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Background: Earlier studies shows that tooth brushing can be challenging when individuals have impaired motor skills, impaired cognitive function, mental illnesses and natural teeth. Sometimes force is considered in order to get the residents toots cleaned. How can it be that clean toots is considered so important that one may consider the use of force in order to get the toot brushing done? The article is based on the theory that one can find explanations on contemporary practices by analyzing the rise of the practices. Aim: Create new understanding on tooth brushing challenges in nursing homes. Method: The article is mainly based on analysis on documents and on interviews with ten auxiliary nurses. Results: The norm that mouth and teeth should be clean occurred in connection with the modernization of Western countries. This norm health professionals in nursing homes tries to meet by providing the residents tooth brushing once a day. When residents don’t want to brush their toots, the staff can experience a difficult a dilemma between the consideration of the resident’s autonomy and the consideration of oral hygiene. Conclusion: The study shows that the modern norms on toot brushing that occurred about 120 years ago still is so important that caregivers could use force in order to brush the resident’s teeth.

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