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How To Get Toddler To Brush teeth

Dear Dr. Laura,
My 16 month old hates it when I brush her teeth. It has gotten worse because she is giving up one of her naps and now I'm trying to keep her up until 7:00 and brushing teeth is one of the last things we do after the bath and before bed -- she is crazy then, throwing a fit. I really don't want her to get cavities. Should I just hold her down and brush? -- J

Toddlers don't really understand why they need to brush their teeth, no matter what stories we tell them about cavities.  And having someone else put something in your mouth and move it around is simply scary, or at least uncomfortable.  Most of us don't enjoy visiting the dentist every six months; we ask kids to open their mouths for us twice a day.  No wonder they resist.

Holding a child down is always a bad idea. It's guaranteed to make them hate brushing their teeth.  And it undermines your relationship.  So I really don't like the idea many dentists suggest, that two adults work together to lie the child down and hold his hands while the other person brushes his teeth.  Imagine if someone did this to you.  How could it not be traumatizing?

That doesn't mean you should give up on brushing your toddler's teeth, obviously. Reconciling those two things can be tough,  but I have seen many families do it.  Basically, you start small and keep at it, just as you do with every other habit.  They all brush, eventually.   A few suggestions:

1. Make brushing teeth just part of the routine.  You may want to try it BEFORE the bath so she is not so tired. Or even during the bath.  More awkward for you, but  she will be more playful and relaxed. Even right after dinner works. 

2. Consider skipping toothpaste.  Most dentists say that's fine at this age, and since most kids don't like toothpaste, you might experiment to see if that makes her more open to brushing. The other option is to buy a bunch of kids' toothpaste (Toms of Maine for instance, prides itself on more natural ingredients) one after the other, trying them and giving her choices.  Maybe she will love one and that will give her incentive.

3. "Play" toothbrushing all day long to help get her used to the idea and work out her feelings about it.
  For instance:

  • Let her brush the stuffed animals' or dolls' "teeth."  
  • Brush all over her body -- her arm, her ear.  "Is this where I should brush?"
  • Let her brush your teeth to reverse the power dynamic and help her work out her feelings about it with a lot of giggling (which releases the same pent-up emotions as crying.)  Here's a terrific post (from one of my favorite blogs) about why doing this helps kids:

4. Use sound to start good habits. Encourage her to say "Teeee" (for the front teeth) and "Ahhhh" (for the back teeth) and roar like an animal so her mouth is open wide while brushing.  This also makes the whole process more of an exciting game.

5. Sing! "This is the way we brush our teeth, after we eat our dinner"  or "The toothbrush in the mouth goes round and round" can be very helpful because singing increases the fun level and  reinforces the routine. Maybe most important, it assures the child that the brushing is time limited, because they can count on it ending when the song ends.  Which leads us to...

6. Keep it VERY short!  Having someone poke around in your mouth can seem interminable even to an adult.  The idea now is to get her used to the idea of brushing.  You can lengthen the amount of brushing time by using songs and timers as she gets older.  

7. Play "copycat".   Since most kids this age enjoy learning by copying us but want to "do it themselves,"  brush together looking into the mirror.  Have her copy you in the mirror as you brush.  She won't do a thorough job, but it is a good start and teaches her that SHE brushes.  That way she doesn't have to rebel totally against brushing teeth even if she goes through periods where she won't let you brush her teeth. Make it a fun game. 

8. Help her finish up.  Most toddlers aren't able to do a thorough job and most parents want to "help" them a bit at the end.  This is the tricky part, because most humans hate having someone else stick things in their mouth.  Try to make this part more palatable by limiting the time (using a song, counting, etc), or making it a game.  A common game that is often successful is to chase things in her mouth.  So you might say you see a giraffe or a tiger in there that you have to catch.  Some people talk about sugar bugs (germs).  I personally liked the game of "Oooh, you had rice tonight, didn't you?  Let's get that rice off your teeth!  I see apples!" etc.

9.  Offering choices helps kids cooperate.  To "finish up" her teeth, does she want her favorite stuffed animal or doll to brush, or a puppet?  (Puppets make it easier for you to hold the toothbrush but she may prefer her doll.  Of course, you can also offer her a choice between two puppets.) Hold the doll or puppet and let them "finish up" her mouth.  Awkward, but it gets the job done.

10.  If she resists, take turns.  Toddlers are beginning to understand "My turn!" so you can say "Baby's turn to brush Mommy!"  and then "Now it's dolly's turn!" and "Now it's Mommy's turn to brush Baby!".

11.  Distract and offer control wherever possible.  It can be very helpful to let the child hold a different toothbrush (or even one in each of her hands) while you brush her teeth.  Let her be in charge of everything you can about brushing -- the toothbrush she chooses, the toothpaste (or not), the song, the position she is in, how many times you have to jump up and down before she's done, etc. Many parents say that simultaneously letting the little one brush their teeth WHILE they brush hers is the best distraction.

If she resists, don't get into a power struggle.  Just "Play" toothbrushing the next day so she sees it is still on the agenda and gets a chance to work out some of her resistance.  Then try some version of brushing the next night.

There are also books and videos out there  that are worth reading with her because it helps her to get used to the idea.  There are even videos on utube of toddlers brushing.  She probably wants to mimic other kids, right? 

BUT I need to add that you can only fight one battle at a time.  That is a good general, if frustrating rule, about any change you want to create.  So I would not stress about tooth brushing while you are transitioning her nap.  If she is too tired at night to handle it, then wait two months until she is taking longer naps.

Dr. Laura

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Anonymous commented on 15-Dec-2010 12:14 PM
This is a wonderful idea! I totally agree. I've been on mommy boards where the parent would suggest holding the childs head still to brush their teeth just for the sake of, "But multipul days of unbrushed teeth lead to cavities."

I see it this way, in the old days there were NO tooth brushes and we did fine. Part of the reason wisedom teeth need to be extracted now is because back then teeth were worn down and fallen out by the time wisdoms came in and so they took place the lost molars. (I should know I had all 4 molars taken out due to genetic tooth rot problem) But my wisdoms are coming in and taking place of the lost molars I had.

But, yes, my son is 14 months old and has no issue brushing by himself (or rather chewing on it). I hand him the brush and do it with him. No fuss, no mess, no drama.
Family Dentistry The Woodlands TX commented on 28-Feb-2012 11:46 AM
Positive reinforcement is always the best method to encourage children to brush their teeth regularly, flossing however, is an additional challenge. We're often asked how long each brushing should take...the time it takes to sing the 'Birthday' song. Our
young patients enjoy humming Happy Birthday to themselves when they brush their teeth.

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