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Pediatric Dental Month: Tooth Brushing

Updated: Mar 23

Sokuntheary Prak, Humera Rohail, Kathleen Shang

Project Smile Global

March 18, 2024

During Pediatric Dental month, it’s important to understand the significance of brushing

teeth, especially making sure that it’s a habit for kids right from the get-go. Brushing your teeth is not just about making sure your breath smells good - it’s to prevent diseases and health complications. There are over 700 strains of bacteria in your teeth, including S. mutans, which feeds on sugars and produces acid that increases chances of tooth decay (Stinton). Refusal to brush teeth regularly can lead to plaque accumulation. In fact, it also leads to an increased chance of dementia and diabetes (Stinton). However, spending a long time brushing your teeth is not sufficient. Most oral healthcare professionals recommend that brushing your teeth for two minutes, while employing effective techniques, leads to the best outcome; angling the toothbrush and dividing brushing time among different sections of your teeth is best recommended (Godman). It only takes a few minutes to brush and floss every day, but starting that habit early can contribute to a lifetime of healthy teeth.

For children with sensory sensitivities, the experience of brushing teeth can be

overwhelming due to the intense sensations involved, making it a particularly difficult routine to establish. Consequently, specialists use behavioral science to assimilate a nighttime routine consisting of brushing, storytime, and dreaming for a minimum of 21 days, as it can transform into a habit (Busch). According to Gardner, a repetition of a simple task can result in our brains creating neural pathways that make the behavior less reliant on conscious decision-making, and through associative learning (664). As we repeat these actions over and over, this behavior becomes habitual (665). Guardians are encouraged to demonstrate the behavior they wish to see, as it establishes a perception-behavior link from and to their children (665). This ‘chameleon effect’ promotes group cohesion and bonding—seen through brushing with your child at the same time (Rice). For many children, personalization allows for a sense of control—from the inventions of tasteless, foam-free, or fluoride-free toothpaste, to new models and colored toothbrushes (Neff). Resultantly, this reduces the sense of threat and makes children less resistant to the transition

(Neff). Making toothbrushing a fun and engaging activity creates an anxiety-free environment, including singing a song, having a timer, or playing a game.

To better understand tooth brushing behaviors, a cross-sectional study was done by the

University Medical Ethics Committee Khan and colleagues (Khan et al.). The tooth brushing

behaviors were assessed by parental response and observations of the children and their parents via video recording (2). An oral examination was also done which recorded plaque, gingival, and dental caries indices (3). In the study, 92 preschool children were observed with 53% girls and 47% boys, and 38% age 4, 29% age 5, and 33% age 6 (4). It was observed that 51% brushed for 1-2 minutes, 50% used fluoridated toothpaste, only 11% of parents guided their toothbrushing, and 46% were totally uninvolved during the toothbrushing session (6). These observed statistics differed heavily when compared to the reported results, as seen in Table 1. Based on this study, it was seen that the toothbrushing behavior of preschool children was inadequate and their oral health was poor. Setting aside dietary habits and socioeconomic status, having parental guidance during the child’s tooth brushing is directly associated with better oral health status in their

children (10).

In conclusion, the habit of regular tooth brushing is a fundamental aspect of overall

health, particularly for children. Beyond ensuring fresh breath, this routine serves as a

preventative measure against various diseases and health issues. The study highlighted certain inadequacies in the tooth brushing behaviors of preschool children, emphasizing the importance of cultivating oral health habits early on. Establishing a tooth brushing routine through behavioral science techniques and making the experience enjoyable contributes to transforming this essential task into a lifelong habit.

Works Cited

Busch, Melissa. “New Campaign Uses Cognitive Method to Get Kids to Brush at Night.”, 20 Mar. 2020,

Gardner, Benjamin, et al. “Making Health Habitual: The Psychology of ‘Habit-formation’ and

General Practice.” British Journal of General Practice, vol. 62, no. 605, Dec. 2012, pp.


Godman, H. What’s the right way to brush your teeth? Harvard Health, 23 Nov. 2022,

Khan, I.M., Mani, S.A., Doss, J.G. et al. Pre-schoolers’ tooth brushing behaviour and association with their oral health: a cross sectional study. BMC Oral Health 21, 283 (2021).

Neff, Megan Anna. “Tooth Brushing Tips.” Insights of a Neurodivergent Clinician, 8 Sept. 2023,

Rice, Mae. “Here’s Why You Unconsciously Copy Other People’s Mannerisms.” Discovery,

Discovery, 13 July 2022,

Stinton, Natalie. “What Happens If You Don’t Brush Your Teeth?” Geisinger, 10 Apr. 2023,

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