Dental Hygiene in Children on the Spectrum

Today, we'll tell you some strategies that can help achieve proper dental hygiene in children on the spectrum.
Dental Hygiene in Children on the Spectrum

Last update: 02 August, 2022

Children with autism spectrum disorder (ASD) may have problems when it comes to attending to their dental hygiene. This can lead to the development of oral diseases such as caries, gingivitis, and periodontitis. So, how can parents approach dental hygiene in children on the spectrum?

When we talk about ASD we’re referring to a group of developmental conditions characterized by difficulties in social interaction and communication, restricted interests, and repetitive behaviors. All these aspects can interfere with the performance of some common activities of daily life.

The need for accompaniment or help when cleaning the mouth lasts much longer than in other children. Keep reading and find out some strategies to make this task easier with your little ones.

Common oral health problems in children with autism spectrum disorder

Although some of the oral diseases present in children with ASD are the usual ones of childhood, there are also others related to poor dental hygiene, the type of diet, medications, and repetitive mouth movements.

Cavities, bruxism, and mouth breathing are the most common oral disorders in these children. And for that, below, we’ll tell you in detail what the factors that lead to them are:

  • Poor oral hygiene: some children on the spectrum or their caregivers have difficulty cleaning their mouths. This favors the accumulation of bacterial plaque, the formation of tartar, and the development of cavities, gingivitis, and periodontitis.
  • Oral habits: children with ASD often have repetitive behaviors that can impact oral health. For example, grinding your teeth, hurting your gums, and biting their lips or tongue. Also, eating very hot foods or non-food substances, such as dirt, sand, clay, ice, or plastic.
  • Diet: in general, children on the spectrum have many food aversions and their diet is mainly limited to carbohydrates. Other times, sweets and soft drinks are used by caregivers as elements to reinforce the desired behavior. In both cases, a high intake of sugars increases the risk of dental caries.
  • Seizures: children with ASD may have seizures and fall frequently, which increases the risk of trauma and dental fractures.
  • Medication: some of the medications usually prescribed for children with ASD may have added sugar, cause dry mouth, or cause gum tissue to enlarge. All this increases the chances of suffering from cavities and gum disease.
A child with autism grinding his teeth.
Some repetitive movements with the mouth, such as teeth grinding or biting, can lead to various oral diseases.

Dental hygiene tips for children on the spectrum

Learning and assimilating the habit of dental hygiene in children with autism spectrum disorder will be similar to the establishment of other routines. For this reason, the experiences of each family will vary according to the characteristics of the children.

Just the same, here are 6 tips that can be useful when teaching and incorporating oral care habits. Take note!

1. The choice of toothbrush

Choosing the right instrument to brush teeth is very important in children with ASD. Many times it is necessary to try several options until you find the brush that the child likes.

You should look for an instrument of the right size for the child’s mouth, with soft or intermediate hardness bristles, depending on the sensitivity and comfort that the child perceives.

If there are problems holding the brush, the handle can be adapted with a rubber band, a foam rubber pad, or a ball. All these strategies favor grasping when there are difficulties in the development of fine motor skills.

Choosing options with some attractive design, such as a character known to the child, can make the instrument a more appreciated object. Electric toothbrushes or musical toothbrushes provide good motivation for some kids, while for others, they can be off-putting.

2. Have hygiene accessories

Just as it’s important to take the time for the child with ASD to choose their toothbrush, it’s also important to look for the best option for toothpaste and dental floss.

You should always try to make the child feel comfortable with the products that they put in their mouth.

Toothpastes vary in color, flavor, and textures. You’ll need to try different options until you find the one that the child prefers. If your little one has the ability to spit, it’s best to use a product with fluoride to prevent cavities.

Similarly, the size, taste, and texture of dental floss can vary between brands. The child will be able to choose the one that feels most comfortable and best suits the separation of their teeth. Using handles to bring dental floss into the mouth can make it easier to use.

3. Establish routines

The order and repetition of the same behavior every day help to establish a routine of dental hygiene and this applies in general to all children. For this reason, it’s advisable to have all the elements in a certain place and to carry out the cleaning at a specific time of the day.

To instill the notion of the time that brushing should last, it’s a good idea to set a small clock or an electric timer that activates an alarm at the end of the period.

It’s also important that the environment in which hygiene is carried out is relaxing and comfortable for the child and that it meets their sensory needs (the intensity of light and adequate sound). Cleaning the mouth should always be carried out in that same space.

4. Teach the technique in an appropriate way

Parents are great role models for children, even those with autism spectrum disorder. Seeing a parent execute a routine helps to understand what it is and why it’s important to carry it out.

The adult is the scaffolding on which the child builds their learning.

The caregiver should show the child how to open the mouth to promote cleaning. And before putting the brush in the child’s mouth, you should present it to them and allow them to feel it with their hands and lips.

It’s key that the adult’s the one who cleans the teeth of the child with ASD to help them discover how they feel and, in turn, fulfill the desired objective. Then the little one can be encouraged to hold their brush, while the adult guides them.

Finding a comfortable position for both is key when cleaning teeth. For some parents, it works to sit behind the child and rest their head on the chest. Others prefer to sit facing the child.

For children on the spectrum who close their mouths suddenly, a soft foam mouth support can be implemented. This prevents accidents or bites in caregivers.

Making children on the spectrum part of the dental hygiene process as much as possible and showing interest is essential. Accompanying means being willing to help them in the face of any difficulty while strengthening the routine.

5. Always motivate the little one

Children respond better to certain stimuli than to others, and their parents are the ones who are most aware of these particularities. Taking advantage of the understanding of their interests and adapting the hygiene routine to them awakens the motivation for dental care.

Here are some proposals that can encourage children on the spectrum to take care of their mouths:

  • Using images of the mouth that explain the areas to be cleaned, how to place the toothbrush, or how many times to clean is a very useful visual aid. On the internet, there are several options available or you can use your own photos adapted to a sequence.
  • Always congratulate achievements: showing joy every time the child completes one of the steps of the hygiene routine helps to reinforce the behavior and motivates them to continue it.
  • Reward: record each achievement on a whiteboard or in a glass jar and award a prize for collecting a certain amount can be a great motivation for the little ones. It’s important that the reward isn’t something that compromises the child’s health, such as sweets or treats.
  • Play through the process: turning dental hygiene time into a game is often a great motivator for some children with autism spectrum disorder. Playing “my turn, your turn” and touching your mouth with the brush so that the little one copies the movements of the adult is a good example.
  • Distract: if the other strategies don’t work, you can do the dental cleaning while the child does another activity of their liking. For example, while a song is sung to them or a story is read to them.

6. Sensory modifications

Many children on the spectrum have a special sensitivity in their mouths. For this reason, brushing or flossing can be quite inconvenient and troublesome for them. Hugging your little ones during those moments is one of the best ways to reduce their anxiety and calm them down.

Wearing a “superhero suit” when it comes to dental hygiene can also help manage stress. You can simply wrap the child in a blanket, put a cape on them, or put a hat or any unusual accessory on them in order to generate an unusual sensory impact.

It may also be helpful to start by wiping your child’s mouth with a cloth or small sponge until they get used to the sensations in their mouth. Gradually, you can go to the bristles of the brush, the floss, and the toothpaste.

Playing motor activity games can be useful to get the child used to having objects in their mouth: Offering them whistles, a wand to blow bubbles, or moving a marble in a spoon are good practices.

A small girl blowing bubbles.
Teaching children games that involve using items in their mouths can help lower their sensory threshold and get them used to it.

Look for help

Making the moment of dental hygiene a situation without discomfort is essential for children with autism spectrum disorder to incorporate this care routine. Seeking help and ideas from occupational therapists or specialist dentists can make all the difference. Likewise, making regular dental visits allows you to control dental health and prevent complications that are more difficult to solve.

It’s true that caring for the mouth of children on the spectrum may require more time and creativity, but with committed caregivers, little ones can have a healthy smile.

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