To you, it’s a simple toothbrush. To your child, it may be a feared object.
For our kids, toothbrushing can be extremely stressful. It’s an invasive process that a child can perceive as highly unpleasant or even painful. Figuring out what is causing the distress is key to providing the best environment, equipment and techniques to make toothbrushing more pleasant for the whole family.
Firstly, is your child a sensory seeker or do they have sensory defensiveness in his or her mouth? If you don’t know the answer to this question, ask for guidance from your occupational therapist. Generally, however, sensory seekers tend to seek movement, are constantly on the go and can be difficult to calm down. A sensory seeking child is more likely to mouth non-food objects and grind their teeth (aka “bruxism”). Also, a sensory seeking child may have a hard time standing still to just brush their teeth at all. These kids do best with vibrating toothbrushes, a wide toothbrush or a toothbrush that sings songs (yes,some do). You can also sing a song (one that is long enough for an average toothbrushing or at least a minute). Allowing your child to move around while brushing is also helpful. A timer is a good way to get them to know when they are finished.
For a child with sensory defensiveness, brushing teeth can range from pretty unpleasant to almost unbearable. Often these kids don’t move food around in their mouths well, can have low tone in their mouths and tend to have a very limited repertoire when it comes to textures. Try these ideas to help your child become more comfortable with having a toothbrush in their mouth:
1. Stand behind your child and give firm pressure to the back of their head using both your hands. It should be calming touch and hold for a count of five. Repeat X3 and try to do as often as possible. This is done to provide counter calming touch to the back of the child’s head that feels good.
2. Once your child tolerates that touch, begin providing the same firm and calming pressure to other areas, such as forehead and face, below the ear and lower cheeks. Then, using calm strokes and consistent pressure, make deep sweeping motions from the ears to the chin. Finally, add deep pressure to the lower lip, upper lip and cheek bones.
3. When you get to the lips, repeat the previous steps using a warm wash cloth.
4. Once your child can tolerate the warm wash cloth on their lips, try having them accept it into their mouth. You can make it a game by having your child pretend to be a pet who licks then chews on or bites the wash cloth.
5. Once your child can accept you touching the front and side teeth with a washcloth, then introduce the toothbrush. Go slowly. This process may need to be done over and over. Do your best to make it fun. Don’t use toothpaste yet.
6. There are a huge variety of pieces of equipment which are helpful. Ask your occupational therapist, speech therapist and your dentist for guidance. These are preliminary ideas to help get a toothbrush into your child’s mouth without force. There are many other approaches and techniques which can be useful. Go into it with a deep breath and an open mind, despite the stress you may be feeling about your child’s dental health.
Thanks to fraser.org and Delta Dental for some of the tips.
Advanced Pediatric Therapies 