Daily Oral Hygiene for Kids

Why Kids’ Oral Hygiene Matters So Much

Tooth decay is the most common chronic disease in children—5 times more common than asthma.

According to the CDC, 23% of children ages 2-5 and 52% of children ages 6-8 have had cavities in their baby teeth.

The good news? Cavities are almost entirely preventable with proper daily oral hygiene.

Establishing good brushing and flossing habits early has lifelong benefits:

• Prevents painful cavities that can affect eating, sleeping, and learning
• Protects permanent teeth developing beneath baby teeth
• Establishes habits that carry into adulthood
• Reduces need for dental treatment and associated anxiety
• Supports overall health—oral bacteria can affect the whole body

Age-by-Age Guide: How to Care for Your Child’s Teeth

Birth to 6 Months (Before Teeth)

Even before teeth appear, you should clean your baby’s gums.

This removes bacteria, gets your baby accustomed to oral care, and establishes a routine.

How to do it:

1. Wrap a clean, soft cloth or gauze around your finger
2. Dampen with water (no toothpaste needed yet)
3. Gently wipe along baby’s upper and lower gums
4. Wipe the tongue if there’s visible milk residue

6-12 Months (First Teeth)

Start brushing as soon as the first tooth appears. The American Academy of Pediatric Dentistry (AAPD) recommends fluoride toothpaste from the first tooth—not “training toothpaste” or water only.

How to do it:

1. Use a soft-bristled infant toothbrush with a small head
2. Apply a tiny smear of fluoride toothpaste (size of a grain of rice)
3. Position baby in your lap or on a changing table
4. Gently brush all surfaces of each tooth
5. Brush the gums where teeth will emerge
6. No need to rinse—the small amount of toothpaste is safe to swallow

Ages 1-3 Years (Toddlers)

This is often the most challenging age for brushing.

Toddlers want independence but lack the skills to brush effectively.

They may resist, clamp their mouths shut, or grab the toothbrush.

Recommended position for toddler brushing:

Tips for resistant toddlers:

• Let them hold a toothbrush too (give them the “fun” brush, you keep the “working” brush)
• Sing songs or use a 2-minute timer app with characters
• Let them “brush” a stuffed animal’s teeth first
• Make it a game: “Let’s find the sugar bugs!”
• Offer choices: “Do you want the dinosaur or rocket toothbrush?”
• Be matter-of-fact: Brushing isn’t optional, but how you do it can be fun

Ages 3-6 Years (Preschool)

At age 3, increase toothpaste to a pea-sized amount.

Children this age want to brush “by myself,” which is great for building independence—but they still need a parent to do the actual cleaning.

The “You-Me-You” approach:

1. You (child): Let them brush first to practice independence
2. Me (parent): Parent does a thorough “check brush” to clean properly
3. You (child): Let them finish with a final brush if they want

Teach children to spit out toothpaste after brushing (not swallow), but don’t rinse with water—letting fluoride sit on teeth provides more protection.

Ages 6-8 Years (Early Elementary)

Most children can begin brushing independently around age 7-8—when they can tie their own shoes (which requires similar fine motor skills).

However, parents should still:

• Spot-check brushing several times per week
• Supervise to ensure 2-minute duration
• Help with flossing until around age 10
• Monitor toothpaste amount (kids tend to use too much)

Ages 8+ (Independent Brushing)

By age 8-10, most children can brush and floss independently.

Parents should:

• Ensure brushing happens twice daily (morning routine check)
• Provide reminders about flossing
• Replace toothbrush every 3-4 months
• Consider an electric toothbrush with timer
• Schedule regular dental checkups every 6 months

Proper Brushing Technique for Kids

Effective brushing removes plaque—the sticky film of bacteria that causes cavities.

Simply moving the brush around doesn’t guarantee clean teeth. Here’s how to brush properly:

Step-by-Step Brushing Guide

1. Angle the brush: Hold the toothbrush at a 45-degree angle to the gums
2. Use gentle pressure: Don’t scrub hard—let the bristles do the work
3. Use short strokes: Small circular or back-and-forth motions, one tooth at a time
4. Brush outer surfaces: All teeth, upper and lower
5. Brush inner surfaces: Tilt brush vertically for front teeth
6. Brush chewing surfaces: Back-and-forth strokes on molars
7. Brush the tongue: Removes bacteria that cause bad breath
8. Spit, don’t rinse: Spit out toothpaste but don’t rinse with water

The 2-Minute Rule

Brushing should last 2 minutes—most people brush for only 30-45 seconds.

Ways to ensure adequate time:

• Use a timer app designed for kids (many have characters and songs)
• Play a 2-minute song
• Use an electric toothbrush with built-in timer
• Divide mouth into 4 quadrants, spend 30 seconds on each

Morning vs. Night Brushing: Which Is More Important?

Night brushing is more important. Here’s why:

• Saliva decreases during sleep: Saliva naturally protects teeth, but production drops at night
• Bacteria multiply overnight: Without saliva’s protective effect, bacteria thrive
• Food sits longer: Anything left on teeth has 8+ hours to cause damage

Never skip the bedtime brush. If you must skip one (you shouldn’t!), skip morning rather than night. Nothing should go into the mouth after night brushing except water.

Fluoride Toothpaste: How Much and What Kind

The AAPD and ADA recommend fluoride toothpaste for all children starting with the first tooth.

Fluoride strengthens tooth enamel and can even reverse early cavities. The key is using the right amount.

How Much Toothpaste by Age

Is Swallowing Toothpaste Dangerous?

The rice-grain and pea-sized amounts are specifically designed to be safe if swallowed.

However, swallowing large amounts of fluoride over time can cause dental fluorosis (white spots on permanent teeth).

That’s why proper amounts matter.

To minimize swallowing:

• Use only the recommended amount
• Parents should dispense toothpaste, not children
• Choose toothpaste flavors kids don’t want to eat (mild mint vs candy flavors)
• Teach spitting as early as possible (usually by age 2-3)
• Store toothpaste out of reach

Fluoride vs. Fluoride-Free Toothpaste

The AAPD recommends fluoride toothpaste for all children.

Fluoride-free “training” toothpaste does not protect against cavities.

If you have concerns about fluoride, discuss them with your pediatric dentist—the risk of cavities from not using fluoride far exceeds any risk from proper fluoride use.

When and How to Floss Kids’ Teeth

Start flossing when any two teeth touch each other—usually around age 2-3.

The toothbrush can’t reach between teeth where they contact, but bacteria and food particles hide there, causing cavities between teeth (called interproximal cavities).

Flossing Options for Kids

How to Floss Your Child’s Teeth

1. Use about 18 inches of floss, wound around your middle fingers
2. Hold floss tightly between thumbs and forefingers
3. Guide floss gently between teeth using a zigzag motion
4. Curve floss into a C-shape against one tooth
5. Slide up and down against the tooth surface
6. Curve around the adjacent tooth and repeat
7. Use a clean section of floss for each space

For young children, floss picks are perfectly acceptable and much easier than string floss.

The goal is to clean between teeth—any flossing is better than no flossing.

Choosing the Right Toothbrush

Manual vs. Electric Toothbrushes for Kids

Both manual and electric toothbrushes can clean teeth effectively when used properly.

However, electric toothbrushes offer some advantages for children:

Electric toothbrushes can be especially helpful for children with special needs, kids who are resistant to brushing, or those who tend to rush through brushing.

What to Look for in a Kids’ Toothbrush

• Soft bristles: Always choose soft—medium and hard bristles can damage gums and enamel
• Small head: Should fit comfortably in your child’s mouth, reaching back teeth
• Easy-grip handle: Chunky handles are easier for small hands
• Age-appropriate size: 0-2, 2-4, 5-8, and 8+ sizes are common
• ADA Seal of Acceptance: Confirms safety and effectiveness testing

When to Replace Toothbrush

Replace your child’s toothbrush (or brush head) when:

• Every 3-4 months (bristles lose effectiveness)
• Bristles are frayed or splayed
• After your child has been sick
• If the brush has been contaminated (fell on floor, etc.)

Do Kids Need Mouthwash?

Mouthwash is generally not necessary or recommended for children under age 6.

Young children are likely to swallow it, and the alcohol in some mouthwashes can be harmful.

Proper brushing and flossing is sufficient for most children.

When Mouthwash May Be Helpful

For children ages 6 and up who can reliably spit, mouthwash may be beneficial if:

• They’re at high risk for cavities (dentist may recommend fluoride rinse)
• They have braces (helps reach areas brush can’t)
• They have persistent bad breath (after ruling out other causes)

If using mouthwash: Choose an alcohol-free, kid-friendly formula with fluoride.

Use after brushing but don’t rinse with water afterward—let the fluoride stay on teeth.

Common Brushing Challenges (and Solutions)

“My Toddler Won’t Let Me Brush Their Teeth”

This is the most common complaint pediatric dentists hear. Solutions:

• Stay calm and consistent: Brushing isn’t negotiable; your attitude matters
• Make it routine: Same time, same place, every day
• Use distraction: Songs, videos, mirrors, counting teeth
• Give choices: Which toothbrush? Which song? Standing or lying down?
• Keep it short initially: 30 seconds is better than 0 seconds—build up
• Use the “knee-to-knee” position: Gives you control and visibility
• Two-brush technique: Let them hold one while you brush with another

“My Child Gags When I Brush Their Back Teeth”

Gagging is common, especially with the back molars. Try:

• Use a smaller toothbrush head
• Have them breathe through their nose
• Brush back teeth first (before they’re tired/irritated)
• Let them lean forward slightly rather than tilting head back
• Distract them with humming or counting

“My Child Wants to Do It Themselves”

Independence is great—but young children lack the motor skills to brush effectively. Use the “You-Me-You” approach: let them brush first, then you do a “check brush,” then let them finish.

This builds independence while ensuring teeth get clean.

“We’re Always Rushing in the Morning”

If mornings are too hectic for proper brushing, prioritize the bedtime brush (it’s more important anyway) and do a quick brush in the morning.

You can also brush before breakfast—the fluoride protection helps, and you won’t need to wait 30 minutes after eating acidic foods.

Frequently Asked Questions

Sources & References

• American Academy of Pediatric Dentistry. (2024). Guideline on Fluoride Therapy. AAPD Reference Manual.
• American Dental Association. (2024). Brushing Your Teeth. MouthHealthy.org.
• Centers for Disease Control and Prevention. (2024). Children’s Oral Health. CDC Oral Health Division.
• American Academy of Pediatrics. (2024). Brushing Up on Oral Health: Never Too Early to Start. HealthyChildren.org.
• Wright JT, et al. (2014). Evidence-based clinical practice guideline on the use of pit-and-fissure sealants. Journal of the American Dental Association, 145(3), 190-199.

Dr. Mary

Dr. Mary G. Trice is a renowned pedodontist based in Queens, NY. With an unwavering dedication to children’s dental health. In addition to her clinical practice, Dr. Trice is the writer and manager behind the informative platform pediatricdentistinqueensny.com. Through this site, she offers valuable insights, tips, and resources for parents and guardians, aiming to bridge the gap between professional dental care and everyday oral hygiene practices at home.