Preparing a Child for Toothbrushing: Ideas from an Occupational Therapist

Pediatric Occupational Therapists work with children to make participating in their daily occupations more independent through adaptation or skill building. An important occupation for children is brushing their teeth or at least allowing an adult to brush their teeth. For children with special needs, this can be challenging because toothbrushing requires one to be able to grasp and sustain a hold on the toothbrush, accurately bring the toothbrush to one’s mouth, cross midline to brush teeth on the opposite side of the mouth, wrist rotation to brush all surfaces of the teeth, sequencing of steps for toothbrushing, oral motor coordination to spit toothpaste out versus swallowing it, and tolerance of oral sensory input. Who knew there was so much involved in a simple, but important 2 minute task of brushing your teeth?

Below are some ideas to help introduce, adapt, or prepare a child for toothbrushing:

  • Play with a toothbrush so that this tool is no longer intimidating – Use a toothbrush as a paintbrush, brush a favorite stuffed animal’s teeth, or brush “wind up chatting teeth”. There are many ideas on Pinterest if you are feeling creative.
  • Read about brushing teeth – Read to your child daily a social story for brushing teeth that has been created by your child’s Occupational or Speech Therapist. Also, there are MANY good books available that are kid friendly and talk about brushing teeth.
  • Provide visual support for sequencing this task – Discuss with your child’s Occupational Therapist the benefits of having a visual/picture schedule to organize multiple steps necessary to brushing teeth.
  • Positioning – Look at the best positioning for your child to complete the task of brushing teeth since standing on a step stool at a sink requires balance and core strength. A supported sitting position may allow your child greater independence with this occupation.
  • Use a timer – There are a variety of timers to choose from including a sand timer, toothbrushing app timer, and singing the song “This is how we brush our teeth…” for a specified number of times. For example, start with singing the song 3 times, but each week gradually increase the number of times the song is sung until you reach the 2 minutes necessary for brushing teeth. Just verbally prepare your child with how many times you are going to sing the song so your child knows your expectations. The same concept can be applied to using a timer in that you want to start your child at a small increment of time, say 30 seconds, and slowly build up to the 2 minutes.
  • Routine – Children thrive on routine and the task of brushing teeth is important to not only include within a morning/evening routine, but to also develop a routine for the specific task.
  • Adjust water temperature – Some kids respond more positively to luke warm water versus cold water.
  • Try different toothbrushes – For some kids, toothbrushing independence is all about having the right tool. There are many options to try including a finger toothbrush, vibrating toothbrush, light up brushes, cartoon character brushes, firm or soft bristles, and a toothbrush with a short vs. long handle.
  • Toothpaste – Some kids do not like the task of brushing teeth simply because of the taste/texture of the toothpaste. There are a variety of flavors of toothpaste to try. If toothpaste is the trigger to unsuccessful toothbrushing time, then start with water only and slowly introduce toothpaste with a dot the size of a grain of rice.
  • – Lisa, Occupational Therapy Team