NC Guidelines for Toothbrushing in Infant and Toddler Classrooms

From Tooth Eruption to Third Birthday

These guidelines share clear, easy steps for toothbrushing in infant/toddler classrooms. These steps follow state guidelines for sanitation and the correct toothpaste amount for this age group.

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What to Know About Toothpaste, Toothbrushes and Storage

Steps for Individual Brushing

  • 1

    Prepare to Brush

    • Clean and disinfect the designated sink before toothbrushing begins.
    • Wash your hands and wear powder- and latex-free disposable gloves to prepare supplies.
    • Lay out one paper towel for each child who is having their teeth brushed. You can also use wax paper or paper plates.
    • Place a small smear of fluoride toothpaste on each paper towel. A smear is the size of a grain of rice. (Note: Children in this age group do not need to spit or rinse, so there's no need to place the toothpaste on the rim of a small disposable cup.)
    • With gloved hands, remove the child's toothbrush from the rack and scoop up a smear of toothpaste on the bristles.
  • 2

    Individual Brushing

    When using a smear of toothpaste, spitting is not necessary, and rinsing is not recommended. The small amount of fluoride toothpaste left in the mouth helps strengthen the teeth and prevent cavities, according to the American Academy of Pediatrics.

    Accordion
    Tab/Accordion Items

    Positioning Tips

    • Sit in a chair and place the child sideways in your lap, leaning the head back cradled in your arm. Have the child open wide like a lion (or favorite animal) and count the lion’s teeth out loud as you brush them.
    • Sit in a chair and have the toddler stand while you brush his/her teeth. 
    • Remember that crying during toothbrushing is ‘noisy cooperation.’ When the mouth is open, you can see the teeth. Just do your best and keep trying! Children’s behavior may improve over time as brushing becomes part of the daily routine and as they enter new developmental stages.

    More Tips

    • Sing a child’s favorite song while brushing their teeth.
    • Praise children for opening wide like a lion or a favorite animal.
    • Use a toothbrushing chart where each child may place a sticker after brushing. The chart also serves as a classroom toothbrushing monitoring system.
    • Making toothbrushing fun will create a positive experience for all.
  • 3

    After Individual Brushing

    • Place the unrinsed brush on the paper towel.
    • Have the child wash their hands if they took a turn brushing their own teeth.
    • Remove your gloves, wash your hands and re-glove before preparing the next child's toothbrush.

    Repeat above steps until all children's teeth are brushed.

  • 4

    Clean Up

    • Clean and disinfect the sink before rinsing toothbrushes and returning them to the rack.
    • Wash your hands and put on gloves.
    • Pick up the toothbrush by the handle using the paper towel underneath. Rinse the bristles under running water. Place the brush and paper towel on a flat surface to dry. Repeat this process for each brush. Use the paper towel as a barrier; be careful not to touch the brushes with your gloves.
    • Clean and disinfect the sink. Remove the gloves and wash your hands.
    • When the brush handles are dry, wear gloves and pick up each rinsed brush using the dried paper towel. Return each brush one-at-a-time to the storage rack slot with the child's name or number.
    • Clean and sanitize surfaces where the brushes dried. Remove the gloves and wash your hands.