How to brush your child's teeth correctly

Brushing a small child's teeth is one of those tasks that sounds simple and turns out to be a nightly negotiation. At Victorian Dental Group we know the challenges parents face, so here is the technique, the timeline, and what to do when it goes badly.

Toothpaste, by age

Worth getting right, because this is the question we are asked most and the advice online is inconsistent.

A child at higher decay risk is sometimes advised differently. If we have told you something other than the table above, follow what we told you — it will be for a reason specific to your child.

And in every case: spit, do not rinse, and do not let them swallow it.

The technique

1. Use the right toothpaste for their age (see the table above) on a soft children's toothbrush with a small head.
2. Position matters more than anything else. Sit the child in your lap facing away from you, or stand behind a taller child. Tilt their head back against your body so you can actually see all the tooth surfaces. Brushing from in front, facing them, means brushing blind.
3. Angle the bristles towards the gum. Move the brush in gentle circles to clean the outer sides of the teeth and gums.
4. Brush in gentle circles on the inside surfaces of the teeth and gums.
5. Brush back and forward on the chewing surfaces.
6. Encourage them to spit out the toothpaste — and not to rinse with water afterwards. Rinsing washes away the fluoride that is doing the work.

Technique adapted from guidance published by Dental Health Services Victoria.

Positions that work

Most brushing battles are really access problems. Three that help:

• Lap-to-lap for a baby or toddler with two adults: sit facing each other, knees touching, child lying with their head in the second adult's lap. One holds hands gently, one brushes. Excellent view
• On the bathroom floor, child lying with their head between your knees, looking up. Sounds odd; works well
• Standing behind, child's head tilted back against your body, both of you looking in the mirror. The best option once they are tall enough

The common feature is that you can see what you are doing. Facing a child and brushing towards yourself is how the inside surfaces get missed for years.

Where children's teeth actually decay

So you know where to concentrate:

• The chewing surfaces of the back molars — deep grooves, and the hardest place to reach
• Between the back molars, once they touch. A brush cannot get there at all
• The gumline of the upper front teeth, especially where a bottle or sipper cup has been used
• Behind the very back tooth, which is missed almost universally

If you only have thirty calm seconds, spend them on the back teeth. The front ones get cleaned incidentally by everything else.

When to start, and when to hand over

Start before the first tooth. Wiping the gums with a clean, damp cloth gets the child used to having their mouth attended to, which makes the transition to a brush far easier.

First tooth, first brush. As soon as a tooth appears, brush it twice daily.

Keep doing it yourself until around seven or eight. This is the part most parents are surprised by. Children lack the manual dexterity for effective brushing until roughly the age they can confidently tie their own shoelaces. A four-year-old brushing enthusiastically is developing a habit, not cleaning their teeth.

Then supervise. Even once they are brushing competently, a check afterwards — particularly at night — catches the back teeth, which are almost always the ones missed.

A useful arrangement for a six- to eight-year-old: they go first, you go second. It preserves their independence and still gets the teeth clean. Calling your turn "the check" rather than "doing it properly" helps.

The two minutes

Most people, adults included, brush for far less time than they think. Two minutes is longer than it feels. A song, a timer or a brushing app all work; what matters is that the time is genuinely spent, and spread across all four quadrants rather than concentrated on the front teeth that are easiest to reach.

The night brush is the important one. Saliva flow drops during sleep, so whatever is left on the teeth sits there for hours. If a day goes badly and only one brush happens, make it that one.

Flossing

Start cleaning between the teeth as soon as two teeth touch. Once there is contact, a brush cannot get between them, and the contact points between back molars are a very common site of childhood decay. Floss picks are easier to manage in a small mouth than a length of floss.

Realistically, once a day is enough, and at night is best. Be gentle at the gum — snapping floss down hurts, and a child who has been hurt once will not let you do it again.

When it goes badly

Almost every parent hits a stage of refusal. Some things that help:

• Let them choose the brush and the toothpaste flavour. A small amount of control makes a large difference.
• Brush together, so it is something you do rather than something done to them.
• Try a different time. An exhausted child at 8pm will fight anything. Brushing before the bath, or before the last story, often works better than at the very end.
• Two-brush approach. Give them one to hold and chew while you use the other. It removes the fight over possession.
• Count, sing or narrate. Predictability reduces resistance more than distraction does.
• Accept a partial win. A quick, calm brush is better than a thorough one that ends in tears and makes tomorrow harder.

A few more that work in practice:

• A mirror. Many children will tolerate brushing while watching it happen
• Brushing a toy's teeth first, then theirs
• Letting them brush your teeth, then swapping
• A sticker chart for the week, not for each brush
• An electric brush from about three. The novelty helps, and the timer settles the argument about how long
• Naming the teeth you are cleaning — "now the ones at the very back" — which turns it into a game with a structure

If a child suddenly resists having a particular area touched, that is worth mentioning to us — it can indicate a sore tooth rather than defiance.

What not to do: force a struggling child, pin them down, or turn it into a punishment. The two-minute brush you win tonight is not worth the six months of resistance it buys.

What to avoid

• Do not share brushes, or clean a dummy in your own mouth. Decay-causing bacteria transfer readily from adult to child.
• No bottle in bed with anything other than water. Milk or juice pooling around the teeth overnight, when saliva flow is lowest, causes a distinctive and severe pattern of decay.
• Do not rinse after brushing — spit only.
• Do not use adult toothpaste for young children; the fluoride concentration is higher than it needs to be.
• Do not leave a sipper cup of milk, juice or cordial within reach through the day. Water between meals.
• Do not brush straight after vomiting — rinse with water and wait thirty minutes.

Brushing with braces, or with additional needs

Braces make cleaning harder at exactly the age when it is least reliable. Brush after every meal, angle above and below each bracket, and use an interdental brush under the wire. White marks around brackets are permanent.

Additional needs. Tell us what works and what does not, and we will adapt the advice. Things that often help: a consistent time and place, a visual sequence of steps, a three-sided brush, a chewy brush to desensitise first, an electric brush for the vibration — or for some children, avoiding one entirely because of the noise.

First visit, and check-ups

Bring your child for their first visit by around twelve months of age, or when the first tooth appears — whichever comes first. Early visits are about familiarity rather than treatment — a child who has sat in the chair a few times when nothing was wrong copes far better on the day something is.

Then at the interval we recommend, usually every six months, so we can watch their development, apply preventive treatments like fissure sealants where they are warranted, and catch problems early.

Who provides this here

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. Children are seen by our dentists and oral health therapists. Where a child needs care beyond general practice, we refer to a registered specialist paediatric dentist.

We would much rather show you the technique in person and check your child's teeth while everything is straightforward. Read more about family and children's dentistry, or book an appointment.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.