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Dear Melissa,
I have a 4-year-old son with a diagnosis of Autism. He has extreme defensiveness to touch and food textures, and he gags easily. This oral sensitivity also makes brushing teeth a nightmare! He refuses to let me brush his teeth and refuses to brush them himself. I’m hoping that not brushing or flossing will be OK because he just has baby teeth.
Following up from last week, yes baby teeth matter…a lot! To further respond to your question I’m again reaching out to Dr. Karen Green, a Board Certified Pediatric Dentist at Pediatric Dental Associates and Orthodontics. As I have mentioned before, I use her for my own kids, and I also recommend her to the families I work with.
Melissa: What if a child cries and fights teeth brushing? Do you having any tips?
Dr. Green: Some children fight brushing, while others are more compliant. It can vary depending on many factors such as oral sensitivity, gag reflex, and often stubbornness! The best time to get a routine established is in the first year of life. The earlier the better.
- You can try having the child sit in your lap while you brush, but this makes visualizing the teeth somewhat difficult.
- Another method is to have the child lay on the floor or on the couch/bed while you brush. It makes seeing the teeth much easier!
- If your child is aggressively fighting you while you are trying to brush, and you don’t have another adult to help stabilize the child while you brush, you can use a towel to wrap the child while holding him in your lap.This will prevent his arms from reaching up to grab you. This works really well on younger children.
Melissa: As an occupational therapist, many of the kiddos with Autism that I work with are very orally defensive, and they perceive brushing teeth as very painful. What are your thoughts on the strategies I use to gently get a child more accustomed to more regular oral care? For example:
- Using clear infant toothpaste (rather than fluoride toothpaste; the taste is more gentle)
- Not using toothpaste
- Using a toothette sponge rather than a toothbrush
- Using a shortened time (while singing ABC’s x 2)
Dr. Green: I like the techniques you have suggested. I think working up to optimal oral hygiene gradually is a great thing for those that need more time.
Melissa: For parents with kids who are orally defensive, how important is diet?
Dr. Green: A low sugar diet, especially things that are very retentive (think really sticky and sugary), is very important. Even gummy vitamins can be really bad on a child’s teeth. The bacteria that cause cavities metabolize/eat sugars. So, if your child’s diet is high in sugar, the bacteria are being fed often, producing more acid, which leads to cavities. The more orally defensive a the child is, the more attention needs to be placed on diet.
Melissa: What are your feelings about drinking juice, soda, etc?
Dr. Green: Many parents don’t realize how bad soft drinks are for their child’s teeth. They are very acidic and often loaded with sugar, which can be very damaging to the teeth. A child should be drinking mainly water and unsweetened milk at meal times.
Melissa: Any other tips for good oral care at home?
Dr. Green: Unfortunately, sometimes kids get cavities, and we have options based on the child’s level of comfort and treatment needs. We try to make it as comfortable for both child and parent as possible, but prevention is always better! Plaque (a sticky film on the teeth where bacteria grow) forms on the teeth after eating or drinking. Brushing and flossing removes plaque. Establishing a good oral health care routine at home, where parents are actively involved, is critically important.
A special thanks to Dr. Karen Green for participating in this month’s Blogs!
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Pediatric Dental Associates & Orthodontics, Fayetteville, AR
Visiting the Dentist for kids with Sensory Defensiveness, Children’s Therapy TEAM Dear Melissa Blog for Parents (February, 2015)
Baby Teeth…Big Concern, Children’s Therapy TEAM Dear Melissa Blog for Parents (February, 2015)