Any dentists who would not mind giving advice?

[GreenTeaMug]

I am worried about DS1s (aged 10) teeth.

He has ASD and a number of sensory issues that has made teeth cleaning a bit of a nightmare. We have always managed to clean his teeth twice a day, and things ARE improving. But his (bottom) teeth have plaque and are slightly yellow and although we are at his dentist every 3 months (before lockdown) they only manage to scrape one tooh at a time before he has a meltdown.

Currently our tooth cleaning regime is this:

upon waking we clean his teeth. He cannot tolerate an electric toothbrush, so what I do is I clean his teeth as thoroughly as I can. Then he rinses with kids mouthwash and then I get him to brush his teeth himself again straight away. (he does a cursory brush which is why I am first of all doing it msyelf and then supervising him). I use an egg timer to try and get a thorough brush.

We have managed to get him to start having those plaque disclosing tablets once a week. We have just managed to implement flossing. I have been plugigng away at flossing for months and months now etc as hsi almost has hysterics, his eyes roll back in his head he starts to shake and scream etc.

he has nutella on toast for breakfast (after teeth brushing). He does not have any juices and occasionally smoothies, but if he has an ice cream or a sweet thing in the day I always ask him to have a quick mouthwash rinse first.

We have the same routine in the evening.

He had two holes in his teeth a few years back but nothing since then. But his teeth do look slightly yellow and a bit plaquey on the bottom.

I just do not know what else to do? Every time we go to the dentist i get another disapproving lecture, but I swear to God I am trying my hardest. The dentist knows how he reacts because he gets it hismelf and because it took 3-4 trips as a toddler before he would even allow the dentist to touch his mouth at all.

Does our cleaning regime sound okay? Is there anything else I can do - improve - tips? I am at the end of my road as I am worried about it all.

I'd be grateful for (hopefully non-judgemental) advice. Thanks.

I sound like I am tortuing the poor kid. :( The hysterics and meltdowns are part of the ASD.

Bribery works well. The plaque disclosing tablets started being tolerated after I began trading them for roblox money.

Mouthwash shouldn't really be used at tooth brushing time as it washes the fluoride away from the toothpaste. Have you tried the interdental brushes instead of floss or those little floss harps you get? You get little dental sets with picks for scraping teeth. Would he tolerate you having a go at using them on his teeth?

Thnaks demented this is exactly the sort of stuff I am keen to hear.

Right- mouthwash out at brushing time.

Is my idea of using mouthwash before a sweet treat (within reason- I used to carry it in my handbag but have stopped now) a good idea?

The floss harp things are what i use.

I can try a dental set- I was worried about scraping his teeth myself and causing damage. Is there a chidlren specific sort of set I should look at?

Thanks again. It worries me so much.

Why are teeth brushed before eating?

That was something I learned from MN actually. Bacteria grows in the mouth overnight. When eating the salvia weakens the enamel so to brush straight aftwrwards actually causes damage. (I think that was right).

OP, you sound like you're doing the right things. Have a look at this website, I think it's brilliant. jamiethedentist.com/care/

I wouldn't start scraping things yourself, you're not likely to damage the teeth but it will
Probably be unpleasant for you both.

What about using non foaming toothpaste?

Mouthwash is pretty useless tbh, most is classs as a Cosmetic rather than a medicine.

If it's decay you're worried about, using Fluoriguard after lunch could be useful but its snacking/sugar exposures (in the website above under "Stephan curve") that's the key.

Oh brilliant MrsMorton. thanks for the link.

You dont need to use mouthwash, it can wash away the flouride. Using it at different time to brushing is fine but not after brushing

Honestly sometimes with children with ASD you just have to accept that their toothbrushing is not as good as a child without asd. It sounds like you are doing a good job, a bit of build up around his lower teeth whilst not ideal is not the end of the world. And if the dentist has been unable to properly remove it then its not going to go anywhere.

Things that might be worth looking into are high flouride mouthwashes or high flouride toothpaste, which your dentist can prescribe.

It might be bettee in the long run he sees a special care dentist or a community dentist who can offer things like sedation if necessary and tend to have more time with DC with ASD.

@1idea that's the best time to do it. @GreenTeaMug it's the acid in food (and that produced by plaque when it reacts with sugar) that softens the enamel but spot on otherwise.

Also
Agree with recommendation about special care dentist. And sorry about typos. No idea what my phone is on today

Oh thank you all so very much. I was worried I was going to get absolutely slammed as a shit parent.

I am about to change dentists I think because I am struggling with the disapproval. (years worth of disapproval!... I make decisions slowly!!!!!!).

When we first started going one of the exceptionally sympathetic dental nurses had suggested he might be a candidate for sedation. He's got so many things going on with him poor thing. Life is a bit of a struggle for him generally.

thank you. xx

Hi I’m a dentist. It sounds like you are doing a really good job of cleaning. Just a couple of things just use mouthwash once a day, I’m not sure it’s very pleasant just before eating. I would not advise flossing at that age. Some children do have more plaque build of tartar up than others. I still brush my 8 year olds teeth and I’m a dentist and he has to have a scale every 2-3 months as his teeth look yellow. Don’t worry too much as the main issue at their age is to prevent decay. I would definitely cut out the smoothies as they are very high in sugar and not necessary in a child diet. You may feel changing dentists will help if you feel you are not supported. It may help to see a hygienist privately to have more frequent scaling and oral hygiene advice. Hope this helps a little but be reassured you are doing your best.

Thank you it does help very much indeed. I am going to seek out a special care dentist and a hygienist.

I am really glad I posted. Thank you all.