When it comes to dental hygiene, it can be challenging for children with autism to regularly brush their teeth. They might experience discomfort when cleaning for the first time, making them dislike performing this important task. If you are a parent or a caregiver, you must be creative and consistent in finding ways to establish a fuss-free brushing routine that works for your child.
Here are some helpful tips from dentists and other experts who specialize in dealing with oral health for children with special needs.
Finding the best toothbrush for autistic child
Most children with autism have sensory issues—feeling bristles rub their teeth and gums might be too uncomfortable or painful for them. They may also gag when the brush moves toward the back of their throats.
The key is to experiment with different kinds of toothbrushes. You can try a toddler toothbrush with softer bristles or a sensory brush for older children. There are also bristles made with silicone instead of plastic which your child might find more tolerable.
Some children with autism might struggle with brush strokes and fail to brush their teeth thoroughly. For this, you can try a kid’s electric toothbrush. These electric toothbrushes are often available in stores and online.
Finding the right toothpaste for autistic child
It’s not just the toothbrush that can bring discomfort to a child with autism. The wrong kind of toothpaste can significantly affect a child’s experience with brushing.
Observe how your child reacts to the taste and texture of the toothpaste. If your child is verbal, you can ask if it feels and tastes okay. It may take you several tries before you find a flavor or brand your child prefers.
Unfortunately, no one product is the best toothpaste for kids with autism. Instead of finding a perfect product, focus on trying different ones, and see what works best for your child. If you feel the toothpaste’s taste or smell is too strong for your child, you can try tasteless toothpaste, non-mint toothpaste, or any autism-friendly toothpaste. Try as many as you can and hopefully you’ll find a winner.
Establishing a routine at home
Dental hygiene starts at home. Ideally, it should start at a young age when all other routines are being taught. The earlier your child learns oral care, the lesser the chances of him/her developing serious dental problems later in life.
Starting a dental routine may be difficult at first, but it is a necessary phase every parent and child goes through.
Here are some best practices that might help you establish a dental routine for your child.
- Inform the child ahead of time that it will be time to brush his/her teeth in a specific amount of time. Give the child a few minutes to make a shift from what he/she is doing to entertaining the idea of brushing his teeth.
- Create a visual schedule of tasks and include brushing his/her teeth.
- Avoid waiting until your child is too tired before beginning the routine.
- Use a song or visual timers, so the child knows how much longer the task will take.
Visiting the dentistIn most cases, dental problems require a visit to the dentist. Periodontal disease and cavities are just two of the many dental problems seen in patients with autism.
Poor oral care in children with autism may result in:
- Gingival overgrowth
- Tooth decay
- Periodontal gum disease
- Bruxism (a condition caused by constantly grinding teeth)
- Abnormal teeth (size, shape, and the number of teeth present in the mouth)
- The fast or slow eruption of one or more tooth
- Teeth with pits, discoloration, and lines
Going to the dentist may cause fear and/or distress for your child. It certainly is not going to be easy, but with well-placed strategies, it can be done.
There are many reasons your child may struggle with the dentist. The harsh light, noisy equipment, unfamiliar sights and sounds, and other environmental factors can make your child’s first visit to the dentist challenging.
If going to a family dentist seems out of the question, then finding a pediatric dentist that works with special needs children would be your best option. These dentists receive training beyond dental school and have a standard procedure in place. Don’t hesitate to reach out to other special needs parents or your health care provider if you need help finding one. The American Dental Association has an online search tool to find a dentist near you.
Some great examples of preparing your child for the dentist are:
- Give the child a visual sequence of what to expect during the visit
- Watch videos of a “happy” dental visit
- Use social stories to set the child’s expectations and address anxiety
- Go with a parent or sibling and watch the child being examined/treated
- Bring a favorite object or toy for comfort
If your child’s need for dental work is urgent, and he/she refuses treatment, the dentist might suggest sedation. Sedation is common in dentistry and is done even to non-autistic patients primarily to address anxiety. This method keeps the patient mildly awake, unlike anesthesia, which puts the patient to sleep completely.
While this may seem extreme, it might be the only way to get your child treated. If you have concerns, then ask your dentist as many questions as you can to help you make an informed decision.
Sedation might seem like the easier option, but the American Speech-Language-Hearing Association (ASHA) strongly suggests treating sedation as a last resort and instead working on making dental visits a positive experience for your child.
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Seeking help from experts
Therapists and special needs experts can help you prepare your child for his/her first visit to the dentist. Studies have shown that Applied Behavior Analysis (ABA) is effective in creating positive dental care experiences for children with autism.
ABA is a system of treatment that uses positive reinforcement and rewards, as well as explaining the consequences of negative behavior. In this approach, communication is vital between parent/specialist and the child.
In planned activity training for a dental visit, the parent or specialist may:
- Explain what the visit is
- Describe what will happen during the visit
- Clarify what is expected of the child during the visit
- Outline the steps of the visit (front desk, waiting room, dental chair)
- Show pictures of each step of the visit
- Let the child use headphones to lessen noise and/or sunglasses to minimize glare from bright lights
- Visit and talk to the dentist and staff to get to know them
In the study “Applied behavior analysis: behavior management of children with autism spectrum disorders in dental environments,” authors Hernandez and Ikkanda state, “For example, positive reinforce like rewarding with a toy or praising may lead to enhanced compliance in the dental chair. Conversely, negative reinforce like drilling can be handled by doing the procedure for predetermined period like counting from 1 to 10.”
The study concluded parents, experts, and dentists should all be on the same page when it comes to treating the child. Open communication, a clear understanding of autism, and willingness to help can make a powerful impact towards addressing a child’s dental care needs.