She Doesn’t Like to Brush

Author: Kimberly N. Powell, DDS, MS

The title reads “she”, but “she” and “he” can be used interchangeably.  Parents can get frustrated when their infant/toddler refuses to allow their teeth to be brushed.  Parents express their concerns when that same behavior is repeated during hygiene appointments. It is imperative to know that a crying child can be a caregiver’s best offense when attempting to clean their oral cavity.  While the mouth is open, a moist towel or kids’ toothbrush can be used to clean their teeth, tongue, roof of mouth, and cheeks; remember to be gentle.  According to the American Dental Association (ADA), the use of fluoride toothpaste for children younger than 6 years is effective in reducing caries.  The evidence also showed that ingesting pea-sized amounts or more can lead to mild fluorosis (white spots/discoloration of enamel).  Considering children are also exposed to fluoride through consumption of food and beverages and aid in the risk of developing fluorosis per the ADA, the recommended use is a smear of toothpaste from eruption of the first tooth to age 3 years followed by use of a pea-sized amount for children aged 3 to 6 years.  Remember to always supervise your child while they are brushing.


Figure 1.  The toothbrush on the left shows a smear of toothpaste (0.1 milligram of fluoride) and the one on the right a pea-sized amount (0.25 mg of fluoride).

Children get use to most routines.  Even though it is challenging, practicing healthy oral habits early will aid in continuing these practices in adolescents and adulthood.