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Tips of the Week for February, 2017

How do I get my preschooler to let me brush her teeth?

J. Shahangian, DDS, MS


​​The struggle is real. Preschoolers are learning how to be independent, but independence comes with practice (and with your guidance). At this age, children do not yet have the control or concentration to brush their teeth all by themselves. Parents need to supervise and help so that the brush removes all the plaque-causing tooth decay. As you might guess, the number-one dental problem among preschoolers is tooth decay.

It is best if you put the toothpaste on the toothbrush until your child is about age 6. Until children are 7 or 8 years old, you will need to help them brush. Try brushing their teeth first and then letting them finish.

Here are 6 Quick and Effective Tips for Brush Battles:

Tip 1: Recognize you are not alone!

Your unwilling preschooler is actually in psychological transition, and it is very typical for her to challenge you to a "test of wills." With time, this stage will pass and your parenting style dictates how she will react. Your preschooler may be using the toothbrush as a weapon to flex some muscle about her sense of control. Rather than feeding into the cycle of frustration with morning and/or nightly battles, recognize that this is actually normal and consider establishing a routine that is hardcoded into her schedule. For how to practically do this, read on.

Tip 2: Follow bath, book, brush, bed (or brush, book, bed)

After a long day, the bedtime routine is typically carried out by exhausted parents. Your preschooler is tired and cranky and the last thing you're looking forward to is the brush your teeth battle. Sound familiar? Need a solution? You have to name it, and then it can be!

In our house, our nighttime routine is called "bath, book, brush, bed"—We don't say, It's bedtime."  The whole family understands the lingo,"It's time for bath, book, brush, bed."  This order of events helps our girls slow down and get in the best possible mood to transition into bed (and brushing). The name gives them a clear understanding of what's expected and even gives them some degree of control. A child that knows what to expect tends to respond better and may not force their will as much.

See what sequence works best for your family, and make sure that sequence is named and carried out without changing it much from night to night. The order (or even which parent does which part of the sequence) should be kept routine as much as possible. Also, remember the last thing that should touch the teeth before bed is the toothbrush—no snacks or liquids other than water after brushing. Get more tips about brush, book, bed right here on

Tip 3: See it to believe it!

A simple brushing calendar put up in your child's room can also make a big difference. There are many options ready to print. We use this one in our house. Brushing calendars give children a visual cue and sense of control—as well as progress towards a reward (positive reinforcement). Of course, a calendar may not work for a 2-year-old, but young children over age 3 may respond really well to this approach. Putting a sticker or smiley face after each brushing session also gives them sense of control. Simple and typically effective.

Tip 4: Take it to them

This suggestion has saved my wife and me from many "brush battles." When one of our girls falls asleep in the car at night, for example, or one of them is sick or just having a bad, bad day, I bring the toothbrush and floss pick to her bed. We keep up our brushing and flossing routine as much as possible, but instead of brushing in the bathroom, we use a tiny amount of toothpaste—a smear or rice-grain sized amount for children under 3 years old and a pea-sized amount for children older than 3—and a paper towel to spit into afterwards.

I basically brush her teeth when she is already lying down in bed. Even in bad lighting, a kid who is lying down can actually give you a pretty good vantage point and control of that unwilling or tired head. This way, you can get in, get scrubbing, and get out. This also means you will be leaving a coating of toothpaste over their enamel, as they will not be rinsing and spitting. But, this is actually a technique I often recommend to help keep teeth strong!

Tip 5: Morning-rush brush after breakfast

Most parents are rushed in the mornings and getting everyone ready and out the door in time for child care, school, and work. So, the reality is that many parents don't end up brushing their children's teeth in the morning. Those that do, usually squeeze it in before they head over to have breakfast. The problem with brushing before breakfast is the left-over food debris now covers the child's teeth for the rest of the day. If the food is sticky or sugary, this can lead to cavities.

While brushing before breakfast is better than nothing, if possible, brush after breakfast is finished. As a last resort, it may be possible to use the same technique as mentioned in Tip 4 and "take it to them." For example, you could brush your child's teeth after she is buckled in her car seat before you bring her to preschool. Remember to bring that toothbrush inside afterwards to rinse, clean, and air dry.

Tip 6: Drink water

If your preschooler is "having a day," and you know brushing just isn't going to happen, try to at least have her drink a glass of water (preferably with fluoride) after eating or before bed. This will wash away some of the food debris and coat the teeth with fluoride instead of sugary drinks like juice. Drinking water instead of sugar-sweetened beverages is healthy and another routine to establish when children are young!

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J. Shahangian, DDS, MS

​J. Shahangian, DDS, MS, is a board certified pediatric dentist, and a member of the American Academy of Pediatrics Section on Oral Health. He practices in his hometown of San Diego at Scripps Pediatric Dentistry and is an associate professor in pediatric dentistry at the University of California, Los Angeles. Dr. Shahanigan is also on staff at Rady Children's Hospital and is a proud father of three girls. Follow him on Twitter @SugarBugMeNot and check out his Blog.​

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First Aid for Burns: Parent FAQs

What you should do when your child gets a burn depends on how severe the burn is. Simply put, there are three levels of burns; knowing how to treat each of them quickly and efficiently is crucial.

  • First degree. The skin turns red, but it does not blister. It is somewhat painful, like a sunburn.
  • Second degree. The outer layer of skin is burned, and some part of the dermis is damaged. The burn will be very painful and will likely develop blisters.
  • Third degree. The skin will be charred or white. The epidermis and dermis (top two layers of skin) are irreversibly damaged.

Any electrical burn or a burn where the skin is charred, leathery, burned away, or has no feeling is severe and should receive medical attention right away. Any blistering, swollen burn that covers an area larger than the size of your child's hand, or a burn that is on the hand, foot, face, genitals, or over a joint is a serious injury and should be seen immediately by a pediatrician or in an emergency room. If you are worried about a burn, even if it doesn't look like any of the above types of burns, a pediatrician should see it.

My child has a minor burn. How should I treat it?

Most small, blistering burns can treated and cared for at home. If you have any questions about whether a burn can be taken care of at home, discuss with your doctor. 

Here's what to do:

  1. Cool the burn. Run cool running water over the burn for about five minutes. This helps stop the burning process and decreases pain and swelling. Do not put ice on a burn. Do not rub a burn, because this can worsen the injury. Do not break blisters as this can increase the risk of infection at the burn site.
  2. Cover the burn. Cover the burned area with a clean bandage that will not stick to the burned site. This helps decrease the risk of infection and decreases pain.
  3. Protect the burn. Keep the burn site clean with gentle washing with soap and water. Do not apply any ointments to the burn site unless instructed by your pediatrician. Never apply butter, greases, or other home remedies to a burn before discussing with your pediatrician, as these can increase the risk of infection as well.

If my child's burn is still painful after I have cooled it for 5 minutes and covered it, what should I do?

The chances are the burn will still be painful. Don't forget to give your child some pain medicine and reassure your child to remain calm.

Will my child's burn leave a scar?

The deeper the burn, the more likely that it will scar. Minor burns that do not blister usually heal without scarring. Burns that form blisters sometimes form a scar or may heal a different color than the surrounding skin.

To minimize scarring, keep burns covered until they have healed with new skin and do not weep any fluid. After this time, it is OK to keep the burn uncovered, but it should protected from any sun for one year to avoid skin darkening. Sun protection can be coverage with clothing or sunscreen.

Did you know?

According to the World Health Organization, nearly 75% of burns in young children are from liquid, hot tap water, or steam. Another 20% are considered "contact" burns from touching a hot object like a clothes iron or hair appliance. Learn ways to prevent burns and keep kids safe.

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The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


All information provided by  For additional information, please go to the following website:


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