Reducing barriers to brushing teeth

For many autistic children, everyday tasks such as brushing teeth can cause challenges. When we first met Henry, he found teeth brushing incredibly difficult. He was under the care of the community dentist team for cavities that had been identified due to poor dental hygiene. So, when he came to Early Years, this was a top priority for the family, to ensure we could work together to improve the health of his teeth moving forwards.

Henry has a range of sensory preferences that meant brushing teeth was particularly distressing for him. We therefore knew we needed to take a gradual approach and take into consideration Henry’s sensory preferences and motivation.

Finding what works

We trialled numerous strategies without success. This included testing different toothbrushes and toothpastes, brushing teeth in the bath (Henry’s favourite activity at home), brushing at the same time as Henry, incorporating toothbrushes in Henry’s play, gradually building up Henry’s interactions with toothbrushes, and more. However, Henry’s aversion to teeth brushing was incredibly strong, and little progress was made. With low motivation and fleeting attention, working on this area became difficult. We therefore knew we needed to take a different approach.

We noticed that because of Henry’s sensory preferences he enjoyed eating ice. We decided to trial freezing the toothbrush and started to see success. Henry would pick up the toothbrush to bite the ice off of it and gradually became more comfortable around a toothbrush. Once Henry was happy putting the icy toothbrush in his mouth, we faded the quantity of ice and started to add in small amounts of toothpaste to the toothbrush; both with success.

Setting Henry up for the future

Our next challenge was ensuring that Henry’s toothbrushing was thorough enough to prevent any more cavities. Given Henry’s age we knew that he would need to begin to allow adults to assist him with this. To avoid undoing the work gone into building positive associations with a toothbrush, we focused initially on Henry being happy with adults putting his favourite chewy toy in his mouth, gradually building up the duration of this in steps that Henry was comfortable with.

Our next steps are to combine the two processes, with Henry beginning to allow adults to put a toothbrush in his mouth and increasing the duration of this to Henry being comfortable with adults brushing his teeth. As Henry gets older, we would like to focus on Henry being the one to do the majority of the brushing so that he is in control of this area.

There is still a way to go, however working on this skill gradually should mean that Henry is able to build dental hygiene habits that are comfortable for him and are fully functional by the time his adult teeth arrive. By working alongside parents, our Early Years’ team ensure that programmes are fully individualised to each child and we focus on the priorities that are most important to the families. If you’d like to support us in helping more children like Henry, make a donation today.

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Or if you’d like more information on supporting children with issues like tooth brushing, head over to our resource hub and download our self-help skills factsheet.