Things are beginning to get serious. From 6 years old onward, permanent teeth begin to appear.

1.- Between 6-9 years old

The MINIMUM (not maximum) brushing is twice a day. In the morning before going to school, breakfast or not! (Although the ideal is to wake up early to have a good breakfast and enough time for the morning routines, which means of course, going early to bed!)

The second brushing is before going to bed. This is when brushing is important because it is at night when the bacteria entrenches themselves between teeth for several hours, saliva dries and the lips and tongue moves less. (It´s when bacteria do their camping)


In addition it’s at night when it’s less stressful than in the mornings and it’s an ideal time to start to learn to use mouthwash with fluoride in a way that the permanent teeth enamel fortifies.

What can we do to motivate them? The Tooth Fairy is a great ally because we all know that the Tooth fairy pays more for clean and white teeth rather than black and rotten teeth that had to be extracted by the dentist, right!? (Wink, wink!)

There are loads of things that can be done (even purchased!) to stimulate the thrill for the Tooth Fairy. Pouches to collect fallen teeth, tiny doors for the Tooth Fairy to use once advised of a fallen tooth, signals to be hang on the door to let the Tooth Fairy know about the latest news, …

Starting 7 years old is when all the first permanent molars have erupted and baby teeth begin to fall off. This is the time to begin seeing the orthodontist. Just like seeing the general dentist, for the majority of the cases no treatment may be required. In some cases though it may be necessary to redirect the growth of the jaws and it is easier and simpler to carry out at his age.

On these visits the dentist (and no longer the parents) reinforces the importance of brushing and caring for the teeth and gums where in itself also motivates the child. Just like when we visit the pediatrician, it is repeated again and again the importance of a healthy diet and to eat fruits and vegetables so our tummy don’t hurt. It’s always good to have a professional back up, sometimes it makes a deeper impression.

A trick you can use is plaque revealing tablets. These are tablets that reveal where plaque are with stains. These can be found in the chemists.  The child brushes their teeth normally and once a week as a check, the tablet is sucked on (half a tablet usually is enough), and swished around the mouth and teeth inside and out and then spitted out (not to be swallowed!)

Rinse with a bit of water and all that is dark is where the plaque is and is where brushing must be concentrated. Usually in the borders of the front teeth are clean even if they are brushing really badly. You will find usually dirty spots at the back of the teeth and the last molars. Tooth brushing on these areas is then carried out again.


Little by little if we are consistent, the technique will improve and it will get better but then again if we only do this once every three months it’s not going to affect much right? 😉 Ideally we will do it 1/week for 4 weeks.

Remember that if the children follow our lead. If we tell them to eat fruits and we ourselves don’t eat fruits the possibility of them getting the idea is less. Children copy what we do and if we take care of our teeth chances are they will too.

At this stage giving them candies, sweeties, tetrapack juices,… as reward for good behavior is like throwing gasoline to the fire. Not a good plan, use stickers by instance.

 Ortodoncia Nakpil Bueno. Orthodontist Marbella
2.- From 9 years old onward:

At this age one would not know if to jump in a lake or off a cliff because now they know it all and the feel like they’re GROWN-UPS!! The idea is to have to start them young and instill the importance of oral hygiene in the hopes that they go automatic pilot if it’s not the case then…

I would use plaque revealing tablets again because they’re objective and it’s not mum or dad saying so but it’s that magic tablet is the one pointing the finger.

Another external measurement are mobile applications, there are several that you can download to monitor every time they brush their teeth. Later on you can see the weekly or monthly statistics of their brushing time. Usually they have a countdown or a watch to let them know for how long they have been brushing their teeth (at LEAST during 2 minutes every time)

Some children get motivated by the use of an electric toothbrush (for about one week give or take). If the child already brushes his or her teeth well and to top that we get them an electric toothbrush then ladies and gentlemen we have triumphed! But if the child hardly brushes their teeth and we get them an electric toothbrush then it would be like throwing money down the drain, they will end up cleaning Barbie or their pet teeth soon.

My opinion is that the electric toothbrush is a reward after the effort and not before.

I encourage that at the minimum, the very least improvement they do, give them tons of praise. Right there and then. Don’t wait a week. Objectively praise them and see whatever little progress they make would make them want to improve. Telling them all that is lacking in their hygiene might make them want to throw in the towel. (I’m saying this from experience). Aim for tiny objectives at the start and don’t comment on how bad their hygiene is meanwhile magnify all their positive efforts. This may make them want to have the reputation of the whitest teeth of all.

I hope that that this post had been useful. If you have any doubt whatsoever, contact me and I’ll answer you. If you have any tricks that works well for your child to brush their teeth by themselves I would be thankful if you can share your comment so between us all we can improve the oral health of our little ones.

Ortodoncia Nakpil Bueno. Orthodontist Marbella INVISALIGN