Saturday, February 18, 2012

Helping your Aspie Children to Brush their Teeth

I was asked if I could put a gadget on this blog from a site called Love Your Teeth which will help children bush their teeth.  I figured that the best way to get it to fit into the site's topic is to talk about the problems that children and adults with aspergers syndrome may have with this task;

They are as follows;

  • knowing when to do it
  • knowing when to stop
  • brush texture and pressure
  • the taste of toothpaste
  • other forms of dental hygiene
  • cleaning and cleaning everything away

The reason that I've broken this up into so many steps is that children with aspergers don't always pick these things up naturally just by watching others. Often, you really do have to break up "simple tasks" into steps.

Knowing when to do it
Apart from the obvious routine of every morning and/or every night (nights are generally better), there's a few other things that need to be handled.  First of all, as a parent, you need to stress that brushing your teeth is not a part of personal hygiene that can be skipped.  If your aspie is allowed to skip brushing once, you'll be surprised at how quickly they'll decide that skipping is okay.

The other part of knowing when to brush your teeth comes from understanding that you may have issues and motivating yourself to do something about them.  For many of us, it's natural that after eating garlic or onions, a good brushing is in order.  Our children (and adults) with aspergers won't always realise that (a). they have bad breath and (b). that it can offend people.

Bad breath is one of those topics which when broached can send the recipient of the news into a fit of anger.  Perhaps you have seen the episode of Doc Martin where he is about to have first kiss with a very suitable partner only to comment on her dental hygiene right before the event? The results are catastrophic.

People with aspergers syndrome often get into a lot of trouble for commenting on someone else's breath but with neurotypicals, it's the opposite. Their comments are often careful, considered and indirect.  For example they may say "have you been eating garlic?".  An aspie may answer this question with a yes or a no but actually the real question being asked is; "Your breath stinks, will you go and deal with it?". We need to teach our children to interpret these types of questions.

Knowing when to stop
How do you know when to stop brushing your teeth?  When you're done right? For a start, your aspie needs to be reminded to brush all of their teeth, those which are visible and those which are not. They may also need to be specifically reminded to brush invisible surfaces, such as behind the front teeth.

A good rule of thumb can be that if the teeth feel rough on the tongue, brush until they're smooth - not all kids will get this though.  In her book "The parents guide to teaching kids with aspergers syndrome and similar ASD's real life skills for independence" (reviewed very soon),  author Patricia Romanowski Bashe suggests that kids sing happy birthday through twice in their heads while brushing.  It's as good a timer as any.

Brush texture and pressure
Many children with Asperger's syndrome have "sensory issues" and certain types of toothbrushes will send shivers down their spine. If your child has problems with one brush, don't keep forcing them to use it.  Try other brushes.  The latest gimmicky brushes with tongue scrapers on the back may seem like a great idea but remember that the tongue scrapers have an additional texture of their own and sometimes it all becomes too much. Often a simpler brush is better - ideally one emblazoned with a character associated with your child's special interest.

Some children find that electric toothbrushes are easier or more exciting but not all do.  A gimmicky toothbrush isn't necessarily going to increase the chances of teeth being brushed.and some kids find the vibration and noise a bit too sensory or frightening.

There's also the matter of knowing how much pressure to apply. Some children don't apply much pressure at all while other press until their gums bleed.  While a little bleeding is ok, putting too much pressure on teeth can damage their enamel.  You may have to do a little hand-over-hand work with your child to get the pressure right.

The taste of Toothpaste
Some children find toothpaste so unappealing that they can't use it.  If that's the case, start brushing with just water (it's better than nothing) until your child has a bit of a technique, then gradually introduce very small amounts of toothpaste.  If your child doesn't like one toothpaste, try others, sometimes the gels or the bicarbonate toothpaste is less abrasive than the normal stuff.  Don't forget that there are children's toothpastes on the market too - and you should be using them for younger kids.

The other thing to remind the kids about is that toothpaste is for teeth brushing.  It's not glue (even though you'll probably find it squeezed into cracks everywhere).  It's also not for general eating.  Believe it or not, there are some kids out there who like the taste of toothpaste so much that they'll try to put it on sandwiches. It's generally not something you swallow.

When I was younger, I used to have terrible issues with spitting.  I guess I must have had a lot of lectures from my parents or something but I ended up not being able to see myself spit and as a result, I often didn't rinse and swallowed the toothpaste.  It took me a long while to realize that I could just close my eyes for this bit.

Other forms of Dental Hygiene
There are other forms of dental hygiene that your kids need to be aware of.  These include flossing and tongue scrapers, both of which can lead to massive sensory issues. There's also mouthwash to be considered (the ultimate in taste reaction) and things such as toothpicks.

Your child should know what these other items are for and why we might use them but it's really not worth trying to enforce them at early ages as the sensory issues cause way too much trouble.

The other thing to remember is that your child will need to visit a dentist every so often.  Make sure that the dentist is aware of their needs and sensitivities.  Believe it or not, there are actually dentists and clinics which specialize in kids with special needs. Make sure that you go to one of those and be prepared to take several trips to get something done that most children would do in one.  Sometimes it takes our kids a while to just get used to the chair, the lights and the feeling of things in their mouths.

Cleaning  and clearing everything away
The last point about dental hygiene at home is that a dirty toothbrush isn't going to do anyone any good. Make sure that you inspect your child's toothbrush regularly to ensure that it is both clean and serviceable.  Many aspies simply aren't aware that a toothbrush has reached a point where it is no longer effective.  If nothing else, then at least encourage your adult aspies to replace their toothbrush annually.

Being clean also means, clearing off bathroom benchtops and putting the lid on the toothpaste.  Make sure that you child knows that you can't just hold the toothbrush under water for a few seconds to clean it. They need to run their fingers through the bristles underwater too

Below you'll find a link to a utility which makes a custom tooth brushing chart.  It's a good thing to have in the bathroom to remind the kids to brush.

A Public Service by Dentist Advisor


Nicomachus said...

I've had problems with brushing my teeth, too, and even though I've gotten better about it over the years, I've had to set up a system. Brushing just doesn't come naturally to me.

First, brushing upon waking and before going to sleep, obviously. There's no set time, unless there's a set time you get up, and it's an easy habit to get into, once you start. Besides that, I try to brush after I eat a meal (not just a snack or something). It makes my teeth feel better, and it's another routine to ensure I do brush.

Another thing I do is time myself as I brush. I use the stopwatch feature on my watch to make sure that I spend one minute brushing my top teeth, then spend one minute brushing my bottom teeth. (Dentists say to brush for two minutes, I believe.)

I've always hated the taste of toothpaste, and that has been one of the reasons I haven't brushed regularly. Every toothpaste seems to be peppermint-flavored, and it burns my mouth. I solved this by buying children's toothpaste, with flavors like bubblegum or some berry stuff. Not only does it not burn my mouth, it also has an appealing taste, instead of no taste at all, which makes brushing less of a chore.

C... said...

THanks for posting this. I have so much trouble getting my 11 yr old Aspie to brush his teeth let alone do a good job when he does it.

My son hates the taste of bubble gum too so it makes it so hard to find toothpaste he'll use because that's all they make or some awful berry flavor he hates.

Jennifer said...

Thanks for sharing, my 6 year old with autism is horrible with brushing. He pretty much just sucks the paste off (we use floride free for this reason) and then he crunches the bristles until their are ruined!

I haven't pushed too hard so far since he only has baby teeth, but recently an adult tooth came in, so I need to get better at enforcing a good brushing each night.

Since we are also dealing with many allergies and food sensitivities, we use Toms of Maine toothpaste, which is gluten, casein and dye free, and comes in a floride free version.

alexs sinclear said...

I have had bad breath, lost my job due to it. tried to find a new job but it's very hard once you stink up the office. I had tonsil stones and awful bad breath. My friend told me to check Oraltech Labs advice as it got rid of his bad breath and his post nasal drip. I've been following Oraltech Labs advice for about 4 months now and I feel much better, also people are not avoiding me anymore so it seems to have cured my bad breath as well.

Stephanie said...

I printed it off for one of my boys. I'll let you know how it goes.

Barbie said...

Brushing teeth was always a struggle with my Aspie
son. He didn't like the taste of minty toothpaste so milder bubblegum flavors did really well. He has really good teeth so has been lucky so far with very few cavities. (2 I think). He's in college now so I can only hope he continues brushing regularly!

Anonymous said...

Dude all u gotta do is stick your finger on your tonsil and push a little bit. It pops out the lith. I help hundreds of ppl fix their bad breath.

Family Dentistry The Woodlands TX said...

Albeit getting a child with Aspergers to brush is more of a challenge, positive reinforcement should work, and the link to the personalized brushing chart should be a big help.

Anonymous said...

I used to brush my teeth with Marseille soap (yes: the one grandma used for laundry!), as when I was little I could not tolerate the mint flavour nor the strawberry one (the only alternative that time). And I was ok with it, and my parents thought "better than just water".

Then I got I got used to toothpaste, I just use the "sensitive teeth" toothpaste, which taste less minty.

Anonymous said...

I need help my aspie friend is going through a special interest phase which involves collecting teeth. He has killed all family animals and removed teeth and now attack friends with objects to try remove there teeth I don't know what to do

Anonymous said...

I have two sons one is an aspie and the other we are in the process of seeking a diagnosis for the aspie behaviors we see everyday. The older one who is already diagnosed brushes his teeth fine and goes to the dentist with no problems. My younger son doesn't like any part of the tooth brushing process. He noes like the s
Tastes objects or textures in his mouth! At the dentist office we go into a full blown fit every time and he has never been able to have a check up yet. I am unsure of what to do as he won't let them do anything. He has had to have some teeth removed and sedation had to be used. Regular check up are very necessary and not sure what we are gonna do?

Zuno Vågshaug said...

When I was a child my mum had to sit on top of me to brush my teeth between wails. I never really got good at any hygiene, but at least I started brushing myself eventually. I only got diagnosed with Aspergers last year, at the ripe age of 30. So much we should have know growing up =(

I got brushing before bed as a habit, and eventually got even better than my neurotical siblings (who became teenagers and stopped brushing for not caring, I kinda skipped that kind of rebellious stage completely, I had enough struggles ;) ) As a child my teeth were perfect! So my mums hard work paid off, harsh as it seemed. But when I hit my teen, even though I rigorously brushed every night (we never did mornings) my teeth started decaying harshly. The enamel is vanishing, and the dentist is baffled! He can't explain what it is. I don't think I brush hard, and my dentist say it must be some illness as it can't "be done to yourself" as he put it. But my asperger intolerance for awkward situations and slight social anxiety stops me from going as often as I should. There is also the huge cost, which is the excuse I give the people around me (and is a reality too).

I also have atopic excema. I hate showering and claim it dries my skin (well, it does!) so I can't shower more than once a week. I wouldn't shower more if I didn't have a reason.. I hate it.