What Is the Right Way of Brushing Children's Teeth?

Cleaning begins before the first tooth, by wiping the gums with a clean, soft, damp cloth after feeds. When the first tooth comes through, usually at about six months, switch to brushing it twice a day with a soft infant brush. Our guide to teething symptoms covers what to expect around that time.

Starting early matters for two reasons. The tooth can decay as soon as it is through, especially if the baby feeds at night. And a child who has had a brush in the mouth since infancy accepts it as normal, instead of fighting it at three years old.

Use a fluoride toothpaste suited to the child's age and check the label. Under about three years, put on a smear about the size of a grain of rice. From about three to six years, use a pea-sized amount. A pea-sized amount remains the usual advice as the child grows.

The adult puts the toothpaste on the brush. A child who squeezes the tube will use far too much and tends to swallow it. Keep the tube out of reach between brushings. The reasons for these amounts, and the small risk of too much, are set out in fluoride treatment for children.

For a baby or toddler, sit with the child's head resting against your arm or lap, facing up, so you can see all the teeth. Or stand behind a slightly older child in front of a mirror, with their head tipped back against you. Lift the lip to see the front teeth and the gum line.

Use small gentle circles or short back and forth strokes, with the bristles angled toward the gum line, where plaque collects. Do the outer surfaces, the inner surfaces, and the chewing surfaces of the back teeth, which have deep grooves. Spend extra time along the top of the upper molars.

Two minutes is the target, but a toddler may only allow thirty seconds at first. Build up, and do the hardest areas first while the child is still cooperating. Press lightly. Hard brushing does not clean better and can hurt the gums.

A young child cannot clean well because the hand skills are not there yet. An adult should brush, or stand over the child and check, until about seven or eight.

A common routine is that the child brushes first, for practice and pride, and the adult then goes over every tooth. After that, move to supervised brushing, where the child does it and the adult checks and finishes the back teeth. Do not stop supervising just because the child insists.

Replace the brush every three months, or sooner if the bristles splay. A small head and a soft texture suit milk teeth.

After brushing, the child should spit out the foam and not rinse with a lot of water, so a thin film of fluoride stays on the teeth. Young children often swallow, so practise spitting early, with a game if needed. Do not use an adult mouthwash in young children.

Night brushing matters most. Saliva flow falls during sleep, so the teeth are least protected, and a sugary residue left on them feeds bacteria for hours. After the last brush, give nothing but water. That includes milk or juice in a bottle or cup, which is the start of the decay pattern in cavities in milk teeth.

If only one brushing a day happens on a bad day, make it the night one.

Start flossing once two teeth touch, which in many children happens at the back, between the milk molars, from about two to three years. Floss picks with a handle are easier for a parent than string. Clean between each touching pair once a day, usually at night.

To make it routine, brush at the same times each day, after breakfast and just before bed. Let the child pick the brush, sing a short song or use a timer, and brush your own teeth alongside theirs. Praise the effort, not just the result. Never use brushing as a punishment, or the dentist as a threat, as discussed in a child's first dental visit.

If a child refuses everything, a calm, firm routine and a chat with the dentist usually helps. Our kids dentistry page sets out how children's check-ups work.