Toothbrushing & Tantrums: 7 ABA Strategies to Reduce Resistance

Toothbrushing shouldn’t feel like a battle—but for many families, it does. Daily brushing can become a moment of stress and resistance, especially for young children. 

 At POP Therapies, we specialize in early intervention ABA therapy and work closely with families to reduce these daily challenges through evidence-based strategies. Below, we’ve compiled 7 effective ABA techniques to help your child cooperate during brushing time—while keeping things positive and predictable. 

 

7 ABA Strategies for Toothbrushing Success:

1. Make Toothbrushing a Rewarding Experience

Why It Works:
Many kids resist brushing because it feels uncomfortable, unfamiliar, or boring. Turning toothbrushing into a positive, rewarding event can boost cooperation. 

How To Use This Strategy: 

• Use their favorite reward (like a sticker, song, or dance party) right after brushing. 

• Praise specific behaviors like “I love how you kept your mouth open for the whole timer!” 

• Keep early brushing sessions short and build up to longer times with consistent reinforcement. 

ABA Tip: Reinforcement is more powerful when it’s immediate and tied to a specific behavior. You’ll know when you have a strong reinforcer if your child continues to complete the steps to brushing teeth! 

2. Break It Down with a Task Analysis

Why It Works:
Telling a child “brush your teeth” can feel overwhelming. Task analysis breaks the activity into small, manageable steps. 

How To Use This Strategy: 

• Create a step-by-step routine (e.g., pick up toothbrush, add toothpaste, brush top teeth, rinse). 

• Teach and practice each mini-step separately. 

• Gradually fade prompts as your child becomes more independent. 

ABA Tip: Focus support where resistance shows up the most and celebrate every success. 

 

3. Use Visual Schedules and Social Stories

Why It Works:
Visual cues and stories help children understand expectations and reduce anxiety through predictable routines. 

How To Use This Strategy: 

• Use simple pictures to represent each brushing step. 

• Create a social story describing brushing in a fun, clear way. 

• Let your child check off each step—they’ll feel more accomplished. 

ABA Tip: Predictability builds trust and reduces  the chances of avoidant behaviors occurring. 

 

4. Offer Meaningful Choices

Why It Works:
Giving your child a say in the process increases buy-in and gives them a sense of control. 

How To Use This Strategy: 

• Let them choose between two toothbrushes or toothpaste flavors. 

• Allow some flexibility in when brushing happens (“after bath or after story time?”). 

• Always offer structured choices—too many can overwhelm. 

ABA Tip: A sense of control leads to better cooperation. 

 

5. Use “First/Then” Language and Visuals

Why It Works:
This helps your child understand that brushing comes before something enjoyable, creating a clear cause-and-effect. 

How To Use This Strategy: 

• Say “First we brush, then we read your favorite book.” 

• Use visual cards to reinforce the message. 

• Be consistent and always follow through. 

ABA Tip: Pair less preferred tasks with something positive to increase follow-through. 

 

6. Set a Timer

Why It Works:
Timers make routines feel finite, which reduces anxiety and helps your child anticipate when the task will end. 

How To Use This Strategy: 

• Use a visual timer, sand timer, or app with sound effects. 

• Start with short sessions (e.g., 10–15 seconds) and build gradually. 

• Make the timer part of the fun (“Let’s beat the timer together!”) 

ABA Tip: Set clear expectations and stick to them. 

 

7. Reinforce Consistency and Progress

Why It Works:
Celebrating progress builds confidence and motivates kids to keep trying, even if brushing isn’t perfect yet. 

How To Use This Strategy: 

• Use sticker charts or visual trackers for daily brushing. 

• Celebrate even partial success (“You tried today! That’s awesome!”). 

• Set milestone rewards for consistent progress (like choosing a bedtime story or small toy). 

ABA Tip: Reinforcement isn’t just for success—it’s for effort, too. 

 

FAQ: Toothbrushing Troubles – BCBA-Approved Answers 

Q: What if my child spits out the toothpaste?
A: That’s okay! Many children need time to adjust to the texture or taste. Try toothpaste without fluoride or with a mild flavor. Reinforce even the attempt to use toothpaste. Consult your dentist for alternatives if swallowing is a concern. 

Q: Should I force toothbrushing?
A: No. Forcing can increase anxiety and avoidance long-term. Use ABA strategies like shaping (small steps), reinforcement, and choice-making to build positive associations. 

Q: How long should I try before asking for help?
A: If brushing is consistently leading to meltdowns or refusal despite using positive strategies for 2–4 weeks, consider reaching out to a BCBA. Early intervention can prevent further stress for both parent and child. 

Q: What if brushing turns into a meltdown?
A: Stay calm and end the task positively, even if brushing didn’t happen. Later, analyze what triggered the meltdown and adjust your strategy (e.g., try shorter sessions, use visuals, reduce sensory load). A behavior plan may be helpful for ongoing struggles. 

 

Conclusion 

Toothbrushing doesn’t have to be a battle. With ABA-based strategies, you can turn this daily routine into a moment of progress. From offering choices to visual support and reinforcement, each technique builds your child’s confidence and cooperation—one step at a time. 

Have a question or need support? Contact POP Therapies for a free consultation to help create a custom behavior plan for your child’s daily routines. 

 

References 

• AAPD (American Academy of Pediatric Dentistry). (2021). Guidelines on Infant Oral Health Care. 

• Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Pearson. 

• Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins, F. R. (1994). Functional assessment and severe behavior problems. Journal of Applied Behavior Analysis, 26(2), 251–265. 

• Freedman, J. B., & Almond, M. C. (2018). Evidence-based prevention of toddler oral health problems. Pediatric Dentistry, 37(5), 415–420. 

• Gray, C., & Garand, J. (1993). Social stories: Improving responses of students with autism. Focus on Autistic Behavior, 8(1), 1–10.