Teaching a child to brush: what to expect at each age

Start on the day the first tooth appears

Brushing begins when the first tooth shows, usually somewhere around six months, though earlier or later is normal too. A small, soft baby brush twice a day is enough, and a few seconds already counts. What matters at this stage is not how long it lasts but that it happens every day. The evening brushing is the one that is never skipped.

Lay the baby across your lap with their head resting on your knee. You can see inside the mouth from there, and the brush does not arrive as a surprise from above. Wiping the gums before any teeth appear is optional; the real work starts with the first tooth.

How much toothpaste, and what if it is swallowed

Fluoride toothpaste is used from the first tooth onwards, and the amount matters far more than the brand. Young children cannot spit yet, so some of the paste goes down. As long as the amount on the brush is small, that is expected rather than alarming. Swallowing is reduced by putting less on the brush, not by telling the child off.

• From the first tooth to age three: a smear of fluoride toothpaste the size of a grain of rice.
• Between three and six: an amount the size of a pea.
• After brushing, spit the paste out and do not rinse with water, because rinsing washes the fluoride straight away.

The child brushes first, the adult brushes after

A preschool child wants to hold the brush, and that wish is worth encouraging, because the habit is built there. Their turn, though, does not yet count as cleaning. The order is simple: the child brushes, then an adult brushes the same teeth from the start. The second round is part of brushing, not something to negotiate over.

In that second round, look towards the back. The grooves on the chewing surfaces of the molars and the tongue side of the lower back teeth are where a child's own brushing most often stops short. Standing behind your child and tilting their head back a little brings those surfaces into view; in front of the mirror you are both looking at the same mouth.

Hand control is not ready until about seven or eight

A four-year-old can get the brush into their mouth, but guiding it along the gum line in small circles is a different skill. In most children that control is not complete until around seven or eight. Until then an adult keeps brushing, and for a while afterwards keeps checking. The handover is gradual: the child takes on a little more each year.

When there is resistance, punishment and bargaining fail

Refusing the brush is common between two and three and usually passes. Threats, punishments and reward deals turn brushing into something open for discussion, when the aim is the opposite: a fixed step nobody argues about. Keep the time, the place and the order the same, say pyjamas, brush, book. On a hard evening make it shorter rather than skipping it. Let your child pick the colour of the brush, count out loud, sing something; feeling able to choose takes the edge off.

In the early years the real gain is not spotless teeth that evening, but a child who takes the brush without turning it into a battle.

Small details that make brushing easier

Choose a brush with a small head and soft bristles, and replace it once the bristles splay to the sides. Nothing but water after the evening brushing is what makes that brushing worth doing. Once a month, lift your child's upper lip and look along the gum line of the front teeth: dull, chalky white lines there can be the first sign of decay, so show them to a dentist.

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