Helping Children with Autism Brush Their Teeth: A Guide for Parents
Helping Children with Autism Brush Their Teeth: A Guide for Parents
Good dental hygiene is important for everyone, but for families of children with autism spectrum disorder (ASD), toothbrushing and dental care can feel overwhelming. This daily task can be a source of stress for both kids and their caregivers.
Understanding why toothbrushing is hard for your child is the first step toward making the routine easier.
Why Toothbrushing Can Be Challenging
Children on the autism spectrum may struggle with dental care for a variety of reasons, including:
- Uncomfortable sensations from bristles of the brush
- Texture or taste sensitivities to toothpaste
- Motor skill differences that make brushing difficult
- Communication challenges
“A lot of times we think of children refusing to brush teeth as a ‘won’t do’ instead of a ‘can’t do,’ and it’s really important to assess that part of it,” says Natalie Buerger, PhD, clinical director of the Autism Spectrum Disorder Clinic at Huntsman Mental Health Institute at the University of Utah. “Whether it’s a sensory issue, motor issue, communication problem, or even just the ability to stick with a boring task for a set amount of time, finding out the ‘why’ is the most important thing.”
Tips for Daily Care
Figuring out your child’s “why” can help you make the necessary adjustments so that they feel safe and empowered while brushing their teeth. While every child is different, these strategies may help:
1. Choose the right tools
Selecting the right brush and toothpaste can make a big difference.
- Use a toothbrush that is the right size for their mouth and has soft bristles.
- Start with a manual brush as opposed to an electric one. You may be able to eventually work your way up to an electric toothbrush.
- Stick with a toothpaste your child likes.
“Ideally the toothpaste contains fluoride, but otherwise brand or flavor does not matter,” says James Bekker, DMD, a pediatric dentist at the University of Utah School of Dentistry. “Whatever works to aide in getting the child’s teeth brushed.”
If your child has an aversion to the foaming effect of toothpaste, Orajel currently makes a children’s toothpaste with fluoride that does not foam.
2. Start slowly
Let your child get used to the process.
- Introduce the toothbrush gradually.
- Gently touch the bristles to their lips or inside of their mouth.
- Use a pea-sized amount of toothpaste to get them used to the taste and texture.
3. Create a predictable routine
Many children with ASD thrive on structure.
- Brush at the same time each morning and night.
- Use the same toothbrush and toothpaste.
- Brush in the same place each day.
- Add toothbrushing to a visual schedule if that helps your child.
- Use a timer so they can keep track of how long they will be brushing.
4. Model the behavior
Live modeling is a very useful method for teaching children with ASD how to complete tasks.
- Brush your teeth alongside your child.
- Demonstrate each step slowly. This helps them see the entire act of toothbrushing broken down into smaller, less intimidating steps.
- Use instructional videos that show children brushing their teeth as a motivation to learn and copy a beneficial brushing routine.
5. Provide help when needed
If your child needs support with the physical act of brushing:
- Position yourself behind your child and let them lean their head against your chest.
- Help them practice opening their mouth wide enough for thorough brushing of all their teeth.
- Brush gently using the same techniques you would use to brush your own.
6. Celebrate success
Praise and reinforcement can help build confidence.
- Provide verbal praise or rewards at increments that are appropriate for your child.
- This could mean you praise them after completing each step at a time, or after the entire process is complete.
If you and your child are still struggling, don’t give up on toothbrushing all together.
“Sometimes the parent is only able to brush with a wet toothbrush,” Bekker says. “If this is the best option for the patient, then we encourage parents to do this instead of skipping toothbrushing altogether.”
Finding Expert Help
If oral hygiene at home continues to be a cause of stress, families don’t have to navigate it alone. The Neurobehavior HOME Program at Huntsman Mental Health Institute helps people with developmental disabilities meet medical and mental health needs. Parents can turn to this program for help getting their autistic child’s oral care arranged with the University of Utah School of Dentistry.
A significant benefit of utilizing oral care at the dental school is comprehensive dental services for adult patients with autism and other special health care needs. This means a person can stay at the practice even after they reach adulthood—avoiding the stress of transitioning to a new provider.
“One of the things I really appreciate about U of U Health’s dentistry training program is they have people shadow and learn more about populations with developmental disabilities,” Buerger says. “They’re also proactive in finding out information about kids before they come in for an appointment, and if there are things they can put in place to make dental visits easier.”
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