Kids With Sensory Differences and Toothbrushing, Part 1: What You Need to Know

Brushing your child’s teeth and/or teaching them to brush can seem overwhelming.  Toddlers with special needs are even more likely than typically developing kids to throw monumental fits when the toothbrush comes out.  Parents can tell themselves that this isn’t the issue to battle over tonight.  Or the next night.  Or tomorrow morning.  It can get to the point that dentists have to pull toddler teeth due to decay or kids have pain from dental cavities.  If a child cannot communicate, it is hard to know if the tears are from the brushing or the discomfort of dental problems.

I thought I would write a single “helpful hints” style post, but then I did some thinking.  This might need to be a short series.  Sometimes a little trick like singing a song while brushing will work, but sometimes the situation calls for more adaptations.  Once you figure out what the issues for your child might be, then can you make a plan that saves everyone’s sanity.  Take a look at the specific brushes, toothpaste choices, timing, sensory environment and the positive spin you need to put on this experience to help your child.

Children with sensory differences are as different as their fingerprints, but there are some commonalities among them.  Not every child has all of these issues, but here are some of the major stumbling blocks that interfere with getting those teeth brushed:

  •  Children that have aversion to putting food into their mouths often dislike and fear toothbrushing as well.  Seeing a toothbrush loaded with paste coming into their mouth can be as alarming as a fork with food.
  • Sensory sensitive kids can resist the texture of the brush, the flavor of the paste, the touch on their face as you help them, the bright lights, the towels and water splashing, or the head and body positioning for brushing.  Bet you never thought about toothbrushing in that much detail!
  • Children who transition poorly often resist doing a task they don’t value in any way at a time when they are stressed.  Brushing is usually done at times that can be minefields for them (getting ready for school and bedtime).
  • Children with balance and movement issues, even the kids who are just a little unsteady, can be fearful of being held with their head tipped back or while standing on a footstool.
  •  Kids that have issues around control, who feel more comfortable and safe by dictating what happens and when, will either struggle with the task demands or the scheduling of toothbrushing.
  • Toothbrushing can become a power struggle for typical kids as well as special needs kids; it’s an opportunity to “draw a line in the sand ” after a day in which a young child feels (right or wrong) that they haven’t been able to make decisions and allowed choices.  Special needs kids often have full days of therapy and home programs.  Their day is regularly filled with things they must do.  At times a desire for autonomy will be expressed as refusal to participate in daily living tasks such as toothbrushing.

Next:  How your choice of brushes, toothpastes, and other equipment can improve the experience.

By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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