Toothbrushing can be a parenting power struggle. Here's what dentists recommend.

As a mom with three kids age 5 and under, Kathryn Butler says she and her friends "spend a silly amount of time talking about teeth brushing.” For a lot of parents, the sleepless nights and tears brought on by an incoming tooth soon give way to power struggles over brushing those pearly whites — and not just with stubborn toddlers.

Resistance to toothbrushing can be a problem at any age, from babies with just a few teeth to teens who prefer to grab a few extra zzzs in the morning rather than make time to brush, says Dr. Greg Grillo, resident dentist at ExpressDentist.com. 

"Parents often struggle to get kids to brush their teeth, but there are a few tricks that may help,” says Grillo, who recommends that parents try a variety of approaches to get children to tolerate brushing their teeth. It's also worth noting that what works may change as a child gets older.

Dr. Jeffrey Sulitzer, chief clinical officer with SmileDirectClub, says it’s normal for kids to resist every part of personal hygiene, from taking baths to brushing their teeth. The key, he says, is making toothbrushing a part of a child’s regular routine as early as possible. If and when a child does resist brushing their teeth, parents needn't panic, or give in. Instead, it's important to look for age-appropriate ways that'll help teach kids the importance of good oral health.

Babies

According to Sulitzer, parents don’t need to worry about oral hygiene until the baby's first teeth start to erupt around 6 months. Then, babies don’t normally resist too much because they don’t have many teeth that need to be brushed, and the teeth they do have have tend to be in front where they are easy to reach. If a baby does resist, try using a very soft toothbrush, a soft piece of cloth or gauze, Sulitzer recommends. Babies don’t need to use toothpaste. As long as the toothbrush or cloth is wet, rubbing the teeth a few times should be enough to remove any food particles that can cause decay.

Toddlers

Toddlers tend to be more opinionated about having their teeth brushed. As they get older, children have more teeth that need to be brushed in more hard-to-reach places, causing them to gag or balk at having a toothbrush reaching into their mouth. Toothbrushing takes longer and can be a struggle. Sulitzer recommends leaning into a toddler’s natural desire to imitate the grown-ups around them. Parents can model oral hygiene by showing their kids that they brush their teeth at least twice a day. It may also be worth letting a toddler brush Mommy or Daddy's teeth first. Grillo also recommends allowing children to brush one of their stuffed animal’s teeth before brushing their own.

Butler’s 18-month old daughter Charlotte hates having her teeth brushed but the Virginia Beach-based mom of three doesn’t take “no” for an answer. “I don’t mess around with oral hygiene,” she tells Yahoo Life. “I pin her on the ground and make it happen while my other two kids crowd us and encourage her to open her mouth.” She adds that her older two children also didn’t like having their teeth brushed as toddlers but things turned around when they turned 2. Butler expects things to be easier when Charlotte gets older. In the meantime, she follows her pediatric dentist’s advice to “make sure to lift up their top lip and get the gum line of the top teeth because a lot of kids fight you so hard, you miss it.” She also tries to make brushing fun.

“I sing the Raffi 'Brush Your Teeth' song and also narrate 'toooooop,' 'botttoooom,' 'middddle' … and then 'tongue tongue tongue!'" she adds.

Preschoolers and Elementary-Aged Kids

Kids start to develop strong preferences about what they like and don’t like. Grillo recommends allowing children to choose their own toothbrush in their favorite color or with a favorite character. A big reason Sulitzer sees children this age not wanting to brush their teeth is because they don’t like the taste of toothpaste. If that’s the case, parents should try a few different brands until they find one their child can tolerate. Children also tend to respond well to rewards, so using a sticker chart or a reward system can help encourage brushing. Parents might also consider buying a small two-minute hourglass-style sand time to help them know when they've brushed long enough.

Children this age also do well with apps that can make brushing fun and distract them while brushing their teeth. Many new electronic toothbrushes for kids now come with apps, an approach that has worked well for reluctant brusher Henry, 8, from Hartford, CT. His mother, Katherine Martinelli, says that Henry didn’t like brushing but “once he got a ton of cavities, he's gotten much better … he won't yet think to do it on his own but doesn't complain when it's time.” Apps help now distract Henry when it’s time to brush and get him through the recommended two minutes of brushing.

Research also backs up the electric toothpaste approach. In November 2023, research published in the International Journal of Pediatric Dentistry found that oscillating-rotating (O-R) electric toothbrushes were significantly more effective at reducing plaque and gingivitis in kids ages 3 to 10 compared to manual toothbrushes. After a four-week trial conducted by the Hebrew University-Hadassah Faculty of Dental Medicine, 55.7% of kids ages 3 to 6 experienced greater whole mouth plaque reduction and 34.3% greater back-of-the-mouth plaque reduction; for children ages 7 to 10, the improvement was 94.5% for the whole mouth and 108.4% for the back of the mouth.

Sulitzer says it’s OK for parents to get what they can when it comes to brushing. “If I can get a minute of brushing out of a reluctant elementary-aged child, I’m happy,” he says. Sulitzer also says that children this age can begin to understand why they need to brush their teeth. Explaining in simple terms that food left on teeth can cause cavities may be enough to get them over the hump.

Tweens and Teens

Tweens and teens start to become more concerned with their appearance and what others think. When it comes to toothbrushing, parents can use this to their advantage by explaining that brushing teeth will also get rid of bad breath. This is often effective since no teen wants to be caught with bad breath by their peers. Parents can also take steps to remove obstacles to brushing. For example, busy teens may head straight out the door after breakfast in the morning. If they don’t want to stop in the bathroom to brush, move the toothbrush to the kitchen.

Teenagers are also better able to understand the long-term consequences of not brushing. Kids this age are sometimes receptive to a more in-depth explanation of what causes tooth decay and the long-term consequences of not brushing.

Sarah, a mom of teens in the Washington, D.C. area who doesn’t want her last name used for privacy reasons, has a teenager who is resistant to brushing. “The advice I got from her therapist was to be a hard ass — for example, no phone [unless] we witnessed her brushing her teeth," she says. "But all that did was ramp up conflict between us,."

Instead, she worked hard to get to the bottom of why her daughter didn’t like brushing. It turns out she didn’t like the sound the electric toothbrush she was using made. Sarah bought her a quieter toothbrush and things got better. The teen still doesn’t like to brush twice a day, but because she hasn’t had any cavities Sarah has accepted bruising once a day “with the dentist's blessing.” Sarah adds that her dentist said it’s more important to brush at night than in the morning if you can only get a child to brush once a day. “If I've learned anything [from] parenting ... [it’s that] good enough is good enough,” says Sarah.

When nothing works

If parents take the dentist’s advice and still can’t get their children to brush the recommended two to three times a day, there are other steps they can take to promote good oral health.

While there is no substitute for brushing, Sulitzer says that food containing xylitol, which is found in some brands of lollipops, sugar-free gums and lozenges, can help prevent tooth decay. He also recommends eating hard fruits and vegetables like apples and carrots that “clean the teeth mechanically.” While Sulitzer believes that all children should avoid gummies and other tacky foods, this is especially important for children who are resistant to brushing. “Anything that sticks is not good,” he says, because these foods are hard to remove from the “nooks and crannies” in teeth.

When it comes to drinks, kids should avoid soda, energy drinks and other beverages that are laden with sugar. “Water is the best,” Sulitzer says. Some children might be receptive to a Countertop Flosser that shoots water into the mouth and can clean between teeth and around the gum line. If all else fails, he recommends rinsing with water after meals to remove at least some food that would otherwise remain on the teeth. However, Sulitzer reiterates that brushing is the single best way to clean teeth and that parents should continue to work on introducing regular toothbrushing and making sure that their children go to the dentist at least once every six months.

This article was originally pushed on April 30, 2023 and has been updated.