IEP goals for toothbrushing
By the IEP Atlas editorial teamLast updated
Short answer
A brushing teeth IEP goal states where and when the student brushes, which steps or mouth areas count, the support allowed and a criterion across sessions. Example: after lunch, using a picture sequence, the student will complete 9 of 10 toothbrushing steps independently and brush for 2 minutes on 4 of 5 school days.
Toothbrushing shows up in IEPs for two reasons. Some students cannot yet do the routine without an adult's hand on the brush. Others can do the motions but brush for 10 seconds, skip the back teeth, or refuse the brush in their mouth at all. Each problem needs a different goal and a different measure.
This page gives 16 goals in four groups, each with an illustrative baseline and a template link. Brushing at school usually happens after lunch in a classroom sink or the nurse's office, so plan where the student's supplies live before you write the goal. The life skills IEP goals pillar shows where toothbrushing fits among other self-care routines.
Choosing a toothbrushing goal
| What you see | Sub-skill | Measure | Data sheet |
|---|---|---|---|
| Needs an adult for most steps | Step sequence | Steps independent out of 10 | Task analysis data sheet |
| Does the steps, brushes 10 to 20 seconds | Brushing time | Seconds brushing | Duration data sheet |
| Brushes front teeth only | Coverage of all four zones | Zones brushed out of 4 | Accuracy data sheet |
| Gags, bites the brush, pulls away | Tolerating the brush and paste | Seconds tolerated, or steps tolerated | Duration data sheet |
| Brushes well at school, not at home | Starting and generalizing | Brushing sessions started without a cue | Opportunity data sheet |
Talk with the family before choosing. If the student brushes twice a day at home with a parent's help, a school goal may only need to cover the after-lunch routine and a home carryover check.
A 10-step toothbrushing sequence
- Get the toothbrush, paste and cup from the bin.
- Wet the brush.
- Put a pea-sized amount of paste on the brush.
- Brush the top outside teeth.
- Brush the bottom outside teeth.
- Brush the inside surfaces, top and bottom.
- Brush the chewing surfaces.
- Spit into the sink.
- Rinse the brush and the mouth.
- Put the supplies back in the bin.
Steps 4 to 7 split the mouth into zones so you can score coverage. Ask the family or school nurse whether the student's dentist has given any specific instructions, and follow those over this list.
Goals for the brushing steps
| Goal | Baseline (illustrative) | Measure | Template |
|---|---|---|---|
| 1. After lunch, given a picture sequence taped to the mirror, the student will complete 9 of 10 toothbrushing steps independently on 4 of 5 school days. | 4 of 10 steps | Task analysis | Template |
| 2. With the toothbrush bin placed at the sink, the student will gather supplies and apply a pea-sized amount of paste (steps 1 to 3) independently on 8 of 10 sessions. | Steps 1 to 3 independent on 2 of 10 | Task analysis | Template |
| 3. After brushing, the student will rinse the brush, wipe the sink and return supplies to the bin (steps 9 and 10) with no more than 1 verbal prompt on 9 of 10 sessions. | Leaves supplies at the sink on 8 of 10 | Task analysis | Template |
| 4. Using forward chaining, the student will complete the first 5 steps independently, with adult help on the rest, on 4 of 5 consecutive days before the next step is added. | First 2 steps independent | Task analysis | Template |
Forward chaining fits toothbrushing better than it fits handwashing, because the early steps (getting supplies, applying paste) are easy to teach and the brushing zones are the hard part. Add one step at a time.
Weak: "The student will brush teeth with assistance."
Measurable: "After lunch, given a picture sequence on the mirror, the student will complete 9 of 10 toothbrushing steps independently on 4 of 5 school days, measured by task analysis."
Goals for brushing time and coverage
A student who does every step in 15 seconds needs a time or coverage goal, not another steps goal.
| Goal | Baseline (illustrative) | Measure | Template |
|---|---|---|---|
| 5. Using a 2-minute sand timer or brushing app, the student will keep brushing until the timer ends on 4 of 5 sessions for 3 consecutive weeks. | Median 18 seconds | Duration | Template |
| 6. Given a 4-part picture of the mouth, the student will brush all 4 zones for about 30 seconds each, moving to the next zone at the timer chime, on 8 of 10 sessions. | 1 of 4 zones brushed | Accuracy (zones out of 4) | Template |
| 7. After brushing, the student will check the mirror and brush again any zone a disclosing tablet shows as missed, on 4 of 5 checks. | Does not recheck | Opportunities | Template |
| 8. After brushing, the student will floss using a floss pick on the top and bottom teeth, completing 6 of 7 steps, on 3 of 4 weekly probes. | 1 of 7 steps | Task analysis | Template |
Disclosing tablets turn missed plaque pink or purple. Use them only with family consent, and check with the school nurse before giving any product by mouth.
Weak: "The student will brush teeth thoroughly for an appropriate time."
Measurable: "Using a 2-minute timer, the student will keep brushing until the timer ends on 4 of 5 sessions for 3 consecutive weeks, measured by duration."
Goals for tolerating the brush
For some students, the brush in the mouth is the whole problem. These goals build tolerance in small steps. Plan them with the OT, and with the SLP if gagging or oral sensitivity is part of the profile. Keep each session short and stop before distress.
| Goal | Baseline (illustrative) | Measure | Template |
|---|---|---|---|
| 9. Given a choice of 2 soft brushes, the student will allow the brush on the front teeth for 10 seconds without pulling away on 4 of 5 trials. | Allows 2 seconds | Duration | Template |
| 10. Using unflavored or mild paste chosen with the family, the student will brush with paste on the brush for 30 seconds on 4 of 5 sessions. | Refuses paste on 5 of 5 | Duration | Template |
| 11. When brushing is uncomfortable, the student will use a "pause" card or sign instead of biting or pushing the brush away on 8 of 10 occasions. | Bites or pushes on 7 of 10 | Opportunities | Template |
| 12. With a vibrating or electric brush introduced in 3 steps (hold, touch lips, touch teeth), the student will brush the outside surfaces for 30 seconds on 3 consecutive sessions. | Holds the brush, will not mouth it | Task analysis | Template |
Goal 11 matters because it replaces a behavior. Giving the student a way to say "stop" often makes the next 30 seconds possible. See sensory processing goals for how OTs write the related sensory goals.
Weak: "The student will tolerate toothbrushing."
Measurable: "Given a choice of 2 soft brushes, the student will allow the brush on the front teeth for 10 seconds without pulling away on 4 of 5 trials, measured by duration."
Goals for starting and generalizing
| Goal | Baseline (illustrative) | Measure | Template |
|---|---|---|---|
| 13. After lunch, the student will go to the sink and begin brushing within 3 minutes of returning to class, without a verbal reminder, on 4 of 5 days. | 0 of 5 days | Opportunities | Template |
| 14. At home, using the same picture sequence, the student will brush before bed on 5 of 7 nights as recorded on a family check sheet. | Family reports 2 of 7 nights | Opportunities | Template |
| 15. On overnight or extended field trips, the student will pack a toothbrush kit using a packing list (4 of 4 items) on 2 of 2 trips. | Forgot kit on last trip | Task analysis | Template |
| 16. When the toothpaste tube is almost empty, the student will add it to the supply list or tell an adult on 3 of 3 occasions. | Does not report low supplies | Opportunities | Template |
Weak: "The student will brush teeth at home."
Measurable: "At home, using the same picture sequence, the student will brush before bed on 5 of 7 nights as recorded on a family check sheet."
How to measure toothbrushing progress
Score steps on the task analysis data sheet with one column per session and the 10 steps down the side. Record I, G, V or P for each step and count only the I marks. One session a day is enough.
For time goals, use duration recording: start the stopwatch when the brush touches the teeth and stop when it leaves the mouth for more than 5 seconds. For zone coverage, a simple 4-box checklist scored as zones brushed out of 4 is enough.
Home data needs to be simple. A check sheet on the bathroom wall with one box per night works better than a full task analysis. Count home data as a separate line on the graph, because the conditions differ.
Review every 2 weeks. If the steps count has stalled at the same level for 6 sessions, look at which step is the sticking point and teach it on its own. Task analysis examples shows how to break one step into smaller ones.
Adapting by age and support level
| Student | Typical focus | Criterion example |
|---|---|---|
| Preschool and K-2 | Tolerance, first 3 steps, short brushing time | 30 seconds of brushing on 4 of 5 days |
| Grades 3 to 5 | Full sequence, timer use | 9 of 10 steps on 4 of 5 days |
| Middle school | All zones, flossing, starting without reminders | 4 of 4 zones on 8 of 10 sessions |
| High school and transition | Home routine, packing kits, buying supplies | 5 of 7 nights at home, supplies restocked |
Toothbrushing pairs naturally with handwashing goals and the morning routine on the daily living skills goals page. More templates sit on the hygiene goal hub and the daily living goals page. Run your draft through the goal checker before the meeting.
Present levels should explain why the routine matters for this student's functional performance, and the goal should follow from that statement.[1] Teams that collect the baseline the same way they will measure the goal can show real growth at the first progress report.[2]
Frequently asked questions
Can a toothbrushing goal be written for a student who refuses the brush?
Yes. Start with a tolerance goal measured in seconds, such as allowing the brush on the front teeth for 10 seconds. Add a way for the student to ask for a pause. Move to a steps goal once the student accepts the brush for 30 seconds or more.
Where should students brush their teeth at school?
Any private sink the team agrees on works: a classroom sink, the nurse's office or a single-stall restroom. Store each student's labeled supplies in a closed bin. Confirm the plan with the school nurse and the family.
How do I count brushing time accurately?
Use a stopwatch. Start when the brush touches the teeth and stop when it leaves the mouth for more than 5 seconds. Record the total seconds each session and graph the median across the week.
Use it in IEP Atlas
- Hygiene goal hub
- Self care goal hub
- Toothbrushing goal template
- Duration recording guide
- IEP goal checker
Related guides
- Life skills IEP goals: the complete map by domain
- IEP goals for handwashing
- IEP goals for showering and deodorant
- Daily living skills IEP goals
- Menstrual care and puberty hygiene IEP goals
Sources
- 34 CFR §300.320: Definition of individualized education program, Legal Information Institute, Cornell Law School
- Progress Monitoring: Data & Goal Setting, National Center on Intensive Intervention
- American Occupational Therapy Association, AOTA
Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.