Each classroom will have daily supervised tooth brushing in conjunction with meals, that models and teaches good dental hygiene and prevents cross-contamination between children, toothbrushes, and toothpaste. (Cross contamination is the physical movement or transfer of harmful bacteria from one person,object or place to another).

The University of Iowa Procedure will be used to guide tooth brushing procedures at all HSOLC and CCC sites.


  1. Each child will have her/his own labeled toothbrush and brushes will be stored in holder and kept out of the reach of children when not in use.
  2. Sanitation/Storage: Each toothbrush holder will be sanitized two times a month. The holder can be washed with warm water and soap and air dried.
  3. Each classroom will be provided with a new toothbrush three times a school year: September 1, December 1, March 1.
  4. The sink area must be sanitized before and after tooth brushing activities.
  5. Tooth brushing with fluoride toothpaste will follow these guidelines to prevent cross-contamination:
    1. Group tooth brushing must be supervised by staff and/or volunteers who have been trained to monitor for activities that could result in cross contamination (spitting, playing with toothbrushes, etc). Children should never perform tooth brushing without adequate supervision.
  6. To prevent cross contamination of the toothpaste tube, ensure that a pea-sized amount of toothpaste is always dispensed onto something other than the toothbrush first (wax paper, paper cups, or onto the child’s cup) **(Do Not Use Toothpaste Tube To Dispense Toothpaste to the Brushes)
    1. Classroom procedure must insure that each child picks up only his or her own toothbrush.
    2. Classroom procedure must insure that children do not have the opportunity to spit onto or near other children’s toothbrushes.  This will vary dependent on classroom layout, and it is the responsibility of teaching staff to determine the procedures that work best for their physical layout.
    3. Classroom staff will insure that toothbrushes are rinsed and stored properly after use.  Plastic cups will be cleaned in the sanitizer after use.

This policy complies with Head Start Performance Standard 45CFR Section 1304.22.
Guidance provided by CDC recommendations for Tooth brushing programs in Schools and Group Settings.
It has been approved by Policy Council on June 10, 1997
Revised May 28, 2002. August 2009

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REVIEWED: April 2021