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Ask Dr. Sears: Toothbrushing Resistance

Q. It's such a struggle to get my 3-year-old to brush his teeth every night! I've tried using one of those kid toothbrushes that are supposed to make brushing fun, but every night it's the same tantrums and tears. Any tips on how to make the process easier?

A.
Teaching your toddler to take care of his teeth is just one way you can show your growing child how to take responsibility for his body. This can be a challenge because 3-year-olds are motivated mainly by fun and pleasure, not by health and necessity. If you want to end his resistance to brush, your best bet is to make this nightly chore a fun ritual for him. Here are a few tricks you can use to do just that:

Play copycat. Capitalize on a toddler's natural desire to mimic fun activities he sees. Bring your child into the bathroom with you to watch you brush your teeth. Be sure to lay out his toothbrush where he can reach it. While you're brushing, exaggerate a show of excitement. He'll likely be encouraged to copy what you're doing.

Make the toothbrush a toy. Let him play with it. For example, show him how to brush his teddy bear's "teeth," or even let him brush yours. Create the impression that toothbrushes are fun to use.

Play show and tell. While you are showing your child how to "play" with the toothbrush, tell him why tooth brushing is important. Say: "Sticky stuff collects on your teeth. The sugar bugs like the sticky stuff, and if they stay there long enough, they'll eat into your teeth, and then your teeth won't be strong and white." If you have a cavity that's filled, show it to him to reinforce this point.

Use your finger as a toothbrush. If he still doesn't seem enthralled by his toothbrush, wrap a piece of gauze around your finger (you can actually purchase slip-on gauze pieces for this purpose) and use your finger to clean his teeth. Some toddlers find this less frightening than a long, plastic toothbrush. If you use toothpaste, choose one that has a flavor he likes. A word of caution: If you choose a toothpaste with fluoride, as most dentists recommend, use only a pea-size dab no more than once a day. Many children this age will swallow toothpaste. As a preventative medicine, the mineral fluoride has a narrow risk/benefit ratio: Just the right amount of fluoride (via brushing) can help protect against tooth decay, but too much (via digestion) can contribute to weakened enamel.

When nothing else will work: Try the two-person technique we resorted to in our family to successfully brush the teeth of our resistant toddler. Have your child lie on your lap with his head facing you, while your partner sits in front of you knee-to-knee, supporting your child's body in his lap. Have your partner lean forward and hold your child's arms and legs while you gently brush his teeth from above (a position that will give you easier access and a better view).

Your child will eventually catch on that brushing his teeth is a regular and necessary part of taking care of his whole body - and he'll enjoy doing it.

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