to the California Dental Association. And to make matters worse, tooth decay is contagious, just like the measles, the flu, and small pox. The bacteria that cause decay can be passed from one person to another by kissing or sharing drinking cups or silverware.

Pain and suffering due to untreated tooth decay can lead to problems in eating, speaking and paying attention in school. In other words, cavities hurt. And having them filled hurts too. (New laser treatments are promising to make cavities and fillings pain free. But don’t yet mention that to your child.)

One way to avoid cavities is to make sure your child brushes twice a day, every day with a soft brush. This comes directly from the top, the ADA. Unfortunately, until your child is about six years old, he won’t have the coordination to brush his teeth on his own. He can get the process started, but you’ll need to give his mouth a once-over to make sure the job gets done right.

As your child gets older, show him how to brush with a fluoride toothpaste and floss on his own. There are all kinds of flavored flosses out there that you can buy to make to task less onerous. You also might want to pick up some disclosing tablets or drops at your local pharmacy. You may remember these tablets from grade school. When you chew them or swish the drops around any unbrushed spots on the teeth will show up red. Use the tablets or drops every day for the first week that your child is brushing solo. Then cut back to once or twice a week.

If your child refuses to brush, you’ve got a few options.

1. Sticks. Taking away some privileges or treats until the teeth start gleaming.
2. Carrots. Incentives and rewards for doing the job right. This is generally more successful then punishment.
3. Scare tactics. Caring for your teeth and gums does more than improve your smile and your breath. The bacteria that cause tooth decay can get into the bloodstream, where they increase the risk of ulcers, pneumonia, digestive problems, heart disease, stroke, and diabetes. This is absolutely true.
4. Gum and candy. Yep. But not just any kind. It has to be sugar free and sweetened with xylitol, a natural sweetener that keeps bacteria from sticking to teeth. Chewing gum with xylitol for five minutes after each meal has been shown to reduce cavities.
5. Sealants. About 80 percent of cavities in kids are on the tops of their molars, and studies have shown that sealing these teeth with a special kind of resin is extremely successful in preventing cavities.

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Armin Brott's bestselling books have helped millions of men around the world become the fathers they want to be—and their children need them to be. His most recent is Fathering Your School-Age Child. Armin has been a guest on hundreds of radio and television shows, writes a nationally syndicated column, “Ask Mr. Dad,” and hosts a weekly radio show. He and his family live in Oakland, California.