Improving Your Child’s Oral Hygiene Routine

Published on

Trisomy 21 Update

So much of our family morning routines can be stressful with getting dressed, eating and getting out the door in a timely manner. This may sound very similar to the nighttime routine: eating, bathing, getting dressed and going to bed in a timely manner. It is safe to say that many of these daily activities are considered “nonpreferred” by children — especially, their twice-daily oral care routine.

It is very common that brushing teeth can be a battle. Your child may insist on doing it themselves (which may consist of brushing one tooth, then chewing on the toothbrush) or, you may have to become an octopus in order to hold down their legs and arms, just to get the toothbrush passed their lips.

Here are some helpful and new ideas to improve your child’s acceptance of oral care. 

Strategies to Improve Oral Hygiene Acceptance

  • Start oral care at a young age so your child begins to understand a structured oral care routine that is predictable.
  • Allow your child to brush his or her teeth first. This way, it is on their terms and they are in charge. Once completed, give lots of praise! Now, it is your turn to brush to ensure thoroughness.
  • Use imitation as your friend. Have your child look in the mirror. Touch the toothbrush to your lips and count to three, then say “your turn.” Slowly progress using this method to the inside of the mouth.
  • Take turns while brushing teeth in front of the mirror.
  • Make sure there is a clear start and end point. You can use a visual timer, flashing toothbrush or sing a song.
  • If your child does not like the taste of toothpaste, you can try dipping the toothbrush in mouthwash or purchase flavorless toothpaste.

Special tips for sensitive children

If your child is sensitive, consider the following:

  • Start applying input gradually further away from the mouth (such as hands, arms, chin and cheeks) and slowly work your way towards the inside of the mouth. You can also use a toy or a cloth. Try using a slogan such as “1, 2, 3, away!”
  • Massage the cheeks or chin area with a soft cloth or using lotion after a bath, using firm pressure in order to increase comfort around the face.
  • Do not force any input! Make it as fun as possible.

Apps and Videos

  • Brush Up Toothbrush Trainer
    Brush Up is available as an app for your phone as well as a website. It helps children teach themselves to brush their teeth using interactive characters and music. It also provides a photo assessment on how thoroughly your child brushes their teeth. It includes a one-month trial.
  • Visual Timers
    There are a plethora of visual timers available online. Since children with Down syndrome learn best through their vision, visual timers are a helpful tool to include in your daily routine. It offers your child a clear start and end point, so they know what to expect.
  • Videos and Music
    This is a simple one! Allow your child to watch his or her favorite video or listen to a favorite song. The video or song should ideally be about two minutes in length. Sometimes, this is just enough to distract them from a less-preferred task.
  • Sesame Street: Healthy Teeth, Healthy Me: Brushy Brush PSA
    A video available on YouTube of Elmo and other celebrities brushing their teeth. It is a catchy song and a helpful way to motivate children. 


  • Teethers and Gummy Sticks
    Gum massaging teethers are a nice way to work on oral exploration, which can be a precursor to oral hygiene. This is especially important if your child is orally sensitive. Starting these dental hygiene expectations early can help set you up for success in the future. Some teethers have an anti-choke shield as well as gentle vibration which can help soothe teething and achy gums. 
  • Starter Toothbrushes
    There are many starter toothbrushes on the market which can be started as early as 6 months of age, with supervision. You can dip the toothbrush in mouthwash or just water and allow your child to orally explore.
  • Three-sided Toothbrush
    A three-sided toothbrush brushes the tooth from all angles, allowing more thoroughness in a shorter period of time. This is a great option for kids who are sensitive and do not want the toothbrush in their mouth for a lengthy amount of time.
  • Electric Toothbrush
    Children who seek oral input, meaning they like to put items in their mouth (toys, hands and clothing) and chew, sometimes enjoy an electric toothbrush.  Keep in mind that some children are sensitive to noise and may not like the sound of the vibration. For older children, there are models of electric toothbrushes that come with an app to reward children for proper brushing and personalized stickers to put on their toothbrush handle

Try to keep your routine short, predictable and fun! Talk to your child’s occupational therapist about tailoring a routine that is a good fit for your child. It may take some extra time and creativity, but it will be worth it in the long run.

Contributed by: Tricia Kinslow, MS, OTR/L