Explore MySmileEd
Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
Ask Cozy
What would you like to learn?
TRY ASKING
Browse by topic
What a daily tooth-care routine looks like from the first tooth to the teenage years, and how the job moves from grown-up to child along the way.
The AAPD’s advice for every child comes down to a few steady habits: brush twice a day with fluoride toothpaste, use the right amount for your child’s age, and spit rather than rinse. Once teeth touch, cleaning between them joins the routine.
What changes with age is who does the work. The AAPD describes it as the parent’s job at first, then a shared job as the child matures, and finally the child’s own job when they are ready.
Brushing is a team job. Grown-ups help first, and then you get to do more and more yourself!
Spit out the extra toothpaste, but don’t rinse with lots of water. That way the fluoride stays on your teeth for longer.
These are the same few steps at every age. Only the amounts and the amount of help change.
Every child is different, so treat these as a guide rather than deadlines.
Start brushing with a smear of fluoride toothpaste as soon as the first tooth appears. A grown-up does all the brushing, and any flossing once teeth touch.
Move up to a pea-sized amount. Your child can hold the brush and have a go, but a grown-up should still do the brushing or actively help.
Children take on more of the job, with a grown-up checking. Kids usually take over flossing around age 10 or 11. Teens often need encouragement to keep going.
A tiny smear, about the size of a grain of rice.
Just spit out the extra. Rinsing a little or not at all helps the fluoride keep working.
Twice a day is the core. The AAPD recommends twice-daily brushing with fluoride toothpaste for all children, whether or not your water is fluoridated. It notes that brushing less than twice a day, and difficulty brushing during the preschool years, were significant predictors of cavities by age 5.
The amount is part of the advice. A smear under 3 and a pea-sized amount from 3 to 6 balance protection from cavities against the risk of fluorosis, a change in how the enamel of adult teeth looks. The AAPD suggests a grown-up dispenses the toothpaste and does or helps with brushing for preschool children.
Teens need a nudge. The AAPD notes that brushing can slip down the list in adolescence, at a time when the risk of cavities and gum disease rises. It encourages daily plaque removal, including flossing.
There is no set birthday. The AAPD describes the job moving from parent, to parent and child together, to the child alone when they are ready. Your dentist can watch your child brush and tell you when they are ready to take over.
As soon as the first tooth appears. Brush twice a day with a smear of fluoride toothpaste, about the size of a grain of rice. See Brushing for more on getting started.
This is why the amounts are small. The AAPD notes that keeping an eye on how much toothpaste children use may prevent them swallowing too much fluoride. Stick to a smear under 3 and a pea-sized amount from 3 to 6, have a grown-up put it on the brush, and teach your child to spit as soon as they can.
Keep going, even if it is short. Brushing less than twice a day is linked with more cavities in young children. Try the same times every day, let your child have a turn first, and keep it calm and quick. If it is a daily battle, ask your dentist, who can show you positions and techniques that help.
Teens become more independent, and brushing can slip. The AAPD encourages brushing with fluoride toothpaste, daily flossing, and regular professional cleanings for teens. It also suggests talking about benefits teens care about, such as fresher breath and how their smile looks.
The AAPD notes that toothbrushes can be adapted for children with physical disabilities, and that electric toothbrushes and floss holders may help. If the taste or foam of toothpaste is hard for a child with sensory issues, ask your dentist about alternatives. When a child cannot clean their teeth well on their own, a caregiver does it for them. See Special healthcare needs.
The statements about brushing, toothpaste amounts, rinsing, who does the brushing, teens and children with special health care needs come from the AAPD documents below. The guidance on when to start flossing and when children take it over comes from the American Dental Association. The practical tips in “Try it together” and in the refusing-to-brush answer are general guidance from our team.
Review status: pending. No named reviewer or review date yet.
This website is for education only and does not replace care from your dentist, physician, or emergency services.