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If you’re parenting an Autistic or ADHD child, odds are you have experienced toothbrushing struggles! Toothbrushing is a high-sensory experience and can be a particularly challenging task for children with sensory sensitivities!

From the taste of toothpaste to the texture of the toothbrush, sensory issues can make it difficult for kids to develop healthy oral hygiene habits. These challenges can be frustrating for both the child and the parent, but with patience and understanding, toothbrushing can become a manageable task for children.

If toothbrushing is a stress point in your family, it's helpful to understand the specific areas where your child is having trouble so you can build targeted supports.

This blog post walks through potential areas of struggle to consider and provides some troubleshooting ideas for supporting sensory-sensitive children in their toothbrushing!

Sensory Overload & Tooth Brushing Check-List

Here is a checklist of areas to consider when your child is struggling with toothbrushing

1. Taste, texture, and smell of toothpaste

2. The sensation of the toothbrush in their mouth

3. Dyspraxia, fine-motor control, and coordination difficulties

4. Heightened pain sensitivity

5. Executive functioning difficulties

6. Transitions and task-switching  

By identifying which areas are causing struggle, you can take steps to address them and create targeted supports for your child to make toothbrushing more manageable!

Taste and Texture of Toothpaste

One common issue is taste and texture. Some kids may find traditional toothpaste too strong and off-putting. Consider tasteless, foam-free, or fluoride-free toothpaste as an alternative. There is also sensory-friendly toothpaste available in a variety of flavors. Experiment with different options until you find one that your child enjoys.

Here are some sensory-friendly toothpaste you can try:

• Hello Toothpaste (comes in many different flavors). This is our go-to toothpaste in our household!

• Fluoride Free Strawberry-Jack and Jill

• Flavor-Free -Jack and Jill

Dyspraxia, Fine-Motor Coordination and Toothbrushing

For children who struggle with motor mechanics, toothbrushing can be quite difficult! Children with dyspraxia (or other motor struggles) may face challenges with toothbrushing, such as holding and angling the toothbrush to reach all areas of the mouth. Additionally, they may struggle with squeezing toothpaste onto the brush. They may squeeze too hard, causing excess toothpaste to come out!

Here are some tips for children with dyspraxia or coordination difficulties:

1. Use an electric toothbrush: An electric toothbrush can make it easier for children with dyspraxia to brush their teeth. It reduces the need for complicated movements and allows for more efficient cleaning.

2. Teach your child to hold the toothbrush still on each tooth: Instead of brushing in circular motions, encourage your child to simply hold the electric toothbrush still on each tooth for a few seconds before moving on. This will ensure that each tooth gets an adequate cleaning.

3. Encourage your child to count to 2 before moving on to the next tooth. This helps them to establish a consistent rhythm and ensures that they spend enough time brushing each tooth. This also increases certainty (it creates rules to follow), helping the task to feel less overwhelming.

4. Practice, practice, practice: It can take time and practice for children with dyspraxia to get the hang of brushing their teeth. Encourage them to practice regularly and provide encouragement for all their effort!

5. Use a toothpaste pump: A toothpaste pump can help children with dyspraxia dispense the right amount of toothpaste without squeezing too hard.

6. Experiment with different toothbrushes: Different toothbrushes may work better for different children with dyspraxia. Experiment with different types and styles of toothbrushes until you find one that works well for your child (see the next section for some ideas).

7. Make it fun: When children with dyspraxia encounter something that is physically difficult, it can create a sense of helplessness and anxiety. Making toothbrushing a fun and playful activity can help to reduce anxiety and stress around the task. Try playing music or singing a song while brushing teeth, or finding other fun rituals to incorporate into the toothbrushing routine.

8. Additionally, consider working with an occupational therapist to improve fine motor skills and toothbrushing techniques.

Heightened Pain Sensitivity and Toothbrushing

Another challenge that some children with sensory sensitivities may experience during toothbrushing is heightened pain sensitivity. If the act of brushing hurts your child's gums, consider using a softer brush or massaging the gums before brushing to increase blood flow and reduce pain. You can also try distraction techniques such as deep breathing or visualizations to help your child relax during toothbrushing.

Here are some sensory-friendly toothbrushes to consider:

• Extra Soft Toothbrush for Sensitive Gums and Teeth

• DI QIU REN Extra Soft Toothbrush for Sensitive Gums

• Goaycer Eco-Friendly Bamboo Toothbrush (this is our personal favorite in our home, but note the head is a bit bigger, so it works better for older children)

Note that some sensory-sensitive toothbrushes can be dense, and the toothpaste may become compacted at the root of the bristles. To support ongoing hygiene, it's important to clean the toothbrush regularly and replace it more often to prevent build-up and ensure proper dental care.

Executive Functioning and Toothbrushing

Executive functioning can also impact toothbrushing for children with sensory sensitivities. This is because the process of toothbrushing requires a set of complex tasks that rely on executive functioning skills, such as planning, organizing, and sequencing. For children with executive functioning difficulties, this can be overwhelming and make toothbrushing more challenging.

Here are some tips for working with executive functioning difficulties and toothbrushing:

• Break down the task of toothbrushing into smaller, more manageable steps. For example, you can start by having your child wet the toothbrush, add toothpaste, brush the front teeth, back teeth, and so on.

• Consider using visual aids to help your child understand the sequence.

• Use a  timer to help your child with time management so they can visualize time. To make it more playful, you can consider a  musical timer.

• Create a toothbrushing schedule and routine to help establish a habit and make toothbrushing a more automatic task.

Transitions, Task-Switching and Toothbrushing

Children with sensory sensitivities often need extra time to transition between activities or tasks. This can be especially true when transitioning from a preferred activity to a task that is overwhelming, like toothbrushing. When children are engaged in an activity they enjoy, they may struggle to switch gears and transition to a new activity.

To help with transitions and task-switching, it's important to provide clear and consistent cues that signal the end of one activity and the start of another. This can be as simple as giving a five-minute warning before ending the current activity and moving on to toothbrushing. Additionally, using visual aids such as a visual schedule or checklist can help your child understand the steps involved in the transition process.

It's also helpful to provide some control and choice during transitions. For example, you can let your child choose which toothbrush or toothpaste to use or allow them to choose a favorite song to play during toothbrushing. This can help reduce the sense of threat to their autonomy and increase their engagement in the process, making them less resistant to the transition.

Finally, be patient and flexible during transitions. Children with sensory sensitivities may need more time or support to make the transition successfully. Stay calm and positive and provide encouragement for their efforts.

Additional Tips: Gamify Toothbrushing

Turning toothbrushing into a game or a fun activity can be a great way to encourage children with sensory sensitivities to brush their teeth.

• One option is to use light-up toothbrushes that flash for a minute, which signals the ideal amount of time for brushing (note this is a good option for sensory-seekers, but it wouldn’t be a good option for children who are sensory avoidant).

• Alternatively, you can try playing a song and having your child brush their teeth throughout the song. Or you can have a special dance during teeth brushing (the bonus is this also works as a distraction technique).

Turning toothbrushing into a playful activity can help reduce the anxiety and stress your child may be experiencing. It not only supports their oral hygiene but also helps them develop resilience and acceptance of difficult tasks, which is particularly important for children with ADHD and autism who are vulnerable to emotional and behavioral avoidance. By making toothbrushing manageable and fun, you are teaching them they can overcome challenging situations, which is a valuable life lesson. It may seem like a small thing, but learning they can survive hard things can significantly impact their overall well-being and ability to navigate the world around them.

Summary: Sensory Overload & Tooth Brushing

So to summarize, toothbrushing can be a challenging experience for sensory-sensitive children, but there are many ways to make it more manageable. By understanding the root of your child's discomfort and providing sensory-friendly solutions, such as softer brushes and tasteless toothpaste, toothbrushing can become less of a stress point for your family. Additionally, by incorporating executive functioning strategies, like visual schedules and checklists, you can help your child build good oral hygiene habits while developing executive functioning skills. Most importantly, by turning toothbrushing into a playful and positive experience, you can help your child develop resilience and a willingness to tackle difficult tasks. With patience, creativity, and a little bit of creativity, you can help your child have a healthier relationship with oral hygiene.