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Tooth Brushing Requirements
Children must brush their teeth at least once daily. Tooth brushing should include meaningful educator interactions following CLASS guidance for interactions, transitions, and classroom organization. Sites will execute an intentional family health education program that consists of a solid home-to-school connection to establish a dental home for the family, good oral hygiene at home, and oral hygiene education, including the relationship between oral and general health.
GHC requires each child should have a personally labeled, soft toothbrush of age-appropriate size. No sharing or borrowing of toothbrushes should be allowed. After use, toothbrushes should be stored on a clean surface with the bristle end of the toothbrush up to air dry so that the toothbrushes cannot contact or drip on each other and the bristles are not in contact with any surface. Racks and devices used to hold toothbrushes for storage should be labeled and disinfected as needed. The toothbrushes should be replaced at least every three to four months or sooner if the bristles become frayed. When a toothbrush becomes contaminated through contact with another brush or used by more than one child, it should be discarded and replaced with a new one.
Each child should have their own labeled toothpaste tube. Or if toothpaste from a single tube is shared among the children, it should be dispensed onto a clean piece of paper or paper cup for each child rather than directly on the toothbrush. Children under three should have only a tiny smear of fluoride toothpaste (grain of rice) on the toothbrush. Those three years and older should use a pea-sized amount of fluoride toothpaste. Toothpaste should be stored out of children's reach.
Children One and Under
Children 6 weeks to twelve months, programs will execute an oral health program that includes wiping gums with oral hygiene gum wipes. Once a tooth comes in, use a child's soft-bristled toothbrush and massage the gum tissues with no toothpaste.
Replace toothbrushes every 2-3 months when visible signs of wear occur.
Teeth Brushing Procedures (IDHS)Children's teeth will be brushed twice a day following these procedures:
Ages Six weeks to One Year
1. After every feeding, bottle, and solid food, staff will clean babies' teeth and/or gums.
2. Put on a disposal glove, cover a finger with a dampened gauze pad, and gently wipe the child's teeth and/or gums clean.
Ages One to Two Years
1. Staff will wash their hands and the child's hands using the agency-approved hand washing procedure.
2. Use a child-size toothbrush with soft bristles labeled with the child's name.
3. Provide each child a separate tube of fluoridated toothpaste labeled with his/her name. Dispense a small smear of toothpaste onto the child's brush. Avoid cross-contamination by never using one child's toothpaste on another child's brush.
4. Brush the child's teeth using the following technique:
a. Hold the toothbrush perpendicular to the gum line to clean inside surfaces. Stroke up and down between the gum line and tip of each tooth.
b. Hold the toothbrush horizontally at an angle to the gum line to clean outside surfaces. Make short up and down strokes to get at plaque along the gum line.
c. Brush the tongue lightly from back to front a few times, being careful not to trigger reflex gagging.
d. Wipe the child's teeth with a damp gauze pad. When the child is developmentally ready, he/she may begin to rinse his mouth with a small amount of water dispensed in a paper cup. Demonstrate to the child how this should be done and supervise to discourage water swallowing.
5. Encourage children to use the toothbrush themselves but continue to brush their teeth for them until they have mastered the brushing technique.
6. Always rinse the toothbrush after each use.
7. Store toothbrushes in a manner that promotes drying. Ensure that brushes do not touch each other by covering with netting, especially for this purpose. Do not use caps as they do not allow the brush to dry properly.
8. Replace toothbrushes every 2-3 months or when there are visible signs of wear.
COVID-19 Modification Effective September 20, 2021
In response to the Centers for Disease Control and Prevention’s COVID-19 Guidance for Operating Early Care and Education/Child Care Programs, toothbrushing may resume if programs can implement strategies to reduce the possibility of transmitting the virus to others via salivary droplets during brushing. In support of COVID-19 Health and Safety, GHC Requires recommended that:
Program staff who brush infants’ and children’s teeth or help children brush should be fully vaccinated against COVID-19 and should wear a properly fitted mask covering their nose and mouth for additional protection.
For toothbrushing at the classroom table, seat children as far apart as possible, with staff supervising the brushing. After brushing, clean and disinfect the table. If toothbrushing at the classroom table is not possible, children can brush at the sink with staff supervising. The sink should be cleaned and sanitized after each child finishes brushing.
Encourage children to avoid placing toothbrushes directly on the classroom table or other surfaces.
Wash hands with soap and water for at least 20 seconds before and after brushing or help infants and children brush their teeth. If soap and water are unavailable, staff can use a hand sanitizer containing at least 60% alcohol. After children brush, ensure that they wash their hands with soap and water for at least 20 seconds, or, for children over age 2, use hand sanitizer that contains at least 60% alcohol.
Encourage children to drink water throughout the day and after eating. Water rinses a child’s mouth with every sip.
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