Tips on Brushing Teeth for Autistic Children

Autism Spectrum Disorder, more commonly known simply as autism, is a complex array of neurological disorders that manifest in sensory integration issues, communication delays and social impairments. Extreme over- or under-sensitivity to stimulation is common in autistic individuals, making it difficult for caregivers to approach oral hygiene tasks. Communication problems, including speech and language delays, make explaining the process of toothbrushing to children with autism very difficult. However, there are ways to make the task easier for caregivers.

Start Early

• To ease a child's anxiety regarding toothbrushing, parents and caregivers should begin as soon as the child has his first tooth. Because individuals with autism rely strongly on routine, establishing dental care as a natural part of the daily routine will make the caregiver's task much easier.

Reduce Anxiety

• Choose a soothing place to brush that does not have excessive or harsh lighting. Brushing in front of the bathroom mirror is helpful for children to learn the correct brushing procedure, but reducing anxiety is more important. Try letting the child sit on the couch or in a high chair while brushing. Make the experience as pleasant as possible by incorporating songs and toys. Make up toothbrushing songs to familiar tunes. Use the child's favorite toys to soothe her during toothbrushing or to demonstrate the process.

Tools

• If your child is resistant to toothbrushing, try changing the toothbrush or toothpaste. Training toothpastes are often less intense in flavor than adult toothpastes. Try various flavors to find one the child can tolerate. If the child cannot tolerate toothpaste, brushing with water alone is better than not brushing at all. Use warm water to reduce sensitivity. A soft child's toothbrush is the best tool for brushing. However, if the child cannot tolerate it, try a different shaped brush or an electric toothbrush. Dental sponges or a piece of gauze wrapped around the finger can be used if necessary. The important thing is to get as much bacteria off the teeth as possible and to establish a daily dental hygiene routine.

Task Analysis

• Task analysis is the process of breaking a simple task like toothbrushing into the smaller component steps. Once you have identified the steps, teach the child one step at a time. This process is known as "forward chaining." Reward the child by praising him for each step he is able to perform on his own. The individual steps for toothbrushing might include: pick up the toothbrush; turn on the water; run the toothbrush under the water; take the cap off the toothpaste; put the cap on the side of the sink; put toothpaste onto the brush; brush sides, back and front of teeth; spit out the toothpaste; fill a cup with some water; rinse your mouth; rinse the toothbrush; turn off the water; place the cap back onto the toothpaste; and put the toothbrush away.

Picture Cues and Social Story

• Take pictures of yourself or your child during each step of the toothbrushing process listed in the task analysis section. Use these pictures to tell your child the story or process of toothbrushing. "Read" this story to your child every day.