A few things about brushing teeth…

Parents seem to have multiple questions about brushing teeth. Some of the common ones are:

  • When should I start to brush?
  • How do I brush when they won’t let me?
  • When can I let them brush on their own?
  • What about fluoride toothpaste?
  • What is the preferred method for optimum plaque removal?

These are great questions! … And I’m sure that they can, and do, receive multiple and varying answers, that quite possibly conflict. Some people answer on a scientific basis, some answer on a historical perspective, and others just simply make stuff up.

I’ll give you my view. I like a science-based view, with some common sense involved

When should I start to brush?

You should start to brush as soon as you can. This means, even before your child’s teeth erupt. When the teeth appear, you and your child should already be in the habit of brushing.

Some professionals will advocate for a toothbrush, some will say you should wipe the teeth with a towel, and some will ask you to use something entirely different. It really doesn’t matter what medium you choose, as long as you are attempting to mechanically move the plaque off of the teeth and massage the gums.

Brushing the teeth is much more important than what you use to do it. Get started as soon as you can! Just remember that a soft toothbrush/towel/etc. is mandatory. You can leave the steel wool for the golf clubs. :)

How do I brush when they won’t let me?

Almost all parents come in and say, “my child won’t let me brush the teeth,” or “it’s a fight every time we brush.” This is NORMAL, well at least at my office.

Kids are not small adults. Kids don’t always understand why we do what we do. If a child goes to dart into traffic and you grab their shirt, they most likely won’t like the fact that you grabbed them. They will get mad. They will cry. They will fail to understand what your actions are accomplishing.

Yes, it would be nice for children to go along and brush their teeth properly without a care in the world. However, much like eating your vegetables, good for you doesn’t always translate into doing with a smile…

Sometimes kids require a tag team approach. A knee-to-knee set up allows for control of the child in a safe manner, as well as for direct views of both arches (the upper and lower jaws) by one brusher or the other.

If you’ve been into the office, then you know that sometimes this is the only way to accomplish a dental exam. Some kids are just difficult when they are younger. Most will realize that you are helping them and they will stop fighting, but some won’t. It depends on how committed you are to keeping their teeth spotless.

When can I let them brush on their own?

“He wants to brush by himself, so I let him”…

We get this a lot at the office. Kids, especially around 4-5 years of age, wish to be independent. It doesn’t mean that they can be. Most children at that age lack the manual dexterity to be able to clean their teeth properly.

I used to say, “when you child can sign their name in cursive, then they’re able to have the dexterity to brush”… then the Ministry of Education went and cut cursive writing. So…

The new line used is, “you can turn over brushing to you child when YOU are comfortable having them brush YOUR teeth.”  This is usually quickly followed by a laugh, while the parent comments something to the effect of they would “never trust their little one to clean the parent’s teeth.”

If they can’t take care of YOUR teeth, how can they possibly look after their own?

Yes, it is important to promote independence. However, if your child cannot handle the responsibility of cleaning their teeth properly, it isn’t fair to become upset with them when they fall short and cavities develop.

My preference is to have parents floss first and brush second. If the child then wants to make sure that their parent did a great job and then mimic with the toothbrush, that’s awesome!

What about fluoride toothpaste?

This is a great question, and the answer has changed in the last little while. You’ll hear people talk about the ability to spit as the guideline for when to introduce fluoride toothpaste. Well, I have 9 year old patients that can’t spit (and some grandparents that can’t either!). While these individuals may never have a career as a professional baseball player, that doesn’t mean that they can’t take advantage of the benefits of fluoride toothpaste.

The new recommendation (AAPD, CAPD, ADA, CDA) is for fluoride toothpaste to be introduced at 2 years of age.

Now, please understand, fluoride needs to be treated as a drug. I’m sure you wouldn’t turn over the bottle of Tylenol to you child and just let them have at it. Use of fluoride needs to be supervised. And remember… you don’t need a lot of toothpaste.

I love how pretty the toothpaste looks on the commercials ~ the big swoosh looks amazing… and it’s enough toothpaste for a week! A smear on the brush is enough. You don’t need a lot of toothpaste. Please see below for a picture of what I’m talking about. USE LESS, but do use it. It does help to prevent the teeth from forming cavities.


A smear

too much1

Impressive… but simply too much

What is the preferred method for optimum plaque removal?

Answer: modified Bass technique. (Now you too can pass a random question on the Canadian Dental Exam board). Translating into useful language, it means to make circles with a SOFT toothbrush and after a few circles, brush away from the gum line. I don’t care if you’re from New Zealand and make your circles in the wrong direction :) … Just be sure to make them.  

That’s it.

Brush those teeth two or, dare I say it, THREE times a day.

  • With a smear of fluoride toothpaste on a soft toothbrush
  • Knee to knee if you need to
  • Using the modified Bass technique

Your children will thank you (maybe not right away, but at some point).

Your dental assistant will thank you.

Your dental hygienist will thank you.

Your dentist will thank you.

Prevention is better than treatment. Fight those sugar bugs… and floss on days that end in “y” :)



Policy on Use of Fluoride. American Academy of Pediatric Dentistry (2014).
Retrieved from http://www.aapd.org/media/Policies_Guidelines/P_FluorideUse.pdf