OBJECTIVE The aim of this crossover study was to compare the efficacy of conventional and end-tufted toothbrushes and two methods of plaque removal on partially erupted occlusal surfaces in schoolchildren. METHODS Thirty-seven subjects, aged 5-7 years, with at least one partially erupted lower permanent first molar, were randomly divided into three groups. Occlusal plaque (baseline) was scored using a disclosing solution applied to the occlusal surface of an erupting molar. Subjects were instructed to use a conventional toothbrush with horizontal scrubbing (conventional group); a conventional toothbrush with transverse technique (modified group); or an end-tufted toothbrush (end-tufted group). Subjects returned after a one-week washout period and brushed with the alternate toothbrush or technique. Final plaque condition was evaluated again using the same scoring as at baseline. Occlusal plaque reduction (baseline to final) percentiles were compared using paired t-test. RESULTS No statistically significant difference was found among transverse and end-tufted techniques (modified and end-tufted groups respectively) (p > 0.05). The conventional group was less effective on occlusal plaque removal in erupting first molars than the other groups (p < 0.05). CONCLUSIONS The conventional toothbrushing technique was not satisfactory compared with other tested techniques on occlusal plaque removal. Moreover, the use of a conventional toothbrush with a modified technique was very effective on erupting first permanent molars without any additional costly device.