Q: My 18-month-old refuses to brush her teeth. We have a power struggle every morning and at bedtime. What can we do?
A: This is a very common problem among toddlers. The key to solving it is finding out what's causing your daughter's resistance. Is it that she’s trying to assert some control? Most children her age will protest anything they know is important to their parents. What better way to feel powerful at a time when kids have so little control over so many aspects of their lives. Another possibility is that your child's gums, teeth, and mouth are sensitive and tooth-brushing actually feels irritating to her. Or, perhaps she doesn't like the smell or taste of the toothpaste. Children who have this kind of oral sensitivity also tend to have other tactile issues such as finding certain clothes uncomfortable and itchy, and disliking seams on their socks and tags in their shirts.
If you suspect your daughter is just asserting her independence, forcing the matter probably won't work. You need to find a way to offer your daughter some measure of control, but still get her to brush. It can help to give her some choices: let her decide from among a few different kinds of toothpaste or choose her own toothbrush. You can also allow your daughter to decide at what point in her bedtime routine she wants to brush.
Teaching your daughter about consequences can work too. Tell her if she brushes like a big girl and doesn’t put up a fight then you will have time to read an extra book before bed. Or let her know that if doesn't brush her teeth, she won't be allowed to have any sweet snacks, because not brushing means the sugar in sweet treats remains on the teeth and can cause cavities.
If you suspect that an oral sensitivity to brushing is the issue, then you may need to try a different way to get your daughter's teeth clean. Amy Light, a pediatric dentist in the Washington, DC, area says that all toddlers need for good oral hygiene is some kind of washing and stimulation of the teeth and gums after meals and before going to sleep. Your daughter doesn't have to use a toothbrush or toothpaste. You can clean her teeth by using your clean finger, a tooth finger brush (it fits over your finger), or a washcloth to wipe away the plaque and food residue on her teeth. If your child is sensitive to the taste and smell of toothpaste, you can get flavorless kinds in most pharmacies.