Make The Tooth Fairy Proud! 🦷✨ Tooth Brushing Tips for Success!

During my time as a pediatric OT, I’ve met kids who just ADORE teeth brushing. They tell me about their shiny teeth and their Paw Patrol tooth brush and how proud they are making the tooth fairy….

But if I’m being honest, most kids I meet are… not exactly Tooth Fairy Superfans when it comes to brushing. 

And honestly, I don’t blame them (Shhhh… Don’t tell my dentist!). 

When you break down tooth brushing, there are A LOT of skills and demands packed into this “simple” daily living activity. If even one piece feels tricky or overwhelming, the whole process can feel impossible!

Here are some of the underlying skills and challenges that come into play, plus ways you can support kids who may be having trouble: 

1..Fine Motor Skills 

Holding and positioning the toothbrush, moving it around the mouth, and even squeezing the toothpaste requires skilled movements with the hands and fingers. Skills like fine motor precision, coordination, and endurance are all involved!

Support tips: For some kids, a shorter toothbrush with a thicker handle can feel more comfortable and easier to manage. Or even a finger brush. Some kids prefer to practice their brushing skills outside of their mouth on a doll or toy, to build their skills and confidence in a low-pressure way.

Fun skill-building activity: kids can use a toothbrush to remove dry-erase marker from a plastic toy! I have a plastic mouth toy that I use in my sessions, but I’ve also used small plastic dog figurines (we called it a “dog wash” station) and hotwheels cars (“car wash”).

2. Executive Functioning Skills 

Getting started on the task, remembering all of the steps, and doing the steps in the right order can be a big executive functioning demand. 

Support tips: Some kids benefit from a visual checklist with pictures, a fun song, or youtube video that includes all of the steps. A “body double” is someone (like a parent or maybe a sibling) who stays nearby while your child does a task- like brushing teeth- so it feels easier, less overwhelming, and more doable. A parent could even brush their teeth alongside the child, modeling each step in order.

3. Sensory Components 

Some people have sensory sensitivities that make brushing teeth uncomfortable or distressing. They may have a sensitive gag reflex, or they may be sensitive to the feeling of the brush touching their tongue, gums, or lips. Others may be sensitive to the strong minty flavor (or smell) of the toothpaste. Or even the sounds the brush makes. The bathroom environment itself can pose sensory challenges as well, like bright lights, strange smells, or loud fans. 

Support tips: Explore toothpastes with different flavors or scents- this can make a huge difference for some children. Some kids with sensory needs prefer an electric, vibrating toothbrush. You can also experiment with changes to the environment: Dim the bathroom lights, add background music, or brush teeth in a different location.

4. The “Bor-ing!” Factor 

For some kids, especially those who like to stay busy and intellectually stimulated, teeth brushing can be monotonous, boring, and understimulating. And two minutes can feel like forever. 

Support tips: Have you heard of the podcast Chompers? It includes fun stories for kids to listen to while brushing their teeth, and it even includes cues for when to switch to different parts of the mouth. Audiobooks can also be combined with toothbrushing. Or screentime (if it’s not too distracting). Some kids prefer cool visual timers, like the ones with oil or sand. Sometimes, I’ll include the child in the problem solving: “It seems like toothbrushing feels boring. I wonder if there’s something we could come up with to make it feel more fun and less boring… Let’s brainstorm together!”

5. Just Another Demand

After a long day of doing things they have to do, brushing teeth can feel like one more exhausting demand. That can feel overwhelming, and for some kids (like those with PDA) , it may be activating for their nervous system.

Support tips: One option is to build in choice and autonomy. Some kids may enjoy going to the store and choosing a special toothbrush. Or maybe you can have 2 different toothpaste flavors that they can choose from. The child could choose what song to play while brushing, or even where to brush (maybe they want to be “silly” and brush teeth in the kitchen!) Sometimes, shifting teeth brushing earlier in the bedtime routine when kids still have a little energy in the tank can be helpful.

6. Standing Endurance

Standing at the sink, leaning forward, spitting, and reaching can be surprisingly demanding if a child has low core strength or balance challenges. Not to mention, it can be completely understimulating for a kid who needs to move and wiggle their body to feel regulated.

Support tips: Some kids may prefer an option to sit or lean while brushing. Or prop their elbow on the countertop for support. Others may need permission to move their bodies, pace, or wiggle!

7. Coordination & Motor Planning

Coordinating what you see in the mirror with what your hands are doing with the brush, planning your body’s movements to get the brush to your mouth and position it correctly- this can pose quiet the coordination and motor planning challenge!

Support tips: Some kids may benefit from help guiding the toothbrush to their mouth to begin brushing (make sure to ask the child if it's okay before providing this kind of physical support!) Others may need extra time to slow down, process and plan the movements, check the mirror, and practice the actions.

8. Oral-Motor Skills

Coordinating tongue movement, rinsing, and spitting requires oral awareness and motor control.

Support tips: Play silly games with spitting water in the bathtub, blowing bubbles, or licking around lips to build awareness.

9. Emotional Safety & Body Autonomy

Brushing means entering a child’s personal space in a very sensitive area- their mouth. If they’ve had past negative experiences (like painful dental visits, gagging, or being forced), this adds another layer of challenge in this area. For some kids, brushing can trigger big feelings of anxiety or avoidance. Respecting their autonomy is key to building or rebuilding safety. 

Support tips: Always ask before helping, even if the child has been okay with it in the past. It can be helpful to model on yourself or a doll first, and let kids brush you or a stuffed animal. For some kids, it can be helpful to tell them that they can “raise their hand” when an adult is helping them brush, as a signal to “stop” right away. It’s always okay to stop and take breaks.

In Conclusion

Tooth brushing may look like a quick, simple task, but for many kids it’s actually a big job that involves motor skills, sensory processing, executive functioning, emotional safety, and more. Small steps, playful strategies, and plenty of patience can make the Tooth Fairy (and your kiddo!) proud!

Written by Nicole Raisin, OTR/L