Tooth Brushing Procedures Policy Number and Last Update
(03.03.08e/01-2011)

Children's teeth will be brushed after every meal and snack following these procedures:

Ages 6 weeks to 1 year

  1. After every feeding, bottle, and solid food, staff will clean babies' teeth and/or gums.
  2. Put on a disposal glove, cover a finger with a dampened gauze pad, and gently wipe the child's teeth and/or gums clean.

Ages 1 to 2 years

  1. Staff will wash their hands and the child's hands using the IMSHSP Hand Washing Procedure.
  2. Use a child-size toothbrush with soft bristles, labeled with the child's name.
  3. Provide each child a separate tube of fluoridated toothpaste labeled with his/her name. Dispense a small smear of toothpaste onto the child's brush. Take care to avoid cross-contamination by never using one child's toothpaste on another child's brush.
  4. Brush the child's teeth using the following technique:
    1. Hold the toothbrush perpendicular to the gumline to clean inside surfaces. Stroke up and down between the gumline and tip of each tooth.
    2. Hold the toothbrush horizontally at an angle to the gumline to clean outside surfaces. Make short up and down strokes to get at plaque along the gumline.
    3. Brush the tongue lightly from back to front a few times, being careful not to trigger reflex gagging.
    4. Wipe the child's teeth with a damp gauze pad. When the child is developmentally ready, he/she may begin to rinse his mouth with a small amount of water dispensed in a paper cup. Demonstrate to the child how this should be done and supervise to discourage swallowing the water.
  5. Encourage children to use the toothbrush themselves, but continue to brush their teeth for them until they have mastered the brushing technique.
  6. Always rinse the toothbrush after each use.
  7. Store toothbrushes in a manner that promotes drying. Ensure that brushes do not touch each other by covering with netting made especially for this purpose. Do not use caps as they do not allow the brush to dry properly.
  8. Replace toothbrushes every 2-3 months or when there are visible signs of wear.

Ages 2 to 6 years

  1. When more than half the children are finished with breakfast, lunch, or snack, one staff person will begin to supervise tooth brushing.
  2. Staff and children wash their hands per the IMSHSP Hand Washing Procedure.
  3. Provide each child with a child-size toothbrush with soft bristles, labeled with his/her name.
  4. Staff place a smear of toothpaste on the rim of each child's paper rinsing cup and then have the child transfer the toothpaste to his/her toothbrush (see photo at the end of this procedure).
  5. Establish tooth brushing routine by demonstrating the proper technique of brushing:
    1. Hold the toothbrush perpendicular to the gumline to clean inside surfaces. Stroke up and down between the gumline and tip of each tooth.
    2. Hold the toothbrush horizontally at an angle to the gumline to clean outside surfaces. Make short up and down strokes to get at plaque along the gumline.
    3. Brush the tongue lightly from back to front a few times, being careful not to trigger reflex gagging.
    4. When the child is has finished brushing his/her teeth, have him/her rinse by filling the paper cup with a very small amount of water. Demonstrate to the child how this should be done and supervise to discourage swallowing the water.
  6. Assist children in need of help with brushing until they master the technique.
  7. Teachers model the importance of tooth brushing by brushing their teeth at the same time as the children.
  8. Store toothbrushes in a manner that promotes drying. Ensure that brushes do not touch each other by covering with netting made especially for this purpose. Do not use caps as they do not allow the brush to dry properly.
  9. Replace toothbrushes every 2-3 months or when there are visible signs of wear.