Tooth Brushing should be performed twice a day, using a fluoride toothpaste approved by the American Dental Association. Due to the delicacy of young tooth enamel, toothpastes with harsh abrasives such as whitening toothpaste should be avoided until well into the teen years. It is recommended that for children younger than 3, you place a thin layer of toothpaste that barely covers the bristles like “butter on toast”. For children older than three who are better able to spit, a “pea-sized” amount may be utilized.