Head Start

How can adults encourage infants and young children to cooperate with toothbrushing?

Infants and young children do not have the hand coordination to brush their teeth effectively. They need help from an adult to make sure that they don't use too much toothpaste and that they brush their teeth thoroughly. For this reason it is recommended that an adult brush the child's teeth at least twice a day (after breakfast and before bed). But young children want to be independent, and they don't always cooperate when an adult tries to brush their teeth. Fussing or crying can be common.

The strategies listed below are suggestions. Depending on the child and the situation, they may or may not work. Adults need to be patient and creative and to try different approaches. It's also important to praise a child regularly for doing a good job with toothbrushing.

1. Children like to copy adults, so the adult can invite the child to brush at the same time as the adult. Before the child finishes, the adult can take the child's brush to “check what a good job the child is doing.” This gives the adult an opportunity to brush the child's teeth. If more convincing is needed, the adult can offer the child the chance to check the adult's teeth after brushing.

2. In a classroom setting or if there are two or more children of about the same age, brushing as a group provides a good opportunity for children to imitate the behavior of the adult and other children.

3. Children like playing games, and games can be incorporated into toothbrushing. For example, the adult can give the child the adult's toothbrush and ask the child to brush the adult's teeth. Next, the adult brushes the child's teeth with the child's toothbrush. The mouth can be divided into sections to brush (for example, top, bottom, back, front), which allows for more back and forth between the adult and the child.

4. The adult can ask the child what sounds animals (for example, lions, tigers, and bears) make and how big they open their mouths to make those sounds. The adult can brush the child's teeth while the child is growling. The child may need to growl many times before all the teeth can be thoroughly brushed.

5. The adult can read the child age-appropriate books about toothbrushing to encourage the child to accept having the teeth brushed. The adult should preview books before reading them to the child to make sure the messages are positive. Books that may make the child afraid of the dentist or dental office or that talk about pain should not be read.

6. Children like rewards. As an incentive, children can be offered something special if they allow an adult to brush their teeth twice a day.

7. Discussions with children about brushing should always be positive. Negative consequences of failing to brush, such as having to get a cavity filled, should never be part of the discussion.

Performance Standards

1304.23(b)(3)

References

Casamassimo P, Holt K, eds. 2004. Bright Futures in Practice: Oral Health-Pocket Guide. Washington, DC: National Maternal and Child Health Oral Health Resource Center.

Huntley B, Hagen J. 2004. Cavity Free Kids: An Early Start-Oral Health Education for Pregnant Women, Infants, and Toddlers, rev. ed. Seattle, WA: Washington Dental Service Foundation.


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