Toothbrushing for Toddlers

My friend, also a therapist in our state’s early intervention program, attended an initial team meeting for a child last week and had a discussion that I’d like to share with you.  This child does not like to brush his teeth.  Actually that’s not strong enough wording.  In fact, he HATES to have his teeth brushed.  According to my friend, he fights it tooth and nail.  Pardon the pun. 

His mother wondered if they would be “damaging” him in anyway if they “made” him brush his teeth, or if they should “let it go.” 

Before I weigh in on this, let me just say, that there are LOTS of things we “make” our children do for their own good.  Even if a toddler balks, we make him stay buckled in a car seat while driving.  Even if he hates going to the doctor, we make him go anyway.  If he throws a fit when taking medicine, we might try to disguise it in juice, but we do something, anything to get it into his mouth.  As parents we can’t really make a child sleep, but we do eventually put him to bed, like it or not.  If a little boy dislikes haircuts, we usually continue to do that too.  

Toothbrushing falls into this same category.  You absolutely, positively MUST brush your child’s teeth.  You cannot ignore it, or you and he will pay the price at the dentist’s office.  Frankly, in my opinion, it’s just plain gross if you don’t.

There are ways to make it more pleasant, even for a belligerent, hypersensitive toddler.  Before we talk about that, let me say that resistance to toothbrushing can be both a sensory-based challenge and a behavioral issue.  If your child has sensory problems, there are very real reactions that he’s experiencing when you brush his teeth.  Some children are defensive when their mouths are touched in any way.  Having your mother poke a stick into your mouth and rub it around all over your teeth is offensive and scary to these kids.  He reacts by going into “fight or flight.”  He may have experienced this feeling so much that it becomes a behavioral issue.  All it takes is for him to see you get the toothbrush out of the drawer, and then he lapses into his cycle of “fight,” that is physically resisting you to with every bit  of ”fight” his little body can muster, or “flight, ” running away and hiding, before you come near him.

One way to approach this defensiveness is by giving your child more control, at least initially in the process.  Let him begin by brushing his own teeth, even if he’s just chewing the toothbrush for a couple of minutes;  then have him let you finish the job.  By the way - you can’t totally turn over the responsibility for toothbrushing to a toddler for a long time.  The American Academy of Pediatric Dentistry recommends that parents continue to supervise toothbrushing until a child turns 12.  You read that correctly - 12.  That’s a lot older than 2, so you better figure out a new approach to make it work!   

Ways you could make it more pleasant are -

• If your child has the ability, let him select his own toothbrush from the store.  Take him to the toothbrush aisle and let him pick.  Make it exciting!  Talk about it several times before you go to the store, so it becomes an event.  
• If  she’s crazy about a particular character, search high and low to find a toothbrush with that person.
• Another option is to buy two toothbrushes and let your child “choose” each time which toothbrush he’ll use.  The choice becomes which toothbrush he’ll use, not if he’s going to brush his teeth.  By giving him a little more control, you may decrease the battle.
• Instead of brushing before bed, have your child brush during a better part of the day.  Right after dinner would be optimal, but if not, try before he can do a favorite activity.  If you include roughhousing or tickling as part of your night-time routine, have him brush to get his playtime or tickles.  If he loves to go outside and swing, tell him, “First brush, then swing.”  If he doesn’t respond to this tactic, try to redirect him to another activity until he’s “ready to brush.”  Don’t punish him by telling him over and over, ”No!  You can’t do xyz because you didn’t brush your teeth.”  Brushing becomes punishment at that point, but keep redirecting him by saying, “Brush first, then ______.”  Try not to do the “fun” or “reward” activity until he’s brushed his teeth, but again, keep it light and playful so that you’re not reinforcing the resistance with your own negativity.            
• Brush to music - a song normally lasts between 2 and 3 minutes, and this is the amount of time recommended by dentists to effectively clean your teeth. Brushing to the rhythm of the music will make it more interesting.  If you don’t have music to play, sing.  I like, ”This is the way we brush your teeth, brush your teeth, brush your teeth.  This is the way we brush your teeth early in the morning,” (or “in the afternoon,” “right before bed,” etc…)  If you can’t get this amount of time right now, brush for however long both of you can stand it!  
• Let your child use a battery-powered toothbrush.  These are great for sensory-seeking children!  If new batteries are too strong and scare your child, try to replace the new ones with older batteries with less power.  Your TV remote control or the smoke detector is  a good place to find and trade old batteries for new ones!    
• Try a different location.  My children brushed in the tub for years.  You may also try brushing while he’s watching a favorite television show (if you’re allowing TV).  
• Change toothpaste.  It could be the flavor that’s causing the negative reaction, or you may find a flavor that’s less offensive.  You could skip the toothpaste altogether and brush with water if you think this is a big part of the problem.
• Try having a more fun approach or person do the brushing.  Dad may be able to cajole a child into brushing by turning it into a game that your child has never played before. 

Silly techniques that have worked for children on my caseload have included:

1. A mom pretended to brush several different body parts before finally getting to her child’s teeth.
2. Make the toothbrush “hop” up a little girls’ arm, then shoulder, then face, then mouth.
3. A child took a turn brushing Mommy’s teeth first before she brushed his.
4. A family made toothbrushing a whole family activity so that everyone was in the bathroom brushing at the same time.      

For sensory-defensive children, you may have to get their whole bodies ready first.  For example, try toothbrushing after a 15 or 20 minute period of running, jumping, swinging, or whatever activity seems to be calming and regulating for them.  One other technique is to apply deep pressure, by massaging or squeezing, first their feet, then legs, then hands, then arms, then shoulders, and then massage their cheeks for a while BEFORE you stick a toothbrush in his mouth.      

Hopefully one (or all!) of these ideas will make it easier for your child to brush his teeth.  If not, mentally prepare for the fuss, and do it anyway.  Not brushing is not an option, for you or for him.   

If you’ve found other ideas that work, please add them in the comments section.  I love to hear from our readers!  Laura