Brushing Teeth

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My son, 8, just won't let me do it. He has ASD and other problems.

He will waft a toothbrush round generally but not let me near him. We saw a doctor yesterday who had a quick look in his mouth (literally seconds before he screamed) and he is already showing signs of gum disease.

I've tried different brushes (including electric), reward charts, different toothpastes.

He swallows any teeth that come out - not sure that is relevant but I thought I would throw it in.

Any ideas? Or is this just something I have to put up with. I can't pin him down. He won't open his mouth and it seems like cruelty.

Ds is like this, he had to had 5 teeth removed when he was about 6 years old. He is extremely defensive about his mouth.

Things that have helped, is letting ds control it.

1. He chooses where i should brush ie top or bottom.

1. We count to 5 (very quickly to start with, but make the pauses between each number longer, the more he gets used to it)

1. Just one 5 second brush to start with, then build up to 5 seconds on one side, then another and so on.

If 5 seconds doesnt work, then you could lower it to even 1 second and build up. Even if he only lets you brush one tooth for 1 second, its a start and you can build on it.

Tiny steps and build upon them, would be my advice.

i'd ditch the brush for a few days and see if he'll use a cotton bud to move toothpaste around his teeth?

then work up to very soft brush and yes to counting down rather than up if/when you finally get in his mouth?

DD won't use minty toothpaste at all btw - have you tried berry flavour pastes?

we just spoke to an OT and dentist about this last week and they recommended deep pressure on head and cheeks first, then an electric toothbrush on the outside of his cheeks so he can feel the vibration, then your hand over his hand and let him brush while you control where the toothbrush goes - it seems to have worked (a bit) with our DS but as claw says even if it's only 1-2 seconds that is something

The dentist also said smearing a bit of toothpaste on teeth is better than nothing, and no sugary food in the evening

There a lots of social stories about brushing teeth - it is a common problem.

Have you used a pro-forma one or thought about writing one of your own that deals with his specific problems with tooth cleaning.

DDs dentist is obviously aware of the problem and has given him disclosing tablets that don't taste foul (from his perspective). He has had tablets before but not used them but this time he and his younger brother had great fun making their tongues go blue - unfortunately there was no actual tooth cleaning but small steps.

Thank you all for the prompt replies. Thank goodness I am not alone.

• UnChartered. I have tried Berry flavour pastes. He just sucks them off the toothbrush and swallows them

• claw4. I will try that.

• skidd. What do you mean by deep pressure on head and cheeks first? I know my son likes me to squeeze his head firmly. It comforts him. Is that what you mean?

I can't control his intake of sugary foods due to another condition he has.

Great ideas and advice everyone. Thank you again.

Keep - x posted.

He won't chew a disclosing tablet (I tried). Maybe he will when he's a little older. I'll keep that in mind.

Yes I mean squeezing his head firmly with both hands and slowly moving them down the sides of his face down to his jaw. The OT told us that this this helps him notice that area and will lessen sensory oversensitively so brushing will be less awful for him (I think - anyway, whatever the reason it seems to work!)

tbh I just pinned him down. Held his nose so mouth opened. 15 sec with electric t/brush. No rinse. Calm voice and countdown, reward straight after. Eventually he got used to it. My reasoning was that if i didnt force compliance when young, no-one could start making him brush later, and extensive and lifelong dental treatment would be worse.

He is just so bloody strong and wriggly. I have tried to do the nose holding thing. He ran away and would not come back. I have even tried to brush his teeth in his bed (as I am not bothered if he doesn't rinse tbh) and he still resisted.

I must admit to not trying any of the techniques mentioned today because I'm just didn't feel up to it.

I will try a very quick countdown approach tomorrow, plus firm head holding - because I know he likes that.

I'll report back, just in case in helps anyone else.

I'm afraid that we are also in the headlock club for brushing teeth. He's much better now...still hates it... and some days is more compliant than others...

I look at it as a necessary evil.

another one who's been there and done that.
I used little toothwipes at first (found them in the supermarket baby section- like bum-wipes but small with a seam that lets them sit over your finger- like a cloth thimble?) I also got a baby toothbrush that I used only for playing with (to desensitise his mouth).

Lots of messy play (close links between sensory hand issues and mouth issues). Playing with shaving foam at the table, hand painting, in the garden muck, mixing playdough with sand/rice.

I let him pick out a 'cool' Ben10 toothbrush that has a built in flashing light stand to give him a visual timer for how long to brush.

It has taken a long time but now at 8 he will brush, go to dentist with no problems (he will even use some flavours of mouthwash). He continues to be vigilant to things in his mouth, hyposensitive to mess on his face and absolutely screaming gaga level of sensitivity at his neck.

He won't do messy play, bless him. Freaks him right out. He picked his own toothbrush but hates it.

I am going to go for the countdown, head holding before method to try and de-sensitise him (he only 'brushes' once a day at night - but I am hoping to build that up to morning and night when we have this problem sorted).

Then maybe his gums will stop bleeding.

Right if he wont do messy play and cant tolerate any sensory stuff around the mouth, the next step is deep proprioceptive input into the whole arm, working into the forearm and then the hand...stuff like 'wheelbarrows', supporting legs on a chair while putting body weight on his arms to play on the floor, big sweeping arm movements (think washing the car for example) etc etc. Heavy input through his jaw and around the mouth (will he chew gum?)

You need a local OT (with Sensory training) to show you what to do.

Thanks. This is the thing, as soon as he got in a SN school, the OT stopped coming.

He won't chew gum.

I have just had a small chat with him about tonight and tooth brushing. He has agreed "Mummy do it"

Good luck

Wow! What a difference the head pressure before brushing has made. He asked me why but went with it, then he opened his mouth when asked and let me brush his teeth with a countdown. It was quite a quick brush but it is something I can build on.

I know it seems like such a small thing but it is a victory.

Thank you all so much for your advice.

yippee

Well done! I read this with interest. I have difficulties with DS teeth but counting when brushing so he knows exactly when it will finish, helps. I have recently bought a soft hairbrush for DS which I am slowly buillding up the brushes, this is helping him.

Keep the ideas coming please. Another one here. Iv'e done all said so far as well as specific sensory exercises around the mouth and he still won't brush or allow us. He had 12 teeth taken out a few year back, where afterwards he pulled all the stitching out. My DS also has a heart condition which makes him at risk of endochartitis, caused by bacteria in the mouth. This is fatal, which is my worry.

We use a variety of techniques to teach toleration of toothbrushing and also of dentist visits, scale, polish, x-rays and fillings. Our foster ds is 15 with severe autism, severe developmental delay and loads of other diagnoses. He wouldn't allow anyone I clean his teeth, but now tolerates it well, can nearly do it himself and also uses mouthwash. Over the last two years we have worked with our dentist and he has now had a filling and a baby tooth extraction and ENJOYED both, which was remarkable! All of this was achieved using systematic desensitisation procedures. Also using some of the specialist equipment from Specialized Care Inc. We have used their Surround Toothbrushes and also their reusable mouth prop with wraparound handle that we taught him to tolerate. I had a 13 year old brought in for an evaluation a few months ago that had never had his teeth brushed and within a couple of hours we managed to achieve it with him cooperating with it! Also had a 13 yr old this week that never opens his mouth for the dentist and we taught him I tolerate the mouth prop and have a dentist mirror put into his mouth. It can be done but you do need the right techniques. Hang in there! If you want to know more about how to do systematic desensitisation I'd be happy to tell you more when I get to my laptop later, on phone at the moment and not easy to type long messages.

my little boy is 3y 4m old and has learning difficulties maybe asd and waiting for a multi disiplinary assessment, he has never let me brush his teeth. But i can get him to chew on the brush very quickly in the bath. Then when he takes it out I say "more brushing" and sometimes he will eventually do more chewing on the brush (no rinse). But lately we have started a game I get my brush and go "1...2...3...brushbrushbrush!" and pretend to brush my teeth. then go now your turn "1...2...3...brush",etc or ready steady Go! and he sometimes brushes quite vigourously then! Dont know if this might help you but our son finds it hilarious and i think making it a game might help. Cant say how good my sons teeth are however as he has never been to the dentists - its pointless there is no way he would let the dentist poke around in his mouth however "fun" i tried to make it! xx

www.colliscurve.co.uk/site/1.asp. seems to a way forward if someone won't tolerate an electric toothbrush

This toothbrush does not need toothpaste ecoutlet.co.uk/soladey-2-ionic-toothbrush.html

DS2 couldn't tolerate an electric toothbrush. He can't even tolerate being in the same area when DH is using his own. The noise sends DS2 into a panic.