When can my child brush their teeth by themselves?

Independence and responsibility are incredibly important values to convey and encourage in our children. We want them to grow up to be capable humans who can take care of themselves; I completely agree and encourage this ideal. However, as a pediatric dentist, I cannot encourage 3 - 4 or sometimes even 5 - 6 year olds be solely responsible for their own oral hygiene. From a manual dexterity standpoint, many children are not capable of brushing adequately until they are capable of tying their own shoes.

I believe we can encourage independence while providing a safety net for our child’s oral health. In the beginning, I would say to treat brushing their teeth the same way you treat changing their diaper- it’s something that needs to happen to maintain cleanliness and health- a diaper rash can hurt and so can a cavity- so let’s try our best to prevent both. I believe the more consistent we are in brushing their teeth and explaining to our children why it’s important, the more they will allow us to complete this task and hopefully keep them safe from cavities. 

As they age and start exerting independence, this is a great time to talk about taking turns (something you are likely teaching them anyway). They get a turn and you get a turn. You are their safety net; when they brush their teeth, watch them and see if you can give them helpful feedback- tips and tricks to improve their ability to brush and then hopefully you’ll be able to move more confidently into allowing them to brush on their own. Around the age of 5, I would (if the child is pressing for more brushing autonomy), split the difference; they brush in the morning, you brush in the evening. This way they get learn & develop their skill and you get to give them one excellent brush at night time (a time when saliva production decreases, mouth breathing may be present and bacteria can be more active). 

To transition your child into brushing on their own, I would highly recommend the use of disclosing tablets or disclosing mouthwash. These visual aids are critical to getting your child flying solo- they get visual feedback! They can be used either before they brush (to tell them where) or after they brush (to tell them where they missed). Once they’re brushing well, they are free to brush on their own and with minimal risk of developing dental disease. While making this transition, be sure to inform your dentist & team so that they can carefully monitor for any early signs of the disease process. 

Bonus: if your child gets braces or an expander or any other oral appliance, it is likely worth your while to peak in every now and then to do spot checks and make sure they are effectively brushing. Appliances tend to gather plaque more readily and having one in their mouth increases their risk of developing cavities. Good luck!