The Challenges of Tooth brushing!

I like the Facebook page "Autism Discussion Page" and want to share it with my blog friends. I will keep posting few of them.

The Challenges of Tooth brushing!

Tooth brushing is very intrusive. When training staff we used to have them brush each other's teeth so they see could feel how intrusive it is. We don't realize that we know exactly how hard to brush, where we feel sensitivity, how to miss the gums, and how fast to brush, when we are brushing our own teeth. To have someone shove a toothbrush into your month, and brush your teeth, without you controlling it can be really discomforting. In addition, many of these children have strong sensory sensitivities. Kids that tend to be tactile defensive (touch) are often orally sensitive. There are a variety of things to try, but again, I would start by validating that you (1) recognize that brushing causes discomfort for him and (2) that it is understandable. Then from there I would try.

1. Work slowly and talk him through it, telling him what side is next.
2. It often helps to have a set number of strokes you use for each side (top, bottom, side, front, etc.). Like five back and forth strokes. Count out each stroke. Counting gives the child a definite end, allows them to judge “how much longer”, allows them to hold out a little longer, and gives them something to mentally distract them.
3. It is best to give the child as much control over the brushing as possible. Brush five strokes on one surface, then pause, and wait for child to let you know when ready for next.
4. Let the child do as much of it as they can. Even if they do poorly you can go over it.
5. Throw away your toothbrush, it may be too hard of bristles. Use a sponge toothbrush call a toothette. It is a sponge that is soft and delicate to the gums.
6. Experiment with different toothpastes to find what the child likes the best. Or, don’t use toothpaste at all. Simply use water. If you child will use a mouth rinse, this also can be added. 
7. Work slowly, and pause whenever the child shows discomfort. Continually show the child you are working with them, pausing when discomfort occurs, and letting them control the pace of brushing.
8. Many children with oral sensitivity like to use a battery operated, vibrating tooth brush. The vibration tends to dull their oral sensitivity.
9. Have fun with it. You brush his teeth, and let him brush yours...lol.
10. Reinforce the child with a strong reward once the brushing is complete.
11. Put up a chart, and let the child get a star for each time they brush. After they fill up the chart (five squares, one for each star) then they get a special reward.
12. If child doesn't like the taste of toothpaste, start off with just water, no toothpaste. Then slowly put a little on. There are liquid washes that you can substitute for those who do not like paste.
13. For some kids we actually use a soft washcloth over our finger to rub the teeth and gums, instead of a toothbrush.

When in doubt, stay supportive and try not to force. I know it takes time, but having someone force a toothbrush around your mouth can be very intrusive.