16 year old son, mental health and lack of teeth cleaning

[Reallybadidea]

I'm really hoping that somebody who has been through this could give some support/offer some advice on how to manage my 16 yo's refusal to clean his teeth.

Bit of background - he has an 18 month history of self-harming and 2 suicide attempts. The most recent was in the summer and he was referred to CAMHS and has had about 3 months of talking therapy through them.

His mental health is much better than it was and he is being discharged imminently. A recurring theme though, which we have seen no change at all with, is his oral hygiene. Basically, he rarely cleans his teeth. It's difficult to know how frequently he does clean them, because he will always say he has done them, even when I can clearly see that he hasn't. I have tried ignoring it completely (he's the youngest of 4 and I'm really not in the habit of supervising tooth brushing at this age!), talking to him, bribing him etc. Nothing seems to help. He won't tell us what the issue is, he just doesn't seem to like doing it. He doesn't seem to have bay any other sensory issues and although CAMHS has assessed him for ASD they don't think he really shows any indication of this, although Adhd is looking like a possibility and fits with his other issues.

I'm just so anxious about his teeth and the long term harm he could be doing to himself, although I've tried to keep this pretty light rather than try and scare him etc.

Would really appreciate any words of wisdom, suggestions of strategies etc.

Have you shown him images of rotten teeth and suggest to him that his will end up looking like that ?
Does he also know that it is known that lots of plaque on teeth can lead to heart disease ?

Lack of self care is a symptom of his depression. Shaming him will only make him feel worse.

@BitcherOfBlakiven

Lack of self care is a symptom of his depression. Shaming him will only make him feel worse.

Yes, which is exactly why I have tried really hard not to make him feel ashamed.

I had similar with one of mine. I bought him teeth wipes (you can get them on Amazon). It is a symptom of depression - the feeling they can barely get out of bed to brush their teeth. But the wipes they can do in bed or do anywhere and definitely filled the gap till he was a bit stronger and happy to brush again.

Teeth wipes are a great idea, thank you! I'm not actually convinced that he is depressed at the moment though, CAMHS say he's in a good place right now

Is it the flavour? Ds is autistic and cant cope with minty toothpaste. I buy kids strawberry flavour or you can get mild mint oralieve from amazon

Hi - I rarely admit this but when I get gloomy/tired/drained/stressed I CBA to brush my teeth. I hate it, the mint jolts me and the feeling almost hurts and it all just feels too much. I was very much like this when young. These days I can override it because I am able to rationalise the reasons to do it and also want to set a good example to my kids.

But I would suggest you try to encourage him to do them just once a day and at any time to suit him, or use a product like the poster above suggested, or just use mouthwash, or brush without paste - anything at all is better than nothing. Basically accept that he hates it.

Personally I would not worry about the teeth too much if you can manage that - the mental health issue is more important IMO. Will he go to the dentist? If so, and the dentist is not concerned, that would be positive perhaps for you, plus the dentist can give the lectures?

I neglected my teeth for years when my mental health was bad. Maybe he needs to be scared a bit and shown pictures of rotten teeth. I honestly wish someone had forced me to brush my teeth.
The teeth wipes seem a better place to start though.

I have ADHD and I have to make a concerted effort every time to brush my teeth. I have learned to attach it to another more pressing job ie - I brush my teeth when I have my first trip to the loo in the morning. If I come down stairs first....I've had it.
I brush my teeth at night when I put my PJs on. If I put my PJs on early for some reason, then I brush my teeth early because this is better than not doing it at all

Thanks for all the replies. I definitely think that making it part of his routine would help - he agrees, but then doesn't do it. He's fortunately not at all resistant to seeing the dentist and has regular visits with the orthodontist. They tell him off about his oral hygiene and he makes suitable noises, then carries on as before

My BIL has long term mental issues. He refused to brush his teeth despite cajoling. He then wouldn't let a dentist help. In the end, while sectioned, they took out all his teeth without family permission.
Hopefully this wouldn't happen these days but I thought its useful for you to know..
It causes all types of issues as doesn't chew properly so more likely to choke, gets constipated which makes him irritable....

Sorry I have few practical suggestions but hope you don't end up with same long term issue.

I know you meant well, but telling me horror stories with no practical advice, when I'm already feeling pretty upset about the situation isn't massively helpful. I'm well aware of how bad things could get for him, hence trying to help him!

Sorry I really didn't mean to cause you any further distress

That's OK

I found an electric toothbrush really helps - mine is an expensive one but worth every penny. Even 30 seconds brushing with that has better results than trying to make myself do a full 2 minutes manually.

My teeth are overcrowded, crooked (thanks mother for saying you couldn’t be arsed with all the appointments I’d need for a brace, I now have major issues and cannot afford a brave privately!) and I have impacted wisdom teeth (3 have been removed) and the most severe gum disease which occurred after I was very unwell with Covid.

I also have a major dentist phobia for various reasons which I won’t go into; I have to take 20mg Diazepam just to go for a check up, and I have to be sedated for any work to be done.

It’s shit and I wish I’d looked after them better, however I’ve had to try and be nicer to myself about it.

@Reallybadidea

Thanks for all the replies. I definitely think that making it part of his routine would help - he agrees, but then doesn't do it. He's fortunately not at all resistant to seeing the dentist and has regular visits with the orthodontist. They tell him off about his oral hygiene and he makes suitable noises, then carries on as before

Do they tell him off or do they tell him things are looking bad and his teeth are deteriorating?

Some people can mistreat their teeth and get away with it. Not that you should say that to him - but you may get lucky with this.

Also do try to hold onto the fact that teeth can be repaired these days. I know it is not ideal but it could be worse e.g. heavy drinking where the damage can't be cosmetically treated.

Good luck

@BitcherOfBlakiven that sounds really hard The electric toothbrush is a good tip, he does have one but doesn't always remember to charge it, so I think I'll try and stick it on charge when I see it, so that's one less thing for him to think about.

@rrhuth we don't go into the orthodontist with him usually now (covid, letting him be more independent etc) so I'm not entirely sure. He usually reports back that they say that his gums are inflamed, or that they have told him to pay more attention to brushing. So I don't think his teeth are terrible presently, although he has a 'normal' dentist appointment in a few weeks, so we'll see.

Amazingly, he has actually brushed his teeth before bed the past couple of nights. First time after a bribe and second time more or less off his own bat. So fingers crossed it continues.

@Reallybadidea Hope you don't mind my bumping this thread. I came across it on a Google search because I have a similar aged son in the same situation and I wondered whether things had changed in your case and whether you had any advice, 2.5 years down the line. Thank you.

@howonearthdidwegethere

Sorry to hear that you're having similar issues. It's incredibly stressful isn't it? Getting your child to do basic things to look after themselves feels like such a simple thing, which is maybe why it feels so awful when they aren't able to do it.

I'm pleased to report that 18 months on, things are much better, with occasional ups and downs! A while after starting this thread I basically came to the conclusion that I might not be able to force a 16 year old to clean his teeth, but I certainly wasn't going to provide the means by which he made them worse. So I removed every single sweet snack from the kitchen, including fruit and fruit juice plus crisps, and locked them in a suitcase in my room. I told him that he could have toast, pittas, hummus etc - so he wasn't going to go hungry - but anything else was conditional on him cleaning his teeth twice a day. We also bought an electric toothbrush which links to an app to show how long they'd been brushed for.

He started brushing them twice a day immediately. Literally overnight and after a few weeks of consistent brushing we started checking the app less frequently and reintroduced the snacky stuff. It probably helps that we live quite rurally so nipping to the shop for snacks wasn't an option for him. We had a brief relapse a few months later so we went back to the 'no brushing = no snacking' for a while, but touch wood, that was about a year ago now. I don't think he brushes 100% of the time but his teeth mostly look like they're being cleaned regularly now. It's all about routine with him and it tends to be holiday time when he forgets now. I hope that he will keep it up when he goes to university in a year's time 🙏

I can totally see that it wouldn't work for every teenager and I didn't really expect it to work for us, I was just feeling desperate. I think maybe just breaking the cycle of reminding him constantly was probably part of it. I felt less stressed and upset and I think we both felt like we had some control in a way.

Happy to chat more if you would like 🙂

I went through a long stage like this at a similar age when I went to a similar series of life events . I can’t explain why I didn’t brush my teeth , but it felt like I literally couldn’t . I couldn’t and the longer I left it the harder it became .
Could you chat him to have a swish around with mouthwash twice a day , even if it is spitting into a cup without having to go to the bathroom. Maybe chewing gum after meals ?