Why is toothbrushing such a problem? It might not be about behaviour.

Twice a day, every day. Toothbrushing sounds simple enough.

But for some families, those few minutes in the bathroom can become one of the most difficult parts of the day.

Perhaps your child refuses to brush their teeth, complains about the toothpaste being too spicy, gags when the toothbrush goes into their mouth or just avoids brushing altogether.

It can be easy to see this as difficult behaviour. But what if it isn't that they won't brush their teeth - what if there's something about brushing that they genuinely can’t cope with?

As a parent, and someone who studied dentistry for a while, I know how important brushing is. The NHS recommends brushing teeth with fluoride toothpaste for two minutes twice a day to help prevent the build-up of plaque that contributes to tooth decay and gum disease.

I also know from personal experience that just understanding how important something is doesn't make it any easier to achieve.

When toothbrushing becomes a battle

My eldest child firmly resisted our efforts to establish a regular brushing routine. What should have been a straightforward part of the morning and bedtime routine became a battle of wills twice a day.

At the time, the obvious question was: how do we get him to brush his teeth?

But there's another question that can be much more useful:

What is it about toothbrushing that he doesn't like?

For some children, remembering to brush or establishing a routine is the main challenge. But for others, what looks like refusal or resistance may be a reaction to something about the brushing experience itself.

And when you start looking at brushing from that perspective, there are quite a few possibilities.

Could toothpaste be the problem?

Think about the foods children eat.

Some love strong flavours. Others prefer very mild ones. Some enjoy crunchy foods but dislike anything soft or slimy. Others can immediately detect a flavour or texture they don't like.

We accept that children have food preferences, so why wouldn't they have toothpaste preferences too?

Toothpaste introduces a combination of taste, smell, texture and foam into the mouth, all at the same time.

Mint in particular can be difficult for some. A strong flavour, the cooling sensation associated with mint, or simply a smell they dislike can be enough to make them reluctant to put the toothpaste in their mouth.

Texture can matter too. Some children may prefer a smooth gel, while lots of foam can feel overwhelming or make brushing more difficult.

So if your child doesn't like toothpaste, trying a different flavour or texture could be worth exploring.

When choosing an alternative, remember that fluoride is important for helping to protect teeth from decay, so check that the toothpaste contains the appropriate fluoride level for your child.

What about the toothbrush?

Sometimes it's not the toothpaste at all.

The feeling of bristles against the teeth and gums can be uncomfortable for some children, particularly if they're sensitive to touch or sensation around the mouth.

A smaller brush head and very soft bristles may feel more acceptable and also make it easier to reach around the mouth.

Electric toothbrushes aren't automatically the answer either. Some children love them, while others dislike the vibration, movement or noise. I've even heard children describe an electric toothbrush as making their head hurt.

There isn't one toothbrush that will suit everyone. The important thing is finding one that the person using it is comfortable with.

And if brushing suddenly becomes painful when it wasn't before, or your child complains of persistent pain, it's important to speak to their dentist so that any underlying dental problem can be investigated.

Routine still matters, but it isn't always the answer

Once you've considered whether something about the brushing experience itself is causing a problem, routines can certainly help.

Brushing at roughly the same times each day and linking it to something that already happens, such as getting dressed in the morning or preparing for bed, can make it easier for brushing to become familiar.

Reminders, visual prompts or rewards can work well for some children too.

But if a child genuinely dislikes the taste of their toothpaste or finds their toothbrush uncomfortable, a sticker chart isn't necessarily going to change how that experience feels.

Sometimes it makes sense to change the experience before trying to change the behaviour.

Try changing one thing

If toothbrushing is difficult in your house, you don't necessarily need to change everything at once.

Try experimenting.

Would a different toothpaste flavour make a difference? What about a smoother, lower-foaming toothpaste? Could an ultra-soft toothbrush feel better? Does your child prefer a manual toothbrush to an electric one?

Giving children some choice can also help you discover what they actually prefer.

It's one of the reasons we created the BuddiesForLife Brushing Breakthrough Kit.

The kit includes our ultra-soft sensory toothbrush together with three different sensory-friendly toothpaste flavours to try. It gives you a simple, affordable way to explore different tastes and a gentler brushing experience before deciding which full-size toothpaste pump works best for your family.

Sometimes the behaviour breakthrough isn't persuading a child to try harder - it's discovering what was making brushing difficult in the first place.