NC Guidelines for Toothbrushing in Preschool Classrooms

Group Toothbrushing for Ages 3-6

These guidelines share clear, easy steps to good toothbrushing in preschool classrooms. These steps follow state guidelines for sanitation and the correct toothpaste amount for ages 3-6.

Printable Version (PDF) | Printable Version in Spanish (PDF)

What to Know About Toothpaste, Toothbrushes and Storage

Steps for Group Brushing

  • 1

    Prepare to Brush

    • Clean and disinfect tables and have children wash their hands.
    • Wash your hands and wear powder- and latex-free disposable gloves to prepare and hand out supplies.
    • Place a small, pea-sized amount of fluoride toothpaste on the rim of a small disposable cup for each child. To reduce wait time, prepare cups before handing out toothbrushes.
    • Use a paper towel to remove a toothbrush from the rack to distribute.  Either call child to get their brush, paper towel and cup, or take supplies to the seated child. Repeat process for each child. Use a new paper towel for each toothbrush and avoid touching the brush with your gloves.

    Tip: Brushing after a meal/snack avoids an extra transition

    • No need to sanitize tables between eating and toothbrushing. Children do not need to wash their hands if they did so before eating.
    • Distribute toothbrushing supplies one table at a time. Have children from one table throw away trash, get their supplies from you and return to their seat.
  • 2

    Group Brushing

    • Once all children are seated with supplies, instruct them to use their brush bristles to scoop the toothpaste from their cup rim.
    • Instruct children to brush gently back and forth, up and down, inside, outside and on top of all teeth.
      • Set a timer to two minutes as recommended by the American Dental Assocation.
      • If you model brushing your own teeth or assist a child, remove your gloves, wash your hands and re-glove.

    Children may spit into their cups during brushing to avoid drooling on the table or themselves.

    Accordion
    Tab/Accordion Items

    • Sing or play toothbrushing songs as the class prepares to keep the activity calm and positive.
    • Use child-friendly words to describe areas of the mouth during brushing. Examples: "Chewing teeth" for back teeth, "cutting teeth" for front teeth, "upstairs" for top teeth, and "downstairs" for bottom teeth.
    • Praise children and let them know you support their efforts. Examples: "You're doing a great job brushing all of your teeth!" and "Fluoride toothpaste makes our teeth strong!"
    • If there's more than one adult, break into smaller groups for easier supervision.
    • 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 Group Brushing

    • Instruct children to:
      • Spit into their cup
      • Use their paper towel to wipe their mouth
      • Stuff the paper towel into their cup
    • Rinsing is not recommended or necessary. The small amount of fluoride toothpaste left in the mouth after spitting helps strengthen teeth and prevent cavities, according to the American Academy of Pediatrics.
  • 4

    Clean Up

    • Clean and disinfect the sink.
    • Lay out paper towels on a hard surface (counter or table), one for each child's brush.
    • One table at a time, children can get up to throw away cups and rinse their brushes.
    • Each child should rinse their brush under running water, one at a time. Have them place their brushes on a separate paper towel to dry.
    • Have the children return to the table while you clean and disinfect the sink.
    • Each child should wash their hands at the sink. Wash your hands after.
    • When the brush handles are dry, wear gloves and use the paper towel to pick up each brush. Return it to the storage rack, matching the name/number on the brush with the rack slot.
    • Clean and sanitize tables and surfaces where the brushes dried. Remove the gloves and wash your hands.