It seems most every parent confronts a universal truth early in the process of rearing a child: Kids like to do for themselves. Whether eating, bathing, walking or climbing precariously on a jungle gym, children naturally display a need for independence as they graduate from baby to toddler to preschooler. Parents must often make the difficult choice to stand back, watching trial and error take its course.

While giving them a certain degree of freedom is perfectly normal, there are some obvious areas in life where children should not be trusted to do exclusively for themselves. One of these areas is dental hygiene. When it comes time for tooth brushing, they naturally prefer to do the job on their own, resisting the intrusion of a brush stuck into their mouth. However, children are not physically or mentally equipped to be trusted with their own dental destiny, and even the most hands-off adults must recognize that tooth brushing is no job for a kid.

An Important Job
From the day they first appear, children's teeth are faced with the same insidious enemies as adult teeth. Nature has not armed them with any special immunities, which is why parents must make brushing at least a twice-daily routine. Because it is a commitment that is thankless, laborious and at times downright difficult, parents must be motivated by the reality that the consequences of not brushing are far worse than the struggle the activity presents. Moreover, they should not be lulled into the false notion that just because their child is able to move the brush back and forth against their teeth that actual brushing is taking place.

The commitment is long term, often lasting roughly until the child is able to tie his own shoes. Unlike other milestones of independence, like potty training or walking, there is no "graduation" where they perform the act once to enthusiastic applause. Tooth brushing can only be called a labor of love that lasts for as long as it takes.

Dr. Steven Lasser, a pediatric dentist, board-certified by the American Academy of Pediatric Dentistry with over 25 years experience on children's teeth, knows all too well the importance of proper dental hygiene and sees two functions associated with the toothbrush. "Brushing physically removes the plaque and delivers flouride," he says. "The fluoride is very important for the topical effect that it has on the newly erupted baby teeth."

Dr. Lasser is quick to offer, however, that the key to fluoride is moderation. While he endorses those toothpastes that target children, he cautions that too much of a good thing can be bad. "Fluorosis" results from too much fluoride and can give healthy teeth a splotchy white appearance. Therefore, pediatric dentists usually advocate a "pea size" amount of toothpaste on the brush. Avoiding fluorosis also requires a certain degree of rinsing and spitting, because the more toothpaste a young child swallows contributes to the potential for damage. After age 7 or 8, however, swallowing toothpaste doesn't carry the same negative effects.

Getting Them to Brush
Of course, fluoride is only half of the hygiene equation. The physical act of brushing is the more difficult half, as parents find their brushing efforts are usually met with resistance. To counter this, resourceful parents often resort to games, songs or an appeal to the very sense of independence that makes children fight brushing in the first place. In other words, they give the child a certain degree of control, such as letting them pick out a special character toothbrush.

There is a dizzying array of novelty toothbrushes on the market, which are often good for at least a temporarily-renewed interest in brushing. Among these are also electric toothbrushes, which can make the job slightly easier, but should not dull the interest in doing a thorough job. A number of studies indicate that, overall, electric toothbrushes are no more effective than their non-powered counterparts in fighting plaque, and nothing can substitute for an effective brushing technique.

Teaching a child this technique is clearly the most challenging aspect of their dental independence. Cleaning the gumline and the surface area of all the teeth should be the ultimate goal. "I always recommend that a parent perform the brushing chore without toothpaste," Dr. Lasser says. "That way they can see what they're brushing and where they should concentrate their efforts. The kids should follow immediately, picking up the toothbrush and using the small amount of toothpaste recommended, so that they get into the habit of brushing their own teeth."

Dave and Joanne Bachansingh, a Florida couple with two toddlers, Jessica and Justin, have turned tooth brushing into a daily process that allows the children to be both supervised and self sufficient. "We march down the long hallway twice a day and up on the stool to reach the sink," says Dave Bachansingh. In order to keep it fun and maintain variety, the couple keeps a broad selection of cartoon character toothpastes and toothbrushes on hand. They challenge their kids with an ambitious goal: to brush each tooth at least three times, up and down. While Jessica, 5, is growing fairly proficient, Justin, 3, still needs to give Mom or Dad a turn after he's done.

It's an investment of time and effort, but it's results-oriented and it teaches the children how to take charge of their own teeth. "The kids' favorite moment is showing off their final product with huge smiles," says Bachansingh.

Once children have developed the wherewithal and manual dexterity to brush their own teeth, it stands to reason they still can't be left entirely on their own. While they may, by definition, be brushing, Dr. Lasser stresses that parents should still be vigilant. Between visits to the dentist, one way to police the mouth is through the use of disclosing tablets, an off-the-shelf product that, when chewed, will show bright red patches in the areas where the child's toothbrush missed.

In the end, Dr. Lasser says the most important thing a parent can do when it comes to oral hygiene is to teach the child what a clean mouth feels like. It is not enough to merely brush for them. Children should gradually come to understand that brushing is a lifelong habit. Instilling diligence and self-discipline is difficult, especially when the consequences of poor brushing are not immediately felt. "I've seen too many cases where the parent became lax about brushing," he says. "It's human nature to avoid the kind of conflict that comes with brushing, but over time, bad habits will take their toll."

The great balancing act of parenting is determining just how much freedom to give a child. When it comes to taking care of their teeth, however, the answer is easy. It is the parent's job to do, to teach and to remain watchful, and as much as children may fight it, they will be ultimately grateful for the effort invested in their smile.

Want to see more?

• Tooth Time! Taking Your Preschooler to the Dentist
• Dental Essentials: Caring for Your Baby's Teeth Before They Appear
• Taking the Bite Out of Teething Pain
• Talk about it!