Navigating Toothbrushing Challenges in Children with Autism

Autism-Talk
Feb 23, 2024
5 min read

As a mom of 4 and an autism mom, few tasks have proved as endlessly frustrating and humbling as getting all 4 of my children’s teeth brushed every day. I would love to say, twice daily, but alas we have rarely made that milestone. While I cannot promise any miraculous solutions, I have found a few helpful hints and practical ideas that I can share.

Understanding the Challenge

Children with autism may face unique challenges when it comes to toothbrushing. Sensory sensitivities, difficulty with transitions, and with motor planning can all contribute to resistance when it's time to brush. Recognizing these challenges is the first step toward finding effective solutions.

Social Skill Stories

Simple stories can be incredibly helpful in explaining the importance of toothbrushing and the steps involved. Consider creating a social story that outlines why we brush our teeth, using simple language and clear visuals to illustrate the process. This story can help children understand the rationale behind toothbrushing and what to expect during the activity. Many children with autism are extremely logical and just will not complete tasks unless they really understand the reason behind them. You can create your own if you want to personalize with pictures your child will be familiar with or purchase one that can be downloaded (like these ).

Modeling and Guided Practice

Modeling proper toothbrushing technique is another effective strategy. Show your child how to brush their teeth using a mirror so they can see exactly what to do. You can also offer guided practice sessions where you brush your teeth together, providing support and encouragement along the way.

Visual Schedule for Structure

Visual schedules can be used in 2 different ways. One way that is often helpful is a daily visual schedule that includes toothbrushing as part of the daily activities. In this way children have time to adjust to the idea that after dinner or play toothbrushing will occur. In my own children as well as many I have worked with, the more preparation they have for any directive or transition is helpful.

A visual schedule that breaks down the toothbrushing routine into manageable steps can also be helpful because it makes the task of brushing teeth more concrete and clearer about the beginning and the end. Additionally, many children with autism spectrum disorders struggle with motor planning and a visual guide that shows step by step instructions can make this less overwhelming and provide much-needed structure.

Create a visual schedule using pictures or icons for each step, such as getting out the toothbrush, applying toothpaste, brushing, rinsing, and putting everything away. Think of the most important steps or the steps that you feel are most important for the child to complete and include these pictures. Place the schedule in a prominent location near the bathroom sink to serve as a helpful reminder.

There are so many styles that can be used from ready to print to Velcro. It is most important that the schedules are in a format that will be easy to use and so it will be used consistently. Schedules are really only useful if they are used each time until the child no longer needs the visual supports. If you're feeling creative, you can craft your own, incorporating images familiar to your child. Alternatively, you can opt for a pre-made downloadable version, such as the one offered here .

Experiment

Sensory differences can pose an obstacle for many children. For some children, the sensation of toothpaste can be overwhelming. Trying brushing without toothpaste, at least initially, might be beneficial. Others may have strong preferences for certain flavors or textures, so offering a variety of toothpaste flavors can make the experience more enjoyable. Similarly, exploring different styles of toothbrushes—whether they're smaller, bigger, or electric—can cater to individual sensory needs. For children with autism, these sensory differences can greatly impact their response to toothbrushing. By understanding and accommodating these differences, we can help make the experience more comfortable and effective, ultimately promoting better oral hygiene for our children.

Interactive Activities

Make toothbrushing fun and engaging by incorporating interactive activities. Try brushing a laminated mouth with cavities drawn on using a dry erase marker – your child can "erase" the cavities as they brush away plaque! Additionally, a mini coloring book featuring teeth and toothbrushes can help familiarize them with dental hygiene concepts in a playful way.

Worksheets and Reinforcement: Provide worksheets or coloring pages related to dental health to further reinforce learning. These activities can include tracing lines to practice brushing motions, matching pictures of healthy and unhealthy foods for teeth, or completing a maze to reach the toothbrush. Use these worksheets as a way to spark conversations about oral hygiene and healthy habits. Create your own activities or explore this downloadable option here ."

Positive Reinforcement

Consider implementing a sticker chart to track your child's progress with toothbrushing. Each time they successfully complete the routine, they can add a sticker to the chart. It's important to note, though that for many children, just the sticker itself may not be reinforcing enough. The real reinforcement often comes from using the stickers to earn something meaningful. Set achievable goals and offer meaningful rewards, such as extra screen time, a favorite snack, or a special outing, in exchange for a certain number of stickers. By using the stickers as a tool to earn rewards, you not only encourage consistent toothbrushing habits but also teach valuable lessons about setting goals and working towards them. Celebrate their accomplishments and acknowledge their efforts along the way to keep them motivated and engaged in the process.

Sealants

Lastly, it's essential to recognize that most dentists understand the unique challenges children with autism may face when it comes to brushing their teeth. Many are well-versed in accommodating these needs and may suggest additional strategies to promote dental health. For instance, dentists may recommend dental sealants as a protective measure for children who struggle with traditional brushing techniques. Sealants are a thin, protective coating applied to the chewing surfaces of the back teeth, which helps prevent cavities by shielding against bacteria and food particles. This proactive approach can be particularly beneficial for children with autism, as it provides an extra layer of defense against dental decay and reduces the need for invasive treatments in the future. If you have concerns about your child's dental care, don't hesitate to discuss them with your dentist, who can offer personalized recommendations to support your child's oral health journey.

Conclusion

Incorporating these practical strategies and tips into your toothbrushing routine can help make the experience more manageable for children with autism. Remember to approach toothbrushing with patience, flexibility, and a positive attitude. By using visuals, interactive activities, and positive reinforcement, you can empower your child to develop healthy dental habits that will last a lifetime. Here's to bright smiles and happy brushing!