Wacky New Preschool Toothbrushing Rule: The Law of Unintended Consequences

As a parent and a consultant to a couple of childcare programs, I am impressed and a little quizzical about a new law in my state detailed in Boston Globe journalist and mom Erica Noonan’s blog. Namely, Massachusetts daycares are required, forthwith, to attend to toothbrushing for kids in care settings more than 4 hours a day.

Open Wide:

From babies to preschoolers, the default policy is for all children—with teeth—to have their teeth brushed by childcare providers after meals. The marginal gain in clean teeth for hardworking staff hardly seems worth it, at least for the infants and younger toddlers. Admittedly, a tooothbrushing curriculum may be a great idea and appropriate for the more advanced motor skills of the older toddlers and preschoolers.

Back and Forth, Up and Down:

On the upside, this is a serious program with serious training. Extensive grounding is done for childcare providers and teachers in safety, hygiene, and promoting teethcleaning skills in the children. Clearly, this mandate arose from the horrific rates of caries that impact upon this population, in our Commonwealth and across the country. And, in turn, dental problems that arise from poor hygiene in this age group can cause further vexation later on.

However, the approach for adding this program might be a bit absurd and problematic for the younger infants and toddlers. In the case of my 20-month-old daughter, who has but four erupted teeth, staff would have to brush each tooth for 30 seconds to comply with the letter of the law. (2 minutes brushing per kid per day). As if getting our charges clad in snow pants and mittens to go outside weren’t enough? A process that requires toddler or preschooler to be still for just about anything is challenging on the best of days. And, in the post H1N1 era, the concerns for contagion are to be considered—even with the proper precautions and good technique practiced by trained staff.

Less advertised fact: parents can opt out.

Gargle and Rinse:

As a parent of three children who have benefitted from the excellent care of childcare providers, I am hopeful that the implementation of this policy goes better than I am expecting. The creativity and patience of the childcare providers has surmounted many daunting challenges. Let us hope the same applies here.

In the words of my colleagues, it seems the effort and time would be much better spent in offering fewer sugary snacks and drinks to our kids. Perhaps. Families can work with their children’s healthcare providers and now, their daycare providers in developing these skills at home. In any case, I hope my state works to evaluate the cost and benefit of this endeavor before too long. Otherwise, it might be a total floss.

Photo from Belmont Nursery School; cartoon by me.

Comments