Toothbrushingghtmare - SPD & HFA

[pukkapine]

I posted in SEN but think that was the wrong place... trying here...

I'm desperate for some advice on how to brush my 8 (nearly 9) year old's teeth. He's in the middle of the process for being assessed but it's looking most likely he's going to be diagnosed with Sensory Processing Disorder and High Functioning Autism. He absolutely can NOT bear having his teeth brushed. He goes through periods of slightly better or slightly worse depending on what else is going on for him. But even when it's 'good' we're looking at about 30 seconds with his jaw largely clamped shut. I'm getting desperate though as he now has decay in one of his permanent teeth, and he has tartar all over his new incisors. I've tried everything I can think of, and it's not getting any better. He's more open to it when he's allowed to do it himself but he also has Dyspraxia so his coordination is not great and he's not doing a good job. Currently I've got him using toothpaste that is SLS free as that's apparently the frothing agent, and he seems marginally happier with that, but it doesn't lather so for the few seconds you get the brush in there's not much to work with! I was thinking I could try to gradually get him doing it more himself but I can't work out how to get round the dexterity issue. That would help it become less of a twice daily stress point for both of us, but I'm worried as I can barely do it ok and he certainly can't. I'm just getting more and more worried for the health of his teeth. Does anyone have any suggestions that have worked for them?

I second all of Polter's suggestions.

I would also add that if he is highly sensitive orally, working on increasing his tolerance by using "heavy work" around his mouth. He may also benefit from whole-body heavy work before and after tooth brushing to help his brain deal with the sensation e.g. if you have a mini-trampoline, have him bounce for 60 seconds before and after brushing.

Messy hand play- if he finds it hard to tolerate mess or light touch on the palms of his hands, try to increase his tolerance for this. Tolerating messy hands is closely correlated with tolerating oral sensations.

Finally, if he will tolerate brushing for longer himself, perhaps allow him to get on with it. Many children with dyspraxia can master "splinter skills" with practice. Disclosing tablets are highly motivating for my DS to be more precise with brushing.

Would he be able to tolerate and work with an electric one, rather than manual? In general they clean better, and need less work physically.

wow thanks all - sorry for the delay, my computer decided it didn't like me and kicked me off and has been playing up since...

Some suggestions there I haven't tried so will go and see what I can get on Amazon.

We did try an electric toothbrush a couple of years ago but he wouldn't let it anywhere near him, not even elsewhere on his body. Maybe I should try again now he's older. And Redoubtable that's interesting about the link to hands because he's terrible about having anything on his hands - it's a bit of a joke because this is the kid who can barely use cutlery (think that's probably the dyspraxia) and a real outdoorsy boy but it you give him a slice of cake he insists on eating it with a fork... I didn't even think that could be linked. I feel a bit ignorant about it all.

I'm a bit concerned because I spent a small fortune trying to find a toothpaste he would tolerate, and don't want to end up wasting more money... it's a minefield :(

Great suggestions already re toothbrushing is there a mouthwash he would tolerate? Some are very strongly flavoured, I started off using it very diluted and built up tolerance gradually, the reasoning being that on non-brushing days at least there's something to help fight any decay.
As for getting a mouth feel for something around the teeth, would he tolerate his own finger 'pretending' to be a toothbrush? We started off that way.

Re cutlery, have you tried kids Caring cutlery? It has a dent where you place the index finger and shaped fat handles which make the user have a proper grip and gives good control, we found the difference unbelieveable.

It is a complete minefield for all of our kids, and our pockets I daren't add up the cost of all the things we've tried, but it's all trial and error because what suits one dc doesn't suit another, even if they have the same dx.

Interesting that he can barely use cutlery.
How does he eat then- say if you are having bolognaise or fish fingers and mash?

Is he a child who'll use a fork or spoon and has contorted himself in the chair so that he can get stuff into his mouth?
Is he a child who "picks" at food and takes forever to eat or is he a mouth stuffer?

If he has a strong aversion to messy hands...I would work on that before/in tandem with the oral desensitisation.

Once you've done some work on desensitisation, I'd give an electric toothbrush another try. DS had one I used with him in the bath (so his skin was wet) which helped him get used to the feeling